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Care Home: Welshwood Manor

  • 37 Welshwood Park Road Colchester Essex CO4 3HZ
  • Tel: 01206868483
  • Fax: 01206870615
  • Planned feature Advertise here!

  • Latitude: 51.90299987793
    Longitude: 0.94499999284744
  • Manager: Mr Robin Neal Pickering
  • Price p/w: ~
  • UK
  • Total Capacity: 34
  • Type: Care home with nursing
  • Provider: Davard Care Homes Limited
  • Ownership: Private
  • Care Home ID: 17562
Residents Needs:
Old age, not falling within any other category, Physical disability, Learning disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 29th December 2009. CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Welshwood Manor.

What the care home does well People who use the service and said that staff spoken to them in a friendly fashion, with respect, and they welcomed visitors to the service without restrictions. one person using the service commented "the manager is very nice, business like which is lovely. I have my family visiting me and they are always made to feel welcome. We are never short of stimulation and our brains are always ticking over". Premises and accommodation visited were very well maintained and decorated. Garden areas provide pleasant areas for people to sit outside. Rooms visited were personalised. Positive engagements and interaction were directly observed between the people using the service and the staff. One person using the service commented "the staff are wonderful, always respectful to us". Staff receive some training ensuring that they have a range of skills to meet the needs of the people using the service at all times. One relative visiting the service during the inspection commented "my X has done nothing but improve. The staff are lovely, they cant do enough for you, they are all lovely people. they always do their best". Medication systems are very well managed and people are fully supported in the safe administration of their medication. Activity provision for the people who use the service is thoughtful and stimulating. People are encouraged to engage in meaningful activities and thought has been given to the activities provided. What has improved since the last inspection? A number of improvements have been made to the service since the last inspection. Information gathered from the AQAA determines that the service has "developed a factual website to promote informed choice of home. Annual Service User Survey which directly links to care standards. Implementation of mental capacity assessment for all Service Users. Implementation of new multi disciplinary care record for new Service Users. Extended TV and interactive technology activities to promote health. Provision of upgraded library facilities to 1st floor lounge. Provision of new treatment room and drug storage facility. Provision of environment temperature control to medicine room. Upgrade of shared rooms. Upgraded ensuite facilities to new rooms. Replacement of all site drainage systems. Upgrade of car park and access to home. Increased percentage of staff with NVQ level 2 to 83%. Increased percentage of staff with NVQ level 3 to 55%. Provision of shower room with hairdressing facility". Information gathered on the day of the inspection also determined that many areas internally have been re decorated and that the garden has a new pergola seating area and that the areas of the garden are accessible to all with the new pathways laid. The AQAA shows that the service is able to assure its own quality and make continued improvements. What the care home could do better: A small number of areas for further development have been highlighted as part of this key inspection. The improvements include the service ensuring that all areas of the assessment process are fully completed and reviewed. Those staff who have not received training in safeguarding of vulnerable adults must attend a suitable course. It was also highlighted that those staff who have not yet received training in Infection control, nutrition, food hygiene, equality and diversity and health and safety, would benefit from receiving this. The service should also further expand the individual service users fire risk assessments. Key inspection report Care homes for older people Name: Address: Welshwood Manor 37 Welshwood Park Road Colchester Essex CO4 3HZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Louise Bushell     Date: 2 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Welshwood Manor 37 Welshwood Park Road Colchester Essex CO4 3HZ 01206868483 01206870615 welshwoodmanor@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Davard Care Homes Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category physical disability Additional conditions: One service user, aged 65 years and over, who requires nursing care by reason of a physical disability who also has a learning disability, whose name was made known to the Commission in January 2005 Persons of either sex, aged 55 years and over, who require nursing care by reason of a physical disability (not to exceed 4 persons) Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 19 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 34 persons) The total number of service users accommodated in the home must not exceed 34 persons Date of last inspection Care Homes for Older People Page 4 of 31 Over 65 2 19 34 1 0 4 Brief description of the care home Welshwood Manor provides nursing and personal care with accommodation for up to 34 older people including 4 younger adults with a physical disability.Welshwood Manor is owned by a private organisation named Davard Care Homes Ltd.The home is located at the end of Welshwood Park Road, a quiet cul-de-sac to the north of Colchester and a short drive from the town centre.The home was opened in 1999 and comprises a three-storey property that has been extended to provide additional accommodation. Further upgrading of the premises has been completed recently to provide increased single en-suite accommodation and an additional communal room.There are 28 single en-suite bedrooms and 3 double bedrooms. There is a passenger lift.The fees range from £448.28 to £904.03 weekly. Additional costs apply for chiropody, toiletries, hairdressing and newspapers. This information was provided to the Care Quality Commission on 2007. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspections undertaken by the Care Quality is based upon outcomes for the people who use the service and their views of the service provided. The primary method of inspection used was case tracking which involved selecting a number of people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. The last key inspection took place on the 2nd February 2007. The visit was unannounced and planning for the visit included assessment of the notifications of significant events, which had been received from the service to the Care Quality Commission. We looked at the last Inspection Report and information on safeguarding and complaints since the last inspection. We also looked at the Annual Quality Assurance Care Homes for Older People Page 6 of 31 Assessment (AQAA) and reviewed what the service has improved in the last twelve months and its plans for the next twelve months. During the visit information was gathered directly from the staff, people who use the service and relatives and or visitors to the service. The visit took place between 10:00am and 16:00pm. This enabled the inspector to directly and indirectly observe the care practices and the day to day operations of the service. A selected tour of the building was conducted during which the inspector spoke with people who use the service, staff and visitors and the manager. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? A number of improvements have been made to the service since the last inspection. Information gathered from the AQAA determines that the service has developed a factual website to promote informed choice of home. Annual Service User Survey which directly links to care standards. Implementation of mental capacity assessment for all Service Users. Implementation of new multi disciplinary care record for new Service Users. Extended TV and interactive technology activities to promote health. Provision of upgraded library facilities to 1st floor lounge. Provision of new treatment room and drug storage facility. Provision of environment temperature control to medicine room. Upgrade of shared rooms. Upgraded ensuite facilities to new rooms. Replacement of all site drainage systems. Upgrade of car park and access to home. Increased percentage of staff with NVQ level 2 to 83 . Increased percentage of staff with NVQ level 3 to 55 . Provision of shower room with hairdressing facility. Information gathered on the day of the inspection also determined that many areas internally have been re decorated and that the garden has a new pergola seating area and that the areas of the garden are accessible to all with the new pathways laid. The AQAA shows that the service is able to assure its own quality and make continued improvements. Care Homes for Older People Page 8 of 31 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their needs will be assessed and met at all times, ensuring that they are well cared for by informed staff. Evidence: The service has a sound admission and assessment procedure in place. It was apparent that the staff and the management of the service spent significant time and effort planning admissions to the service in order to ensure that the people feel safe at secure at all times. One relative fed back that my X moved into Welshwood Manor and we did not know what to expect, the manager and the staff could not of helped us anymore, we had all the information we needed and my X has come on leaps and bounds since moving here. Its fantastic. Prospective people and their families are treated as individuals and with dignity and respect for the life changing decisions they need to make. There is a high value on responding to individual needs for information, reassurance and support. Care Homes for Older People Page 11 of 31 Evidence: The service has developed a Statement of Purpose, which sets out the aims and objectives of the service, and includes a guide, which provides basic information about the service and the specialist care the service offers. The guide details what the prospective residents can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All residents are given a copy of the guide. It was also established throughout the inspection that people have copies of all documents available in the foyer. People who use the service are involved in making improvements. The managers ethos is to always engage with people and to seek their views to make further improvements. The AQAA tells us that the service is making improvements to the website. It states review of factual and informative website. Review of Service User Guide and admission policy. All new residents receive a comprehensive needs assessment before admission. This is carried out by staff with skill and sensitivity. One person using the service commented they came to complete an assessment of our needs, and asked us lots of questions about how we would like to receive the support we need. The person was very professional and spent a lot of time making sure all our information was accurate. The service is efficient in obtaining a summary of any assessment undertaken through care management arrangements. Four care plans were case tracked as part of this inspection and it was evident that the service had taken steps to ensure that they had enough information from the local authority, in the form of previous care plans and assessment documents. This further supported the people moving to the service to ensure that the staff and manager had all the information required in order to meet the needs of the person at all times. For individuals whom are self funding, the assessment is undertaken by a qualified member of staff. Individuals are supported and encouraged to be involved in the assessment process. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the ethnic and diversity needs of the individual. The assessment explores many areas, which includes likes and dislikes, cultural and spiritual needs, psychological profile which enables the assessor to record information regarding the individuals personality. The assessment of long terms needs also explores expressing sexuality and social needs, wants and preferences. Of the four care plans case tracked generally all of this information had been completed, however some areas could be more detailed. The manager provided further information and stated that the activity co ordinator is Care Homes for Older People Page 12 of 31 Evidence: currently working with individuals to create detailed life stories. People thinking about moving to Welshwood Manor are given the opportunity to spend time in the service. One relative spent time taking about their experiences and commented my X coming to Welshwood is the best thing ever. The improvements are phenomenal. We had lots of information and advice. We were given the written policies and they spoke at length to us. The information was totally useful and gave us a very good overview. The use of advocates to support people is encouraged. Information regarding advocacy is visible throughout the communal areas of the service and a number of individuals had advocates supporting them. Staff supporting people were seen to interact with total respect and dignity for the individual at all times. Discussions with staff further supported the notion that the knowledge of all staff is detailed, current and accurate to the needs, wishes and preferences of the person. Care Homes for Older People Page 13 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their personal care and health care needs are met and that their care plans provide adequate information in order for staff to ensure the care is tailored to individual preferences and needs. Evidence: People using the service receive effective personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. One person using the service commented the service has made me feel very much at home with good care, warm and friendly atmosphere, caring staff and good food. In addition to this a relative stated my X is seen as a person, an individual. Everything is personal and they can tell me the minutest of details about my X. X has their bright smile back again. Id felt I had lost my X but there are bits of them coming back now. Its unique. The Statement of Purpose sets out the competencies and specialist services the service offers and delivers this effectively through a skilled, trained and knowledgeable staff group that work in a person centred way. Staff are aware that the way in which Care Homes for Older People Page 14 of 31 Evidence: support is given is a key issue older people. Individual plans clearly record peoples personal and healthcare needs and detail how they will be delivered. The service provides a uniformed care planning approach and uses a system called Standex. Each areas of a persons individual health care needs are continuously assessed and reviewed. Nutritional risk assessments were in place monitoring the progress or deterioration of a person nutritionally. This includes the body mass index, manual handling risk assessments and dependency profiling to monitor any changes in care and support needs. Each care plan is written in a person centred way and details many preferences for the person. Examples of this were seen with regards to personal routines, times for rising and retiring to bed and how the person likes to receive personal care support. Staff respond appropriately and sensitively in all situations involving personal care, ensuring that it is conducted in private and at a time and pace directed by the person receiving the care. Aids and equipment are provided to encourage maximum independence for people using services these are regularly reviewed and replaced to accommodate changing needs. Specialist advice is sought by the home to ensure effective use of equipment. Regular appointments are seen as important and there are systems to ensure they are not missed. The service arranges for health professionals to visit individuals at the service when necessary. During the inspection and General Practitioner was on site completing a round and visiting a number of people. Staff are trained and competent in health care matters particularly in the care of individuals who remain immobile for long periods of time. The service arranges training on health care topics that relate to the health care needs of the residents. The training plan provided by the service showed that a number of care staff have received training in pressure care, wound care, palliative care, death and dying and assessments and care planning. The service had a policy and procedures for the safe administration of medicines. Guidance published by the Royal Pharmaceutical Society of Great Britain (RPSGB) was also available for staff guidance. Medication was seen to be stored in a trolley in a secure d room. There was a controlled drug cupboard and a separate drugs fridge. Since the last key inspection improvements have been made to the facilities provided for medication to be stored. There is a separate, thermostatically controlled room. The facilities are excellent and provide a clinical space for the safe and well managed administration of medicines by qualified staff. Care Homes for Older People Page 15 of 31 Evidence: Systems for monitoring daily temperatures were in place. Medication was supplied by a local pharmacy in a monitored dosage system and checked against residents prescriptions by a registered nurse. The service had a contract with a licensed contractor for the disposal of medication as required for a care service with nursing. Stock levels were at an acceptable level. Separate storage was provided for controlled drugs. Records made since the previous inspection confirmed that the full name and address of the supplier was recorded in the dedicated register. Medicines administration records were well recorded and there was a photograph of the resident held with each residents Medication Administration Record (MAR) sheet. Registered Nurses administered all medication, a list of their signatures and initials being maintained for checking against. Systems were also in place to ensure Pin numbers were recorded and checked to ensure they were current. Manufacturers medication information was provided for individual medicines as indicated as good practice. Systems were in place for medication reviews to be undertaken, ensuring that all residents had a review of their medication at minimum six monthly. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The service aim and objectives is the promotion of the individuals right to live an ordinary and meaningful life, appropriate to their peer group, in both the service and the community, and to enjoy all the rights and responsibilities of citizenship. People using the service are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. During the inspection a range of activities were available, from chatting with staff and other peers, bingo, listening to music, being with visitors and completing puzzles. Welshwood Manor has made many improvements over the last twelve months. The AQAA tells us that they have continued the garden development appropriate to client group, upgrade of TV facilities, extended range of activities. One person using the service commented Christmas was wonderful, not to crowded, very peaceful. The staff did a wonderful job. We always get a choice of meals and they are always taste. We had a carol service with young children, which was so lovely to see. In addition to this further Care Homes for Older People Page 17 of 31 Evidence: comments were received that stated we are never short of stimulation our brains are ticking over all the time. In addition to further improvements made Welshwood Manor employs a full time activities coordinator. On the day of the inspection a number of people were observed sitting in the lounge area listening to music, engaging in chatting, puzzles or singing. The atmosphere in the main lounge was friendly and comforting. Everybody observed experienced positive engagement from the environment and other peers. All people looked warm, relaxed comfortable and well cared for. All staff including the activity coordinator were seen to engage with all people is a respectful and dignified manor. One person responded Callum, the activity person is a very pleasant man, very chatty. I feel respected by all the staff and well cared for. During the inspection process and case tracking it was observed that records of activities provided and those participated in, are well maintained. The activity events board is displayed within the service, this outlines whats available. A church service is held one a week at the service where people can attend if they wish to do so. The service understands and actively promotes the importance of respecting the human rights of people using the service, with fairness, equality, dignity, respect and autonomy all being seen as central to the care and support being provided. A relative commented the staff are lovely, cant do enough for you, they are nice people who always do their best. In addition to this a further relative commented the engage well with the residents and there always seems to be something going on in the main lounge. The routines, activities and plans are person centred, individualised and reflect diverse needs in the six strands of diversity. They are regularly reviewed, and are very responsive to individuals changing needs, choices and wishes. Examples of this were seen where a number of different religious services are made available and or offered to people as they wish, in addition to this meals provided many incorporate an individuals cultural needs. The service actively encourages and provides imaginative and varied opportunities for people using the service to develop and maintain social, emotional, communication and independent living skills where appropriate. The service has very strong and highly effective methods, which focus on involving residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. This includes developing and maintaining family and personal relationships. Discussions occurred with the manager of the Care Homes for Older People Page 18 of 31 Evidence: service regarding life story books. The activity coordinator is in the process of supporting individuals with these and gaining vital information from them and their families where appropriate. This will further provide information and guideline to all staff supporting them in a person centred way and improving outcomes for people using the service. Meals are very well balanced and highly nutritional and cater for varying cultural and dietary needs of residents. For those individuals who need support during mealtimes, including those who have difficulty swallowing or chewing, staff give assistance. staff were seen to support people in a discrete and sensitive manor. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. One person using the service stated the meals are marvellous. Christmas day dinner was wonderful. My family visited, I got five bouquets of flowers and five jumpers, it was wonderful. Care Homes for Older People Page 19 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their complaints and concerns will be listened to at all times. Evidence: The service has an open culture that allows individuals including staff, relatives and professional entering the service to express their views and concerns in a safe and understanding environment. One person using the service stated I can always talk to the staff or the manager if I have any worries what so ever. All of the people spoken with and surveyed, including relatives said that they are happy with the service provided, feel safe and well supported by the service. A relative stated I cant ever imagine I would have the need to make a complaint, but Robin, Paul and the whole team are very open and will listen and communicate with ease. I would feel that I could complain with out resentment at all. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats and has been revised to reflect the Care Quality Commissions information. The service makes the procedure available to all people using the service including relatives and professionals visiting the service. This information is also available in the Service users Guide which is readily available. The service has not received any complaints in the last twelve months. The manager provided us with additional information regarding an internal survey conducted during Care Homes for Older People Page 20 of 31 Evidence: 2009. The results show that people using the service are aware of how to complain, that they feel able to complain and are happy with the service provided. The service does not maintain a complaint log as they stated that they have not received any complaint. This was discussed with the manager of the service. The AQAA identifies that the service would use complaints as a learning tool to further improve the service being offered to all. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff working at the service know when incidents need external input and who to refer the incident to. Information provided by staff showed that they received information on all polices and procedures when staring work and that their induction covered everything that they needed to know. The updated training plan shows that a number of staff have attended the safeguarding adults training, however there are a number of people who require the training and or refresher training. All staff that are employed by the service have a number of recruitment checks conducted, in order to ensure that they are suitable for employment. This includes a full enhanced Criminal Records Bureau check and references. Care Homes for Older People Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to reside in a comfortable, safe, well maintained environemtn meeting all individual needs. Evidence: The physical environment of the service provides a comfortable, well maintained safe environemtn for people to reside. The surroundings are very suitable to purpose and over the past twelve months improvements have been made to the exterior of the service. This includes the lawn area with pathways being made accessible to all so access to areas in the garden are safe. The service has many external seating areas and a new covered pergola area for all to use. The AQAA tells us of other improvements that ave occurred and this includes, provision of new treatment room and drug storage, new shower room, upgrade of shared room, development of new garden, upgraded ensuite facilities to new rooms, replacement of all site drainage systems, upgrade of car park and access to home, upgrade of all radiator covers, upgrade of domestic hot water supplies. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. People are encouraged to bring their personal items into the service and the communal areas promote a homely feel. Care Homes for Older People Page 22 of 31 Evidence: The environment reflects the differing needs of all people and people are encouraged to see the home as their own. During the inspection people were seen to be relaxed within their own environment and had personal belongings with them. One person using the service commented I really like how they keep the place nice and clean, I love my room and the views onto the garden in the summer are wonderful. It is a very well maintained, attractive service and has very good access to community facilities and services. It has a wide range of up to date specialist equipment and adaptations to meet the individual needs of people who use the service. The environment is fully able to meet the changing needs of people, along with their cultural and specialist care needs. It is fully accessible throughout to people with physical disabilities, adaptations and specialist equipment are designed to fit within the homely environment. The management has a proactive infection control policy and they work closely with their own staff and external specialists. During the inspection staff were directly observed to practice positive infection control procedures and practices. The home has single rooms available for all people who wish to have one. Individuals personalise their rooms and can use their own furniture if they wish. There is a selection of communal areas both inside and outside of the home, this means that people using the service have a choice of place to sit quietly, meet with family and friends or be actively engaged with other people who use the service. The bathrooms are homely and include aids and adaptations to meet the needs of the people using the service. There are sufficient toilets to enable immediate access. The service spends money on the environment in the best possible way so that outcomes are improved as much as possible for the people using the service. The rights of people who have more difficulty in communicating their views are just as valued as those of other people. All bedrooms promote high levels of privacy and dignity. One person using the service commented staff are always respectful and knock on my door, they are so friendly and approachable. The service is always very well lit, clean and tidy and smells fresh. During the inspection the service was warm and comfortable for all. Care Homes for Older People Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that staff are suitably recruited, supervised and are provided with basic training in order to meet peoples needs at all times. Evidence: The people spoken with and from information gathered from a number of surveys determines that they have confidence in the staff who care for them. One person using the service stated the staff really go the extra mile to make us feel safe and respected. In addition to this one person using the service commented the home has made me feel very much at home with good care, warm and friendly atmosphere, caring staff and good food. The staff always make my visitors feel welcome. Rotas were seen and displayed adequate staffing numbers on duty to meet the needs of the people suing the service. Specific attention was given to the busier periods of the day. A manager on shift and usually supernumerary to the care staff. This enable the service to ensure that numbers were maintained for the safety of all and that record keeping was completed and monitored as required. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. People who use the service report that staff working with them are very skilled in their role and are consistently able to meet their needs. One staff member commented I always feel supported in every way with training plus if there is a Care Homes for Older People Page 24 of 31 Evidence: problem I always feel that I can talk to my manager. All of the staff that were surveyed commented that their induction covered everything that they needed to know in order to care for people and that they knew what to do if some one raised any concerns about the service. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. A total of four staff files were audited and were seen to contain all the required documentation. The AQAA tells us that the service does well by staff turnover very low maintaining a stable workforce. No agency staff used in the last five years. Highly qualified and experienced Manager and Deputy have been in post over seven years. All staff have English as their first language. 83 of all care staff have a relevant NVQ qualification. 75 of Nurses have ENB qualification in care of older people & are NVQ assessors. Training records reviewed, reflected that some mandatory training was up to date, however it identified that there was a need to ensure that all staff working at the service has attended and received training in safeguarding adults. The training plan showed that a high number of care staff had received training in wound care, palliative care and pressure care. The training record did however show that a number of people were still to attend and receive training in food hygiene, health and safety, nutrition and infection control. Whilst these courses are not mandatory course, it would be good practice for the service to provide this for all staff. The training plan did not show any provision for staff training in equality and diversity. It was pleasing to note that a number of the care staff team had also received training in assessments and care planning. Four individual staff commented on the strong team culture of the service and felt that there are enough staff on duty to meet the needs of the people who use the service. Staff recruited confirmed that the service was clear about what was involved at all stages and was robust in following its procedure. There are clear contingency plans for cover for vacancies and sickness and the service does not use agency staff. An on call procedure is in place to support staff as required. During the inspection it was noted that the mix of staff is suitable to meet the cultural needs and mix of people that use the service. People using the service could not praise the efforts of the staff enough. One person using the service commented, the staff are just lovely, they are professional but there is a genuine warmth for each Care Homes for Older People Page 25 of 31 Evidence: person. Staff reported that they felt supported in their roles and that they were to discuss issues with a member of the senior team if required. All staff surveyed commented that they receive enough support to meet with them on a regular basis to discuss how they are working. In addition to this one staff member commented we provide effective care to each of the service users and work as a team in a friendly environment and provide for each persons needs. Care Homes for Older People Page 26 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can feel assured that the manager is suitably qualified and competent to run the service and provide trained competent staff in a safe and well managed environment. Evidence: The Registered Manager has the required qualifications and experience and is competent to run the service. The Registered Manager and the deputy manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services. There is a focus on person centred thinking, with the people who use the service becoming increasingly more involved. The AQAA tells us that they do well by the home being run in best interests of service users who are given direct forums to influence the running of the home. Annual service user surveys are used as a tool for quality improvement and the results shared openly with all stakeholders. Internal audit and self assessment of the service undertaken. Staff are well motivated and supported through direct supervision of Registered Nurses. An on-going programme of Care Homes for Older People Page 27 of 31 Evidence: internal and external training. One person using the service commented that Robin always makes sure that my Xs care is the first priority. The manager was directly observed throughout the inspection to lead by example and manage the service efficiently. The Registered Manager leads and support a stable staff team who have been recruited and trained to satisfactory levels, although a number of areas have been identified to make further improvements. The manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. One person using the service commented the manager is brilliant, he is lovely and the manager is very kind to us all, he is always around for us to talk to. The service has sound policies and procedures, which are corporately and internally reviewed and updated, in line with current thinking and practice. The manager ensures staff follow the policies and procedures of the service. The staff team are positive in translating policy into practice and showed good knowledge of care principles, health and safety and safeguarding issues. This was seen during during the inspection on a number occasions in relation to positive food hygiene practice, positive infection control practices and respect and dignity provided to al people at all times. The service works to a clear health and safety policy. Health and safety is well organised and managed throughout. Records were well maintained. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. The AQAA provides us with information that determines that further safeguarding training is being provided internally and externally in the near future. The service hold a clear fire safety risk assessment and policy. The grounds of the service are mapped and clearly displays room areas and high risk areas. Whilst many areas of risk had been reviewed, documents and assessed the service does not currently risk assess each of the individuals in relation to fire procedure and action. this was discussed with manager during feedback at the end of the inspection. Care Homes for Older People Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 18 Staff who have not received training in the safeguarding of vulnerable adults, must attend. To ensure that people are kept safe and that staff are equipped the right training in order to complete their roles. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 30 The service should ensure that all areas identified in the assessment process are fully completed. Staff who have not received training in equality and diversity, health and safety, nutrition, infection control and food hygiene, should attend. Individual risk assessments should be completed for persons using the service. 3 38 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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