Care Home: West Heath House

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What the care home does well There is good information about the home that is presented in many ways. This ensures that people who live at the home have the information they need before making a decision to move in. Thorough assessments are completed before a person moves into the home to ensure the staff can meet their needs. People who want to go and live in the home can visit to help them make a choice about whether or not they want to live there. Care plans give good detail to staff as to how a person likes to be cared for so staff know how to support them to meet their needs. Health concerns are identified quickly through the good records maintained so the needs of the people who live in the home are met. People were well cared for and their personal care needs met so ensuring their well being. There are good systems in place to manage complaints and people know their views will be listened to. The home is clean, safe, well maintained and comfortable for people to live in. Recruitment procedures are robust to make sure that `suitable` people are employed to work with the people living there. An experienced manager provides effective and competent leadership for her staff. There is a qualified team of care staff who provide continuity of care to the people who live there. What has improved since the last inspection? Improvements at the home have continued since we last visited. The manager continues to ensure that any shortfalls with the service are rectified to ensure the well being of the people living there. The number of agency staff used has reduced to a minimum. Staff have been recruited from other homes within the City Council that have closed. This has ensured that a consistent staff team works with the people living there and know how to meet their needs. As at the last inspection there are no requirements from this inspection. This shows that the quality of the service continues to improve and move forward for the benefit of the people who live there. What the care home could do better: Self medication assessments should be clearer to make sure that people are not at risk of harming themselves. All staff should have the training they need so they know how to meet the individual needs of the people living there and keep them safe. Lists of people`s belongings should be updated regularly to make sure people know what belongs to them and if anything should go missing this can be identified. The fire risk assessment should be updated to ensure all risks of there being a fire are reduced. Key inspection report Care homes for older people Name: Address: West Heath House 90 Alvechurch Road West Heath Birmingham B31 3QW     The quality rating for this care home is:   two star good 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: Sarah Bennett     Date: 0 7 0 7 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 28 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 28 Information about the care home Name of care home: Address: West Heath House 90 Alvechurch Road West Heath Birmingham B31 3QW 01214753614 01214780130 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Notknown Birmingham City Council (S) care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 26 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 26 Date of last inspection Brief description of the care home West Heath House is a large purpose built two storey building, located on the Alvechurch Road in West Heath. It is situated at the top of the road overlooking the main road with views all around the immediate area. The home is opposite a church and parade of shops. A number of bus routes to the city and surrounding area are within walking distance. The building is approached via a drive to the front with some off road parking. West Heath House offers accommodation to twenty six older adults. All bedrooms are single with a wash hand basin facility and emergency call system. Bedrooms are located on the ground and first floor, with access via a passenger lift. Care Homes for Older People Page 4 of 28 Over 65 26 0 Brief description of the care home There are two lounges, a separate smoking room, a dining room with another small lounge off it, main kitchen, office and medical room. The laundry is situated on the first floor. Toilets and bathrooms are situated on both floors, these have facilities suited to those people who require assistance. There is level access for wheelchair users to the front entrance and throughout the home. Corridors are wide and spacious and allow people to move around the home freely and safely. The home has hoisting equipment available for those people who have decreased mobility. An accessible well maintained garden area with outdoor seating is provided. Our reports are available in the home for visitors who may wish to read these. The reader is advised to contact the care home for updated information about the fees charged to live there. Care Homes for Older People Page 5 of 28 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: two star good 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 quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This inspection was carried out over one day. The home did not know we were going to visit. This was the homes key inspection for the inspection year 2009 to 2010. The last key inspection was on 7th July 2007. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home about things that have happened there and an Annual Quality Assurance Assessment (AQAA) completed by the manager. This tells us Care Homes for Older People Page 6 of 28 how they think the home is meeting the regulations and what improvements they are making. Three people who live in the home were case tracked, this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The people who live at the home, visitors, the manager and the staff on duty were spoken to. A partial tour of the premises took place. Care, staff and health and safety records were looked at. Time was spent observing care practices, interaction and support from staff. We used the Short Observational Framework for Inspection (SOFI) tool. This involves spending two hours in a lounge observing and recording interaction with three people, from staff and the other people living there and how this impacts on their well being. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Improvements at the home have continued since we last visited. The manager continues to ensure that any shortfalls with the service are rectified to ensure the well being of the people living there. The number of agency staff used has reduced to a minimum. Staff have been recruited from other homes within the City Council that have closed. This has ensured that a consistent staff team works with the people living there and know how to meet their needs. As at the last inspection there are no requirements from this inspection. This shows that the quality of the service continues to improve and move forward for the benefit of the people who live there. Care Homes for Older People Page 8 of 28 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 28 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 28 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 have the information they need so they can make a choice about whether or not they want to live there. The individual needs of people are assessed before they move in to ensure they can be met at the home. Evidence: In each persons bedroom there was a welcome pack that included the statement of purpose and service users guide. This gave people the information they needed about the home and was written in easy to understand language so that people who had no experience of living in a care home would know what to expect. People are given this information when they show an interest in visiting the home. The AQAA stated that people can visit the home before they move in and more than once if this helps them in their decision about whether or not they want to live there. One person was visiting on the day we visited. Staff were observed spending time talking to them but not overloading them with questions. Staff gave them a chance to Care Homes for Older People Page 11 of 28 Evidence: spend time relaxing and meet the other people living there, they had their lunch there and had a look around the building and their bedroom. Staff had devised a form that includes the things they need to know to meet the persons needs. Staff asked the person the questions needed but in a discreet way so they could find out the persons likes and dislikes and what they needed. People who come for respite care also have a chance to visit the home as much as they want to and staff find out their likes and dislikes in the same way as for people who are going to live there permanently. Records sampled showed that before people move into the home their needs are assessed to ensure they can be met there. The AQAA stated and records sampled showed that the social worker is asked to provide a care plan before the person moves in to ensure their needs can be met at the home. The home does not provide intermediate care. Therefore, standard 6 that relates to this was not assessed. Care Homes for Older People Page 12 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the health and personal care needs of the people living there are met so ensuring their well being. Evidence: The records of three of the people living there were looked at. These included an individual care plan so that staff know how to support the person to meet their needs. Where people were able to they had signed to say they had been involved in their care plan and agreed to the support they were to be given. Some care plans were more detailed than others however, when discussing this with the manager we were told that this was because the person needed little support. This was evident in their records. Staff had signed to say they had read the persons care plan so they knew how to support them. People had been asked how often they wanted to be checked by staff during the night where it was not too high a risk for staff only to check them twice during the night shift. This means that people who do not need to be disturbed by staff entering their bedroom at regular intervals to check on them, are not. Care Homes for Older People Page 13 of 28 Evidence: For some people an About Me document had been completed. This included pictures and was written in an easy to understand way. It included information about the persons life, the things they had achieved and the things they liked and disliked. It gave staff a fuller picture of the person so they could support each person in a more holistic way. Staff said that some people did not want to complete these but wanted staff to know them as they are now. Their wishes had been respected. Records included individual risk assessments. These detailed how staff are to support the individual to take risks whilst ensuring they were as safe as possible. Some people need support from staff to move around. All people had been assessed as to how much assistance they needed and how much of a risk this was to them and the staff supporting them. Records sampled showed that people had been weighed regularly. This is important as a significant loss or gain of weight can be an indicator of an underlying health problem. Staff had monitored peoples weights and where there had been changes had increased the frequency of weighing the person to ensure that any problems could be addressed where needed. Records sampled showed that health professionals were involved in the care of individuals when needed. Records showed that staff had followed the advice of health professionals to ensure that individuals needs could be met. People living there said that staff always attend health appointments with them and support them in these. A relative visiting the home asked staff to contact the GP on behalf of their relative. Staff informed them that this had already been done earlier in the day and their relative had been prescribed medication to treat an infection. The relative also asked staff to contact the District Nursing Service to change a dressing for their relative. Staff responded to this immediately and arranged for this to be done. Some people are able to take some of their own medication. Where it is thought that people may be able to do this an assessment is completed to ensure they are not at risk. For one person an assessment had been completed that showed that staff had some concerns about their ability to do this safely. It did not clearly state how the staff completing the assessment had judged whether or not the person could self medicate. This should be clearly stated so that people who may be at risk of harming themselves by self medicating do not do so. Only senior staff or managers give the medication to the people living there. They Care Homes for Older People Page 14 of 28 Evidence: have received training in this so they know how to give it, what it is for and side effects to look for. The senior staff was observed giving medication to people at tea time. They asked people who were prescribed painkillers if they wanted them or not. Each person had a drink to take their medication with. Each persons medication was taken out of the pack one at a time and they were given this before the senior started administering the next persons medication. The senior said that they would give people who needed eye drops these after tea so they could have them in private. Medication audited matched the Medication Administration Record (MAR) indicating that medication had been given as prescribed. Staff had signed each persons MAR appropriately when they had given them their medication. There was a photograph of the person at the front of their MAR so that unfamiliar staff would know who to give the medication to. The people living there were well dressed in individual styles that reflected their gender, the weather and their cultural background. It was evident that attention had been given to individuals personal care. Staff were observed to support people to go and get changed when they needed it to ensure their dignity. Records sampled stated the name that the person preferred to be called. Staff were observed to address people in they way stated. Staff were observed spending time with the person who was visiting before they moved in to ask them what they preferred to be called. Staff were observed throughout the day speaking to people with respect and ensuring their privacy and dignity. Care Homes for Older People Page 15 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living there are supported to experience a meaningful lifestyle so ensuring their well being. Evidence: Records sampled showed and it was observed that people have an opportunity to take part in activities of their choice. The AQAA stated and minutes of meetings with the people living there showed that they have discussed what activities they wanted to do and changes had been made to Christmas activities at their request. Staff were observed encouraging people to take part in a game in the lounge that they enjoyed. Some people spent time watching TV. One person told us that they could change the channels on the TV when they wanted to but were enjoying watching the programme that was on at the time. Some people were reading newspapers or books of their choice. There are several lounges in the home, a large lounge, two smaller ones and a small room off the dining room. Throughout the day people were observed spending time where they wanted to and doing the things they enjoyed. Some people are able to go out on their own. They said that they can go out when they want to. Some people go to day centres during the week and staff supported Care Homes for Older People Page 16 of 28 Evidence: them to get ready to go to these. People said they could have visitors when they wanted and some people had visitors during the day. Visitors said that they could visit when they wanted to and were always made welcome. One person said that they did not have any family now but treated the staff and the other people living there as their family. The manager said that the local school had put on a tea dance for the people living there as part of a community project. People who had attended had enjoyed this. People who were not able to attend had been given gifts of toiletries, cakes and biscuits, which they enjoyed. Regular meetings are held with the people living there and minutes of these were kept. The minutes showed and the AQAA stated that changes were made to the running of the home as a result of listening to the people living there. The AQAA stated that people who live there had not been happy with the catering arrangements and since we last visited a new cook had been recruited. People spoken to said they liked the food, enjoyed their meals and always had a choice. At a meeting with ten of the people living there in May the minutes stated that people had complimented the chef on the quality of the food. The AQAA stated that some people like to have breakfast in their bedroom or to have it later and this is accommodated. This was observed during the morning. One person told us that they often do not come down for breakfast until 9am but this is okay and they can still have what they want. They also told us that on Wednesdays a cooked breakfast is provided but they do not want it so they can have a choice of cereal and toast instead. At tea time people were observed to be offered a choice of several different sandwiches or a hot meal of cheese and potato pie and beans. A pot of tea, milk jug and sugar bowl were put on each small table and if people wanted more this was given. People who needed support were given this discreetly. The meal was not rushed and people were given time to sit and talk to each other and to staff if they wanted to. Care Homes for Older People Page 17 of 28 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. Arrangements generally ensure that the views of the people living there are listened to and acted on so to ensure their well being and safeguard them from abuse. Evidence: The complaints policy was displayed in the home and available in each persons welcome pack so that people had the information they needed to know how to complain. The home had received one complaint about the food. This was investigated as stated in the procedure and had been resolved satisfactorily. We have not received any complaints about the home since we last visited. Minutes of meetings with the people living there showed that people had an opportunity to raise any concerns they had. Minutes showed that peoples views were listened to and changes made as a result of staff listening to what people want. Staff training records showed that most staff had not received updated training in how to safeguard the people living there from abuse. Senior staff said and records showed that all staff had been nominated to have this training. However, priority is given to staff who work at the new Care Centres and not to other homes. It is important that all staff have this training so to ensure that the people living there can be safeguarded. The manager said that they would continue to update staff in staff meetings and that in house training would be provided. Care Homes for Older People Page 18 of 28 Evidence: The AQAA stated and senior staff said that all senior staff have received training in the Mental Capacity Act and the Deprivation of Liberty Safeguards. Other staff have been made aware of this legislation in staff meetings and the implications this may have for the people living there. Care Homes for Older People Page 19 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, safe, clean and comfortable home that meets their individual needs. Evidence: The home was generally well decorated and maintained. This is good that despite the home not being a priority because of its uncertain future, this has been maintained to provide a homely and comfortable environment for people to live in. Some areas were in need of redecoration and the manager said that these had been planned in the near future. Since we last visited the path in the garden had been widened to provide independent access for people who use wheelchairs. This means that all the people living there can access the garden and spend time in the different seating areas provided. The garden is well maintained. Some of the people living there had been involved in planting the pots. There are a number of lounges where people can sit so that people have a choice of where they spend their time and who with. Lounges were homely and comfortable for people to spend time in. In one of the smaller lounges one of the people who spends a lot of time there had brought their budgerigar there. Other people who use this lounge had been asked about this and agreed to it. A lounge is provided where people can Care Homes for Older People Page 20 of 28 Evidence: smoke but none of the people currently living there smoke. A large screen TV had recently been provided for the larger lounge. The picture on this was clear and people said it was easy to see from all parts of the lounge. Bedrooms seen were personalised to individual interests and tastes with pictures, photographs and ornaments. People are able to bring in their own furniture if they want to. Some rooms have a sofa or comfortable arm chairs so that people who want to can spend time relaxing in their bedrooms. All the bedrooms are now single, there are no shared bedrooms so that people can have privacy. The home was clean and free from offensive odours. Domestic staff are employed to clean the home so that care staff do not have to do these tasks but can concentrate on supporting the people living there. The laundry is on the first floor of the home so soiled laundry does not have to be taken through areas where food is stored, prepared, cooked or eaten. Infection control procedures are in place. Handwash and hand towels are provided in toilets, the kitchen and laundry so to reduce risks of cross infection. Staff have training in infection control and how to reduce risks of infections spreading. Care Homes for Older People Page 21 of 28 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. The arrangements for staffing, their recruitment and development generally ensure that the needs of the people living there are met and they are safeguarded from harm. Evidence: Rotas sampled showed that there were sufficient staff on duty to meet the needs of the people living there. Additional staff have been provided during the night to meet the changing needs of one person living there. This ensures their safety and that of the other people living there. Separate staff are employed to do the cooking, cleaning and maintenance in the home. The AQAA stated and rotas showed that staffing levels have been increased from three to four care staff in the morning. This is because people had requested to get up earlier and did not want to wait for staff assistance. The AQAA stated that staffing levels have been affected because of the programme to close the current homes and build new Care Centres. Some staff had moved to the new Care Centres so agency staff had been used. When we visited this was reduced as staff had moved from another home that had recently closed. Staff said that this had been really good and felt that these staff moving across had a good impact on the home and on the development of all the staff. Care Homes for Older People Page 22 of 28 Evidence: The AQAA stated that 98 per cent of the staff have achieved National Vocational Qualification (NVQ) level 2 in Care, one staff is doing NVQ level 3 and another two staff are waiting to be registered for this. This exceeds the standard that at least 50 per cent of staff have achieved this qualification. This should ensure staff have the skills and knowledge to meet the needs of the people living there. The records of three of the staff that work there were looked at. These included the required recruitment records and evidence that a satisfactory Criminal Records Bureau (CRB) had been completed. This ensures that suitable people are employed to work with the people living there. As stated earlier in this report staff who work here are not a priority for training as this has gone to staff who work at the new Care Centres. However, staff who work with the people living here need to receive training so they know how to meet individuals needs. Minutes of staff meetings showed that staff receive knowledge at these. The manager said this would be developed further so more in house training is to be provided. At the handover of each shift staff have a handover. This was observed at the start of the afternoon shift. Important information was passed on to staff so they would know how to meet individuals needs. Staff were observed to be professional and work together as a team to ensure individuals needs are met. The people living there said that staff are very good and helpful. A training matrix was in place but this was not always updated when staff have had training. Individual staff training records showed that staff had received some training but were still waiting to go on other courses that they needed. The manager said that all staff training is to be inputted into a new computer system, which will highlight when each member of staff needs updated training in each area. Care Homes for Older People Page 23 of 28 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. The management arrangements ensure that the home is well run in the interests of the people living there to ensure their safety and well being. Evidence: The manager is experienced in working with older people and has the skills and knowledge to manage the home. The manager has NVQ level 4 in management and care and has achieved the Registered Managers Award. The manager and all staff assisted us throughout the day with our inspection. An internal audit was taking place on the same day. This was being completed by a manager from another home managed by Birmingham City Council. Their visit was announced and looked in detail at several areas of the home and its record keeping systems. Senior staff were involved in doing audits for other homes and saw this as good for their personal development. A representative of the provider visits the home monthly to do an audit of the home. Care Homes for Older People Page 24 of 28 Evidence: Reports of these showed that these include talking to the people living there and staff and asking for their views as to how the home is run and what could improve. The manager auditing the home on the day looked in detail at individuals personal finances. Therefore, we did not look at these. We looked at inventories of peoples belongings. Of the three looked at one was updated recently, one had not been updated since 2007 and the other was not dated. These should be updated regularly and dated so it is clear what belongs to each person and if anything should go missing it is clear what belongings the person had and when. Staff records sampled showed that staff had regular formal supervision and their performance is regularly monitored. This ensures that staff receive good support so they can do their job well and meet the needs of the people living there. Staff said that they were supported in their role. All seniors and managers have completed first aid training. There is always a senior or manager on duty so there is always staff who would know what to do if a person living there had an accident. Records showed that the equipment in the home is regularly tested and serviced to ensure it is safe to use. Records showed that water temperatures are monitored regularly. These were within the recommended limits so that people are not at risk of being scalded. Fire records showed that staff test the fire equipment regularly to make sure it is working. An engineer regularly services the fire equipment to ensure it is well maintained and would work if needed. Regular fire drills are held so that staff and the people living there would know what to do if there was a fire to ensure their safety. The fire risk assessment was dated July 2008. This should be updated to ensure that action is taken so that all the risks of there being a fire are minimised as much as possible. Care Homes for Older People Page 25 of 28 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 26 of 28 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 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 9 Self medication assessments should clearly state whether or not the person is able to do this. This will ensure that people are not at risk of harming themselves from doing this when they are not able to. All staff should have regular updated training in safeguarding so they know how to safeguard the people living there from abuse and harm. Staff should receive all the training they need so they can be updated with new legislation and best practice. This will ensure they know how to meet the individual needs of the people living there. Inventories of belongings should be updated regularly and dated so it is clear what belongs to each person and if anything should go missing it is clear what belongings the person had and when. The fire risk assessment should be updated to ensure that action is taken so that all the risks of there being a fire are minimised as much as possible so ensuring the safety of the people living there. 2 18 3 30 4 35 5 38 Care Homes for Older People Page 27 of 28 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. 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