Care Home: Westmorland Court Nursing Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Westmorland Court Nursing Home provides a high standard of personal, health and social care to the people who live there. Admissions are well thought out and carefully planned to make the move into the home as smooth as possible for people. Considerable time is put into assessing and getting to know new people, and in helping them to settle in. Health care arrangements are good with people having access to their doctor or other health care staff as needed. Staff are proactive in noticing changes in a person`s condition and seeking specialist advice or treatment as necessary. Staff are knowledgeable about people`s medicines and the overall management of medicines in the home is good. People felt they were being well cared for, in the way that they liked, and were offered regular baths and showers. We saw that staff treated people with dignity and respect and there was a good rapport between them. People were encouraged to make choices about their day to day lives, and staff respected this. Surveys told us, "There is a very caring atmosphere", and "The staff are kind and patient, there is a nice atmosphere". There was a good provision of activities, occupation and entertainment, both within and outside of the home. People joined in with crafts, theatre trips, visiting entertainers, household chores, relaxation and massage, as well as chats and quizzes. People told us they enjoyed the food, and we saw people were offered choices and special dietary needs were catered for. Staff were vigilant in monitoring people`s food and drink intake, and monitored people`s weight to ensure there was no unwanted weight loss. The home has a low level of complaints. The manager is very active in with meeting with people and their families to discuss their needs and expectations. Any concerns raised have been dealt with immediately. Staff are trained in local safeguarding procedures and can recognise, and know how to report, any safeguarding concerns. People told us, "The staff are delightful and so patient, all problems are dealt with cheerfully and efficiently". The staff team are carefully selected and receive good quality training and supervision to enable them to do their jobs well. People spoke highly of the staff group saying, "On our visits there are always staff caring for residents needs", and "They are welcoming, there is a caring atmosphere and good staff ratio". The home is well maintained and is clean and fresh throughout. There is plenty living and dining space, and well equipped bathrooms. There are aids and adaptations throughout the building including a passenger lift, grab rails, hoists and nursing beds. People said, "The cleanliness appears to be excellent", and "The home is bright and fresh, my bedroom is a cosy little haven". Overall management of the service is good, with the manager seeking regular feedback from people through individual conversation and through satisfaction surveys. We saw that people`s ideas and suggestions were listened to, and acted on. What has improved since the last inspection? Since the last full inspection the home has been extended to accommodate a further people, with additional bedrooms, bathrooms and living space being provided. The new accommodation is furnished and decorated to a very high standard. Existing bedrooms are now being upgraded to match the decorative standard of the new bedrooms, and the furniture is being replaced likewise. A new large laundry has been built and equipped with new washing and drying machines. There is now more space for folding and ironing people`s personal clothing. A second kitchenette / food servery has been built for the dining room in the new extension. Two new social care activity staff have been appointed to work with people specifically in the afternoons and evenings. This is in addition to the existing activities and entertainment programme. What the care home could do better: No recommendations or requirements were made as a result of this inspection. The manager listens to what people want, and continues provides a good quality service. Key inspection report Care homes for older people Name: Address: Westmorland Court Nursing Home High Knott Road Arnside Cumbria LA5 0AW     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: Jenny Donnelly     Date: 2 1 0 4 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Westmorland Court Nursing Home High Knott Road Arnside Cumbria LA5 0AW 01524761291 01524762640 westmorland1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Westmorland Healthcare Limited Name of registered manager (if applicable) Mrs Esther Jane Weatherill Type of registration: Number of places registered: care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N 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 - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 48 Date of last inspection Brief description of the care home Westmorland Healthcare Ltd operates Westmorland Court Nursing Home. The registered manager is Mrs Jane Weatherill. The property is a large detached, threestorey Victorian house, which has been extended and adapted for its current use. It is in a quiet setting in Arnside, about half a mile uphill from the village centre. There are mature gardens and ramped access for wheelchairs. There are a three lounges, a Care Homes for Older People Page 4 of 26 Over 65 0 48 48 0 0 7 1 1 2 0 0 8 Brief description of the care home conservatory and two dining areas for people to use. There are 44 single and 2 twin bedrooms, some of which have en suite facilites. There is a passenger lift, handrails and spacious assisted bathrooms. The fees charged by the home range from £525.00 to £567.00 per week. Additional charges are made for personal toiletries, newspapers, magazines, hairdressing, chiropody and beauty therapy. Written information about the service and copies of inspection reports are on display in the care home. Care Homes for Older People Page 5 of 26 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: This was the main or key inspection for the year. The lead inspector Jenny Donnelly asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. We also sent surveys to some people who live in the home, and to staff. The responses are included in this report. Jenny Donnelly made an unannounced visit to the care home on 21st April between the hours of 09.00 and 15.45. During this visit we (the Care Quality Commission) toured the building, spent time in the lounges, and dining rooms where we watched lunch being served. We spoke with people living in the care home and their visitors. We also spoke with the manager and the staff on duty. We looked at files and documents that backed up what we were told and what we saw. Care Homes for Older People Page 6 of 26 Since the last key inspection in April 2007, we have made two visits to this service to carry out random inspections. In November 2008 the home was selected for a short focused inspection, as part of a national programme of random inspections of good and excellent services. The inspection confirmed that the service was still operating to excellent standards, and no concerns were identified. In February 2010 we carried out another random inspection to check on the management of the home whilst the registered manager was on leave, and to monitor the homes infection control procedures following reports of an infection. We found the service was being well managed while the registered manager was away, and sound infection control procedures were in place. Copies of all these reports are available on request from the Care Quality Commission, or from the care home. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Since the last full inspection the home has been extended to accommodate a further Care Homes for Older People Page 8 of 26 14 people, with additional bedrooms, bathrooms and living space being provided. The new accommodation is furnished and decorated to a very high standard. Existing bedrooms are now being upgraded to match the decorative standard of the new bedrooms, and the furniture is being replaced likewise. A new large laundry has been built and equipped with new washing and drying machines. There is now more space for folding and ironing peoples personal clothing. A second kitchenette / food servery has been built for the dining room in the new extension. Two new social care activity staff have been appointed to work with people specifically in the afternoons and evenings. This is in addition to the existing activities and entertainment programme. 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 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager carries out comprehensive pre-admission assessments which help to make sure the service will be able to meet the needs of new people. There is good information provided and time is spent helping people settle into the home. Evidence: There was clear and informative information available to people about the care home and the facilities and services provided. This was on display in the entrance hall along with a copy of the last inspection report. People who completed our survey confirmed they had been given good information about the care home before they moved in, and all said they had a contract of residency. We looked at the admission arrangements for two people new to the service and saw that initial enquiry forms and pre-admission assessments had been completed. The manager or other senior staff visited people in their own home, or hospital, and assessed their personal, health and social care needs, to see if the home would be Care Homes for Older People Page 11 of 26 Evidence: suitable for them. The completed assessments we saw were very detailed and included all necessary information about the persons needs. Information was also gathered from other professionals involved with the persons care, and their family. This enabled the manager to draw up an initial plan of care and helped staff prepare for the persons arrival in the home. People were welcome to visit the home to look around, talk with staff, and ask questions. The manager had visited a number of people in hospital to undertake admission assessments on the day of our inspection. She later told us how she would stagger these planned admissions so new people did not all arrive at once. The manager wanted staff to have time to get to know people as individuals, and allow them time to settle into the home. There was some discussion taking place with staff about which bedrooms people had chosen, and which rooms would be most suitable for people with particular needs. We judged that the service put much thought and planning into admitting new people, to ensure they were properly assessed, their needs could be met and they were helped to settle into the home. Care Homes for Older People Page 12 of 26 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 were receiving a high standard of health and personal care, delivered in a way that was acceptable to them and which benefited their general well being. Evidence: Each person had a written care plan in place and we looked at four of these in detail, choosing people with different kinds of care needs. All care plans followed a set format and were easy for staff to refer to and find the information they wanted. The plans we looked at contained detailed information about peoples personal, health and social care needs and included any specific requests or preferences people had made. All care plans had been reviewed monthly and updated as necessary to reflect any changes in the persons needs or wishes. There was evidence that people had good access to health care services, and we saw people had seen the doctor, dietitian, physiotherapist, dentist and chiropodist as necessary. We saw that any treatment or advice recommended had been included in the persons care plan and carried out by staff. Records showed that staff checked peoples weight regularly and took action where any unwanted weight loss occurred. Care Homes for Older People Page 13 of 26 Evidence: There were good records of wound care, with detailed wound assessments, photographs and clear treatment plans in place. People in the home looked well cared for, were wearing clean clothing and had their hair and personal hygiene attended to. People were offered baths or showers at least twice a week, with some preferring to alternate between bath and shower. People told us; It is clean and warm, and residents are well cared for. There is a very caring atmosphere. People who completed our survey said they always or usually got the care and attention and medical help they needed. We observed staff working with people and saw they were kind and patient, and had an appropriate use of humour. Peoples privacy and dignity was respected, with staff being careful that people were covered when being hoisted, and they lowered their voices where possible. We looked at the management of medicines and saw that all staff who handled medicines had been trained to do so and had access to the homes policies and procedures for this. We observed parts of two medicine rounds, and saw the nurses followed safe practice. The storage and record keeping for medicines was in good order. We stock checked some items and found the amount received into the home, the amount given to the person, and the remaining balance was correct. Medicines due at odd intervals such as weekly, monthly or in variable doses were being well managed. There was a homely remedy policy in place which meant people could have simple over the counter remedies for minor pain or colds, without having to wait and see the doctor first. People were also able to manage their own medicines if they wished, within a risk assessment framework. Care Homes for Older People Page 14 of 26 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. The service provided a range of suitable activities and occupation for people both within and outside of the home. The provision of meals was good with people enjoying their food. Evidence: Since the last inspection the manager has increased the level of in house activities and occupation provided for people. This was done in response to feedback received in satisfaction surveys. Two staff, employed as carers during the morning, now provide social activities in the afternoon and early evening. The manager told us there had been more focus on short bursts of activity as and when people wanted it. There was massage, relaxation, exercises and crafts. People were also encouraged to join in with household chores, such as table setting, if they wanted to. Visitors were made welcome and encouraged to join in with events. We saw the activity plan for April which showed Easter egg painting, an Easter bonnet parade, a magic show, two mini bus trips, one to the theatre in Morecambe and another for a local Scarecrow festival with a pub lunch. There was a film afternoon, visiting country and western singers and on the day of inspection a Music for Health workshop. We also saw notices about Church services and saw photographs of other Care Homes for Older People Page 15 of 26 Evidence: events such as visiting lambs. There was a hair salon / beauty parlour where visiting therapists could tend to people. The completed surveys we received told us there were always or sometimes suitable activities provided. One person wrote, there could be more conversation and day to day activities, which the manager believes has now been addressed by the two new social care staff. We saw some people enjoying a late mid morning breakfast, as was their preference, while others had eaten much earlier. We also saw lunch being served in both dining rooms, where there were plenty of staff in attendance to serve the food and help people with their meals. The main meal was sausages in onion gravy and we saw some people had chosen sliced cold ham or vegetable pasties instead. There were soft meals for people with swallowing difficulties and we saw staff gently encouraging those who were reluctant to eat. There was treacle sponge and custard, fruit or yoghurt for dessert. We saw that people enjoyed their lunch and the surveys we received told us people always or usually enjoyed their meals. One person wrote, my relative enjoys her food and looks forward to meals. Staff monitored peoples weight and sought advice from the dietitian as necessary. We saw that staff were vigilant at meal times in making sure people had enough to eat and drink. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to express concerns and felt confident they would be listened to. Staff understood their responsibilities to safeguard people from harm. Evidence: The home had a complaints procedure on display and people told us they knew how to make a complaint and had someone they could talk to if they were worried. In her Annual Quality Assurance Audit (AQAA) the manager told us she had received one complaint which she had looked into. We discussed this with the manager and found it was not so much a complaint, as a family requesting a change in their relatives care plan, which was attended to. We saw other evidence during our inspection where families had made special requests about their relatives care, and their care plans had been updated and staff informed of the change. It was clear that the manager promoted communication and ongoing consultation with people about their care and the way it is delivered. People reported high levels of satisfaction with the service. Staff had received training in safeguarding people and adult protection procedures. The manager understood the local safeguarding referral procedure and had in the past correctly reported safeguarding concerns to the local authority. The service had worked well with the local authority and with the commission to ensure vulnerable people were protected and were getting the level of help and support they needed. Staff we spoke with were clear about their responsibilities to protect people and knew about the whistle blowing procedures, should they witness something of concern. Care Homes for Older People Page 17 of 26 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 lived in a clean, fresh, comfortable home that was suitably adapted for people with mobility problems. Evidence: Since the last key inspection the home had been extended to accommodate an extra 14 people, bringing the total occupancy to 48. There were 44 single and 2 twin bedrooms, some of which had en suite facilities. The original bedrooms were gradually being refurbished to bring them up to the decorative standard of the the new bedrooms. We saw that people had brought personal items in, to make their bedroom homely. All bedrooms were comfortably furnished and clean. There was plenty of open plan communal space with two dining areas, several lounge areas, a conservatory and a separate lounge, which was used for some activities. All communal areas were clean and bright and provided with suitable furniture and fittings. There were three bathrooms and three shower rooms, fitted with a range of facilities including one large hydrotherapy bath. There were plenty of spacious toilets situated around the home. The home had two sluices and staff had received training in infection control. There was good provision of hand washing facilities, hand gels, gloves and aprons. The home was fresh and clean throughout, and surveys told us Care Homes for Older People Page 18 of 26 Evidence: this was always the case. People commented; The cleanliness appears to be excellent There is good cleaning The home is bright and fresh, my bedroom is a cosy little haven. The home was well equipped with adjustable nursing beds and pressure reducing mattresses. There were grab rails, six hoists with a variety of slings, adapted baths and shower seats. Some people also had their own personal equipment. The extension included a new large laundry room, which was fitted with industrial type machines and had plenty of space for folding and ironing peoples clothing. Bed sheets were sent out to a professional laundry service. People told us they were pleased with the way their laundry was handled, although some people commented on named clothes getting lost. The manager told us they did have a problem when the new washing machine was installed, as it washed the iron on name labels off clothes. The manager wrote to people at the time explaining the problem and asking people to use sewn in labels instead. Laundry is currently done by the care staff and one staff survey told us, They should employ laundry staff instead of carers, residents are our priority. We discussed this with the manager and asked her to re-consider laundry staffing in light of the increased occupancy of the home. There had been an increase in domestic hours to cover the new extension. The service employed a maintenance man, and the home was well maintained through an ongoing programme of decoration, repair and renewal. The manager met regularly with the maintenance man to plan any work needed. Together they did a monthly health and safety walk around the building to check all was in order. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a competent and caring group of staff who have been carefully selected and receive good quality training. Evidence: The home employed sufficient staff to manage peoples personal, health and social care needs. On the morning of the inspection there were two nurses and seven care staff on duty for 41 people. There were also office staff, the cook, two kitchen assistants, two domestics and the maintenance man. Two social activity staff were on duty in the afternoon / evening. The manager arrived in the home at lunch time, after having been to the hospital to assess some potential new residents. The manager said she had increased the future staff rota by one additional carer as occupancy levels were about to increase. People told us the staff were available when they needed them and listened to what they said. People commented; On our visits there are always staff caring for residents needs They are welcoming, there is a caring atmosphere and good staff ratio The staff are very happy and kind to the people Care Homes for Older People Page 20 of 26 Evidence: The staff are delightful and so patient, all problems are dealt with cheerfully and efficiently The staff are kind and patient, there is a nice atmosphere. We received a number of completed staff surveys which told us; We have relevant training, regular meetings, appraisals by the manager, good skill mix on shifts, hand overs between shifts and demonstrations on how to use equipment The manager approachable and updates us immediately with any changes, the home is clean and tidy and well organised. There is good training The home provides high standard of care to all residents, provides activities and a good quality of life Our employer supports staff and staffing levels, we provide very high standards of nursing care. There is a homely atmosphere and good activities. Staff were well organised and had been allocated to work in specific areas of the home and with particular people. The nurses in charge of the shift were in control of what was happening and demonstrated good leadership skills. A number of male staff were employed, both as carers and in the kitchen, and people said they liked this and had a good rapport with all the staff. The manager balanced the staff rotas well to make sure there was a good mix of male and female carers so people could make a choice about who they were comfortable receiving personal care from. We looked at recruitment procedures and saw that new staff were subject to interview, written references and criminal records bureau checks. We looked at the files of some new staff and saw all these checks had been completed before the person started to work in the home. We also saw new staff completed induction training and worked a probationary period before being given a permanent contract. All staff attended regular training updates and there was an annual training plan in place. We saw evidence of staff attending updates in moving and handling, fire safety, adult protection, equality and diversity, dementia care, wound care, medicines, first aid, and prevention of falls. The home supported care staff to gain a National Vocational Qualification in care and 50 of current care staff had achieved this. Staff files had been re-organised and were in good order. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well managed home where their views are listened to and acted on, and staff are managed and work effectively. Evidence: The registered manager has been in post for over nine years and is suitably qualified and competent to manage the service. She demonstrates a clear vision for the future, has good leadership skills and listens to what people who live in the home say. The home owner keeps in regular telephone contact with the manager and makes weekly visits to the home. Regular satisfaction surveys are sent out to people, and we saw the results of the latest survey done in January of this year. There was a good response rate and many positive comments were made about the home. Where ideas or comments were made, the manager had taken action to address these. Some food suggestions had been passed onto the cook for inclusion in the menu, and the two social activity staff had been appointed. Peoples interest in the residents forum had reduced and the Care Homes for Older People Page 22 of 26 Evidence: manager was planning a cheese and wine event for relatives to encourage people to get together and share their ideas and views about the service. The manager completed a number of quality audits, or checks, to make sure staff were working in accordance with expectations and people were receiving a good service. These included monthly care plan audits, weekly medicine checks, monthly health and safety inspections and a monthly review of all reported accidents. We saw that all maintenance records including gas and electrical safety checks, and lift and hoist services were up to date. Staff received regular updates in health and safety training, some were qualified first aiders, and the kitchen had received a five star excellent award from environmental health for food safety. The manager holds money on behalf of some people for safekeeping and we looked at the way this was being managed. The money was held securely in separate named wallets and there were individual records sheets with receipts for all income and spending. The records and money had been periodically checked for accuracy. There was a system of staff supervision and appraisal in place and we saw the records relating to this. Supervision was used to discuss working practice, training needs and career development. We saw evidence that new staff or any staff who under performed were more closely managed and supervised until they reached the required standard. The homes policies and procedures were kept under review and updated as necessary, and the standard of record keeping was very high. We judged the manager ran a very structured service which enhanced the provision of holistic person centred care, as staff team were well organised and had time to spend with people. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!