Care Home: Whitbourne House

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What the care home does well Care plans accurately reflect the individuals` needs and how they will be met. People who live in the home and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. We saw improvements in people making choices about how they choose to live their lives, this is detailed in the care documentation and staff we spoke with told us about the people living in the home, their likes and dislikes and their preferred routines. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs which will help protect the health and wellbeing of people living in the home. Staff have a good awareness of individuals` needs and treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. Mealtimes were dignified and unhurried. The dining experience was a sociable occasion and people were given adequate support where needed. The complaints policy and procedure in the home is effective and all concerns are taken seriously and acted upon efficiently. People can be sure that they will be listened to and that their thoughts and feelings are taken into account. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. The home encourages and supports staff with training in order for them to develop their knowledge so that they have the required skills to meet the needs of the people. What has improved since the last inspection? The home is well organised and managed by an effective, stable management team that promotes the views and interests of all people who use the service. The home has continued to improve following the last inspection and further examples are detailed throughout this report. What the care home could do better: All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. Key inspection report Care homes for older people Name: Address: Whitbourne House Whitbourne Avenue Park South Swindon Wiltshire SN3 2JX     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: Wendy Kirby     Date: 2 3 0 6 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: Whitbourne House Whitbourne Avenue Park South Swindon Wiltshire SN3 2JX 01793523003 01793523016 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Swindon Borough Council care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Service users accommodated under the category Dementia (DE) and Mental Disorder, excluding learning disability or dementia (MD) must not be aged under 55 years. Date of last inspection Brief description of the care home Whitbourne House is a care home for older people, which is owned and run by Swindon Borough Council and is located in the Park North area of Swindon. The local shops and amenities are a quarter of a mile away and there is a regular bus service to Swindon town centre that stops outside the home. The home provides social and personal care for up to 41 older people in need of early stage dementia care or in need of care due to their mental health needs. The service does not offer nursing care. Apart from offering long-term care the home also offers short-term/respite care for a period not exceeding 8 weeks in any one care episode. Care Homes for Older People Page 4 of 31 Over 65 33 10 2 2 Brief description of the care home All service users have single room accommodation. If two residents wish to share, two rooms would be offered so that one could be used as a lounge. Bedrooms are located on the ground and first floor and a passenger lift gives level access. The home has a number of communal lounges and a spacious dining room and there is an enclosed secure garden area. Doors between each living area and at the entrance to the home are kept locked when not in use for reasons of ensuring safety. The home is divided into separate living areas each with its own lounge. Each living area is allocated a core group of staff to help ensure consistency of care. 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: 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: This was an unannounced Key Inspection which included a visit to the home. The visit was completed by one inspector over one day and lasted approximately nine hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following The previous inspection report. The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, it was well written and contained a lot of information about what the home considers it does well and what plans they have for further improvements in the coming year. Care Homes for Older People Page 6 of 31 In addition to this the manager sent us twenty surveys completed by staff in the home as part of their annual quality review. The home also conducts an annual survey programme for people living in the home, relatives and visiting health and social care professionals. Details of the results are referred to throughout the report. During our visit we spoke with some of the people who live in the home, visitors, the manager and other staff members who were on duty. We also looked at how effectively staff engage with people in the home and how they were interacting and communicating with each other. We looked at four individuals care files, which included, pre admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day to day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. We finished the inspection with a feedback to the manager who demonstrated a very caring, committed attitude to his roles and responsibilities in ensuring that the service provides quality of care to the people who live there. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 31 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. Peoples needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. Evidence: We looked at the pre admission assessments, which were comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. People wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive assessments and care plans from other health and social care professionals involved, Care Homes for Older People Page 11 of 31 Evidence: for example, social workers and hospital staff. We spoke with the manager who clearly demonstrated the importance of pre admission assessments in order to ensure that the home can meet individuals identified needs. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Because they are consulted about their health and personal care needs people should be assured that their views and expectations will be considered. The health and personal care that people receive is based on individual needs. Excellent safe systems of practice are in place in receiving, storing, administering, and disposing of drugs which will help protect the health and wellbeing of people living in the home. People can be confident that staff have a good awareness of their needs and that they will be treated with dignity and respect. Evidence: From the pre admission assessments the staff are able to develop a set of care plans based on identified needs. During the first months trial period the plans are reviewed weekly and developed accordingly. Care plans were completed with regards to health and social needs including, psychological, emotional, and cultural needs which Care Homes for Older People Page 13 of 31 Evidence: demonstrates that the home takes an holistic approach to the provision of care. The plans that we looked at were detailed and person centered, including personal preferences and like and dislikes. Plans told us that people had specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Relatives told us that they are kept up to date with any changes in care, one person said, We are always informed promptly and given regular updates. Staff agreed that they had up to date information about individuals needs and confirmed that care plans were reviewed at least monthly unless there were any other significant changes. People confirmed in the home surveys that they knew who their Key worker was and what the role entailed. Comments included, When I last visited my relative, her Key Worker had brought in hair clips for her, we were so pleased, My Key Worker looks after my needs and keeps my family informed and My Key worker is marvelous just like the rest of the staff. Health care needs are monitored and documented in peoples care files. Nutritional assessments are completed on admission and reviewed monthly, people are weighed as part of this review. Care plans are written for people who are nutritionally at risk and how this is to be managed. Specialist health care support is often sought and referrals are made to community dietitians and speech and language therapists. Records of General Practitioner (GP) visits and the outcomes were recorded. Specialist referrals and visits from other professionals including, Chiropodists, Dentists and Opticians were also seen. Four completed surveys were received by the home from community health and social care professionals, outcomes were positive and all agreed that staff were aware of peoples needs and that they had good working relationships with the staff in the home. All staff are receiving training on how to develop individual care files so that they enhance person centered care. The management team audits the care files on a monthly basis and gives written feedback and any action required to staff members. Policies and procedures for receiving, storing, administering and disposing of Care Homes for Older People Page 14 of 31 Evidence: medications were examined and discussed. All systems in place are very effective, well managed and audited. The home operates a monitored dosage system for the administration of medication, which is supplied at regular intervals by a local pharmacist. Six monthly medication reviews for people living in the home are completed by GPs. Fridge temperatures are recorded daily, the administration charts were legible and continuity of administration was shown with a signature from the people dispensing. Staff responsible for the medication have appropriate and accredited training. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. We saw staff knocking on peoples doors before entering, members of staff spoke respectfully about individuals needs and referred to them in the term of address that they preferred, this information was also recorded in the care files. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to live a lifestyle which is both enjoyable stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. The home actively promotes individuals to exercise choice and control over the lives they choose to live. People receive a varied and wholesome diet that they are able to influence. Evidence: Although Whitbourne House is a large home it does have that home from home feel and people living in the home looked comfortable and relaxed in their surroundings. Any interests and hobbies are identified on admission to the home to ensure that people know that they are encouraged to exercise choice and control over their lives at all times. There does not appear to be any unnecessary rules in the home and it was clear that Care Homes for Older People Page 16 of 31 Evidence: the manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Daily routines are flexible within the home, people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in care files, in discussion with individuals and through observation during our visit. The manager and staff are very proactive in ensuring that people feel able to still reach life long ambitions no matter how great or small. One person living in the home has always wanted to travel in a light air craft and this was achieved earlier this year. An additional flight has been arranged for next year where the person has requested to fly over the Isle of Wight. Although there is not an appointed activities coordinator we did not see any evidence that people are not receiving social stimulation. At present the daily routines allow for all staff to be involved with ensuring that people can partake in activities of their choice, whether this is within a group or individually. Family and friends also take part and support activities and events. Additional care staff hours are deployed to ensure that people are supported to go out, for example, bingo, hydro therapy, theater and local pubs and restaurants. We saw consent forms and risk assessments in place to help ensure that people are protected when they are outside of the home. Various entertainers visit the home throughout the year, including, fashion shows, dog agility shows, singers and musicians. Useful information is shared by having several notice boards throughout the home notifying everyone of any news, current events, dates for your diary and a weekly activities programme. We saw photographic displays of memorable days and events which provide memories and topics of conversation for people, where they are able to reminisce and tell stories about their lifes. The home survey asked visitors if they are made to feel welcome. The comments received included, We are made very welcome and provided with a cup of tea, Yes we are always made to feel welcome, they are all nice people here and Our relative has not been here very long but we already feel like part of one big family!. The size and layout of the dining room makes it possible for everyone to enjoy the social advantages of dining together. The dining rooms are light and spacious with the Care Homes for Older People Page 17 of 31 Evidence: tables attractively laid. Staff members supported people that required assistance with eating their meals in a respectful sensitive manner. Staff sat at the same level and assisted them without rushing. The kitchen was well organised and seemed to run efficiently and effectively. The cook was able to demonstrate an awareness of individual requirements and needs including special dietary requirements and personal preferences. The food is home cooked offering various choices of hot and cold alternatives and fresh fruit is available at all times. The four- week menu rota displayed traditional meals and menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. Any visitors to the home are welcome to stay for lunch. The kitchen was very clean, well equipped and spacious. Stores exhibited a good range of foods. Food hygiene training was up to date for staff. Documentation was provided to show that the required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked. Risk assessments were in place and up to date. Care Homes for Older People Page 18 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. There are good policies and procedures in place to manage complaints and people can be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and the awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: The complaints policy and procedure is detailed and requires all the relevant information, this can be found in the service user guide and welcome pack, which is given to people on admission. It is also displayed on notice boards throughout the home. We receive details from the home about any internal complaints investigations and safeguarding referrals, the outcomes have shown us that these have been dealt with openly and effectively. The manager told us that he is committed to encourage an open culture within the home so that people feel comfortable and able to make a complaint or a suggestion without fear of reprisals. The manager makes every effort to see people living in the home Monday to Friday. Being available has meant that people can discuss any concerns or issues with the manager before they potentially escalate into complaints. Systems in place such as Care Homes for Older People Page 19 of 31 Evidence: regular care reviews, Key Workers and holding meetings for people living in the home, relatives, and staff has meant that communication and sharing information has improved. This further promotes people becoming less frustrated thus relieving anxieties and any potential complaint referrals. Building up relationships between staff, people living in the home and families has helped improve staff confidence to communicate with others. All the people who replied to the home surveys said that they felt that issues or concerns were dealt with in an appropriate manner. Comments included, We are very satisfied, all of our questions are answered straight away and I have never had any problems, I can talk to someone if I have a problem. There are policies and procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and the understanding of their role in protecting vulnerable adults who live at the home. Policies and procedures given to staff include, Whistlblowing, How to make a grievance and Harassment in the workplace. We were told that the home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. We spoke with staff who confirmed that they had received this training and they were able to demonstrate its effectiveness when discussing the content of the training. A number of staff have either completed or are enrolled on the National Vocational Qualification (NVQ) in care award and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean comfortable decorated and furnished to a good standard. It provides a safe peaceful and well maintained environment for everyone The bedrooms communal rooms and facilities are suitable for their purpose and meets the needs of the people living there. Evidence: The home has a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide corridors and pathways, passenger lifts, specialised bathing facilities, grab rails, and assisted toilet facilities. We walked around the inside of the home and viewed some of the bedrooms and the communal areas including the dining rooms, lounges and bathrooms. There are some areas that look a little worn. The manager told us that the home was due to be redecorated this year as part of the Swindon Borough Councils Corporate Plan for home improvements. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. Most Care Homes for Older People Page 21 of 31 Evidence: rooms had profiling or divan beds dependent on need and good quality matching bedroom suites, lounge chairs, and a small table. People have individual commodes and communal bathing areas, showers and toilet facilities are located throughout the home. Lounge areas were homely and allow for people to be seated together enjoying the entertainment systems on offer. The home also has a salon whereby people book their own appointments and enjoy the socialisation of this service and the independence it provides. There is a very large sunny conservatory looking out onto pretty private gardens. People will benefit from this area a lot more once the new blinds have been fitted. Some improvements have been made to the garden since the last inspection and work will continue for further development. The garden is secure and has several patio areas with seating for people, a lawn area, planters with flowers and a water feature. The manager told us that the housekeeping hours had been increased since the last inspection and that cover was available from 8am-8pm. Staff were wearing gloves and aprons whilst working and the AQAA told us about effective infection control procedures in place when handling soiled linen.There are strict policies and procedures in the home and there have been no known cases of MRSA or other highly contagious diseases. The home surveys asks people How do you find the cleanliness and decor in the home?. Comments received included, Very good, with such a big area to cover I think they do extremely well, The general cleanliness and decor is acceptable, its always nice to visit and there are no unpleasant smells and I think its all very satisfactory, there is just the normal wear and tear that needs refreshing occasionally. Care Homes for Older People Page 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes staffing levels and skill mix of staff in order to help ensure that peoples needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The training provided to staff should help ensure that staff have the skills and resources to meet peoples needs. Evidence: The manager told us that staffing levels are indicative of needs and the level of care required and confirmed that levels of staff would rise should dependency levels increase. In general staff agreed that there were enough staff to meet individual needs of people living in the home. When there have been staff vacancies regular agency or bank staff have been used to provide continuity and the permanent staff will often cover extra shifts. The AQAA tells us that there has been a recent recruitment campaign and that it is paramount to find suitable staff in order to fulfill the roles and responsibilities expected of them. The home is vigilant in taking their time in this process so that they can find the right person for the job where they have the right skills and attitude to Care Homes for Older People Page 23 of 31 Evidence: look after and care for people with dementia. It is hoped that by taking their time and recruiting the right people for the job will help ensure that staff are committed and remain in the home. We know that the home follows a good recruitment procedure. This will help ensure that people living in the home will be further protected. Records contain completed application forms with a full employment history, two or more written references and Criminal Records Bureau (CRB) disclosures. Staff confirmed that relevant checks had been completed before they started working in the home. There is an induction programme which covers all mandatory training. The home has a mentor system where all new staff are linked with and shadow a senior staff member during shifts to help with continued training throughout the induction process. Staff told us that the induction was fairly good and covered everything they needed to know in order for them to do their job. The home provides the staff at the home with a vast amount of training and development opportunities tailored to individual needs. The manager and all staff are conscientious in attending training relevant to the care needs of the people they are caring for and those relevant to the roles they perform. The manager had recently organised a Raising Dementia Awareness open day for the local community. There were various guest speakers and stalls with lots of useful information available for attendees. Over one hundred people replied to the invite and over eight attended, including health and social care professionals, staff from other local nursing homes, friends and family members of people living at Whitbourne. It was a great success and we saw various correspondence sent to the manager from attendees to thank him for the day. Comments included, I thought it was absolutely fantastic, It was well put together with different speakers sharing various essential information, I thought the stalls set up were great, I was able to get some leaflets and contact details from various agencies including the Alzheimers Society and I can truly say that this was one of the best information giving days I have attended for a very long time. Needless to say there have been requests for the home to arrange future awareness days due to its success and the home must be commended for the great efforts they have made. We received various comments from staff about the training provided in the home. Comments included, We have wanted to raise not only our knowledge of dementia but also for those in the local community, by sharing our knowledge we may all have a Care Homes for Older People Page 24 of 31 Evidence: greater understanding and reduce peoples anxiety, Im looking forward to more training and doing my NVQ in order to further my chosen career, All the training we receive means that we will continue to improve and become an even better team and I am looking forward to continue my learning by the various methods available to me. During our visit we spoke with people living in the home and visitors about their thoughts of the staff and we looked at comments received in the home surveys. The response was very positive and people said, They are caring and kind all the time, Staff are very caring and approachable, They are always there and nothing is too much trouble and They know my relative well and I feel we are all working together to keep my relative happy and comfortable. All health and social care professionals agreed in the home surveys that staff were helpful and courteous when visiting. We spent some time throughout the day talking and observing staff carrying out their duties and assisting people. Staff were respectful, warm, good humoured and sensitive towards people within a relaxed calm environment. Care Homes for Older People Page 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and best interests are central to the management approach in the home. Good accounting methods are followed when handling peoples money so they can be sure that their finances will managed correctly. Staff feel that they receive supervision and support that is appropriate to their roles and responsibilities in the home. The health and safety of people who use this service should be protected by systems in place. Evidence: The manager has worked in the home for nearly four years. He has completed the Registered Managers Award and recently successfully completed the Chartered Management Institute Level 5 Diploma. He has fourteen years experience at Care Homes for Older People Page 26 of 31 Evidence: management level, predominantly in mental health and dementia care. He continues to undertake training in order to further develop his skills and knowledge. The manager is regularly supervised by his line manager. The manager demonstrated good effective leadership and management skills that relate to the aims and purpose of the home. After a lot of hard work and commitment the manager and staff are a stable team that are committed to providing quality of care for the benefit of the people in their care. The staff at the home are very committed to the people living in the home and the roles and responsibilities expected of them. They are empowered by the manager to continually monitor and evaluate the services they provide to people. We saw some very good examples of written documentation where staff express what they think they do well, what they can do better and what plans should be implemented in the future. People who use the service were also complimentary about the staff and the manager. Comments included, The response I have received from the home has been excellent since day one, We are extremely happy knowing that our relative is well cared for and We can approach the manager and all the staff at any time. The home continues to monitor and assess the quality of services provided by giving people questionnaires to complete and by holding meetings for people living in the home, their relatives, families and friends. Regular audits are carried out in the home including health and safety care documentation, medication and other procedures in the home. The policy and procedure for holding peoples personal money was looked at. We looked at the statements of four individual accounts and saw that good accounting methods are maintained and receipts for sundries were available. There is an annual appraisal process which ties in with the supervision arrangements. The manager has established a formal recording of any supervision for all staff. A plan is devised for discussion including people living in the home, work issues staff issues, personal development and training. The manager felt that staff find the sessions are useful and confirmed that they received them on a regular basis. The home also encourages and supports practical supervisions in addition to the formal ones they receive. This has enabled staff to develop their skills on the floor. The home has written policies and procedures in relation to the promotion of the Care Homes for Older People Page 27 of 31 Evidence: health and safety for all people who use the service and associated training was provided for staff in all health and safety matters. Some of the Health and Safety records in the home were examined. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms, equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services and the passenger lift. 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 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 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. 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