Care Home: Whiteladies Residential Home

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What the care home does well Information provided about this home and the procedures that are followed before admissions are arranged will ensure that placement is only offered to those people whose needs can be met. People will be well cared for at Whiteladies Residential Care Home and can be assured that their care and support needs will be met. The people who live in Whiteladies are encouraged to maintain an independent lifestyle but a range of social activities are available as well. They will be provided with a well balanced diet and good home cooked food. The people who live in Whiteladies, and their relatives can be assured that any concerns or complaints they may have will be listened to and acted upon. They will be safeguarded from harm because the staff are aware of protection issues. Whiteladies Residential Care Home is an elegant period home that is safe, well maintained and very comfortably furnished. The recruitment practices ensure that only suitable staff are employed to work at Whiteladies. The staff are well trained, meaning that people can be assured they will be well looked after. Whiteladies is a well managed care home that is run in the best interests of the people who live there. What has improved since the last inspection? Two requirements were issued following the last inspection and both have been complied with. The registered manager has attended safeguarding of vulnerable adults Alerter`s training and is better informed about what to do should any safeguarding issues be raised in respect of people who live in the home. There is better recording made when staff have to help people they are looking after, move or transfer from one place to another, although peoples needs are minimal in this area. What the care home could do better: It has not been necessary to issue any requirements following this inspection, although it would be good practice for the care planning documentation, any healthcare monitoring tasks and risk assessments, to be reviewed on a monthly basis and not three monthly. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Whiteladies Residential Home 22 Redland Park Redland Bristol BS6 6SD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vanessa Carter     Date: 2 4 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 27 Information about the care home Name of care home: Address: Whiteladies Residential Home 22 Redland Park Redland Bristol BS6 6SD 01179739083 01179237662 c.m.goodyear@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Whiteladies Residential Home Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: May accommodate up to two persons with a Mental Disorder over 65 years of age Date of last inspection Brief description of the care home Whiteladies Residential Home is a privately owned residential care home, registered to provide personal care to twenty-three older people and two older people with mental health needs. It is situated in a busy urban area in the city of Bristol and can be accessed by car or bus. The home is a converted older property providing single room accommodation on three floors, all of which can be accessed by a lift. A suitable number of bathrooms and toilet are available and have been adapted to meet the care needs of people in the home. Each room has an alarm call system. The home is situated in its own grounds with gardens to the rear. Visitors are welcome at any time Care Homes for Older People Page 4 of 27 Over 65 2 25 0 0 Brief description of the care home and refreshments are readily available. In-house activities and entertainments are also provided. The home has a brochure that details the services and facilities available, and this can be provided to anyone enquiring about living in the home. Care Homes for Older People Page 5 of 27 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 last inspection of this service was made on 21 st August 2007 and our overall judgement about the quality of the service provided for the people who live in the Whiteladies Residential Care Home was that people received a good service. After that inspection we planned to visit again within two years. In the meantime, we completed an annual service review in August 2008 and were assured that the service was still providing good quality outcomes for the people that lived there. Prior to this inspection we asked the registered manager Mrs Carolyn Goodyear to complete the annual quality assurance assessment (AQAA). This is a self assessment document that focuses on how well outcomes are being met. The assessment had been completed in detail and told us about the improvements that have made over the last 12 months and identified those areas where they felt they could do better. We also sent out Have Your Say About Whiteladies survey forms and these were Care Homes for Older People Page 6 of 27 returned by nine people who live in the home and two GPs who visit people there. During the inspection we looked at records kept by the home, including care records and those that are kept in respect of the running of the home. We spoke to those staff on duty, the registered home manager and we observed the interactions between the staff and the people who live in the home. We also spoke to some of the people who live at the home and asked them what it was like to live in the home. At the time of this report the fees for placement in the home range between 425 and 475 pounds per week. Additonal charges may be made for other services and these are detailed in the homes brochure. 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 set out on page 4. Care Homes for Older People Page 8 of 27 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 27 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 27 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. Information provided about this home and the procedures that are followed before admissions are arranged will ensure that placement is only offered to those people whose needs can be met. Evidence: The Statement of Purpose produced by the proprietor, contains all the necessary information for people who enquire about the home to be able make an informed choice about moving to Whiteladies Residential Care Home. The document is kept under regular review and will be updated to reflect any changes made. There is also a service users guide that details the services and facilities available at the home, and a colour brochure complete with photographs of various parts of the house. A copy of all these documents are kept in the main reception area of the home for people to refer to. Nine people completed our survey forms - five said they had received enough information about the home prior to moving there, and four did not know whether they had. One person spoken with during the inspection said my daughter made all Care Homes for Older People Page 11 of 27 Evidence: the arrangements. All newly admitted people will be provided with a Contract of Residence when they move in to Whiteladies. Again, five people of the nine people who completed our survey forms said they had been provided with a contract - the others did not know. We saw completed contracts of residence as part of our examination of the homes records and can confirm that appropriate arrangements are in place. Before placement is offered to any new person the home manager will arrange for an assessment to be carried out in the persons own home or in the hospital ward. This assessment will usually be carried by the home manager however a senior carer or the deputy may also attend. Additional information is gathered from health and social care colleagues or healthcare professionals where appropriate. A recommendation was made following the last inspection that a copy of the pre-admission assessment be retained by the home to evidence their compliance with standard 3. These records were seen. A number of recent admissions have been by people who have not previously lived in the Bristol area and want to move to Whiteladies to be near other family. In these instances the home manager will collate as much information from other sources about the person and their care needs, in order to be able to make a judgement that the home would be able to accommodate them. Where possible, visits to the home are encouraged before admission, so that the prospective person can have a look around and sample the facilities. People may be invited to visit and stay for lunch and to meet the other people who live in the home. All new placements are arranged on an initial four-week trial basis, with a review meeting being held at the end of this period. Care Homes for Older People Page 12 of 27 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. People will be well cared for at Whiteladies Residential Care Home and can be assured that their care and support needs will be met. Evidence: The care planning documentation for three people were looked at during the inspection including those prepared for a newly admitted person. The plans contained enough information to enable care staff to know what care and support each person needed, they were simply written and covered specific mobility, behavioural or healthcare needs. It is evident that each person is treated as an individual with a differing set of needs. Alongside the care plans a moving and handling risk assessment is completed and specific instructions are recorded so that staff know how to perform any tasks. We were told that most of the people currently living in Whiteladies require only very minimal support with moving and handling tasks, and those that need support with bathing will use the bathroom where there is a swivel seat installed. Risk assessments were also completed in respect of nutritional needs and the likelihood of falls. Plans and assessments are currrently only being reviewed on a three monthly basis - this should be done on a monthly basis to ensure that the Care Homes for Older People Page 13 of 27 Evidence: plan remains up to date and people receive receive the care and support that they need. This was discussed with the home manager and will be implemented immediately. The nine people who completed our survey forms said that they always or usually received the care and support that they needed. One person said I have been extremely well looked after since I have lived here. The home maintains a record of all contact with GPs and any other healthcare professional who may be involved in the care of the person. Where people are able to take themselves to the GP surgery, they are encouraged to continue this activity and maintain their independence. Staff at the home will arrange for the GP to make a home visit where this is necessary. All nine people who returned our survey forms, stated that they always got the medical support they needed. We received two of our survey forms from GPs who visit the home - both said that peoples social and health care needs were properly monitored, reviewed and met and the home contacted them to seek advice when needed. We looked at the measures in place to monitor peoples body weight. Of the three peoples plans we looked at, one persons weight had gained and we could see that the GP had prescribed meal supplements after they had lost weight. For another person who was losing weight, we could see that this was being investigated by the hospital. The third person whose last recorded weight was significantly lower, there was no indication about what action the care staff had taken. The manager looked into this and we were advised that the weight loss was due to some medication (steriods) being stopped - this is an expected outcome. The homes systems for the ordering, receipt, storage, administration and disposal of medications are safe and follow good practice guidelines. The deputy has delegated responsibility for the medication systems. A number of the residents have retained responsibility for some of their medications, enabling them to maintain some degree of independence about their care. People made the following comments in our survey forms and during the inspection we are encouraged to be mobile and independent, the staff go to a lot of trouble for me, we have a lot of fun here and the staff are kind and polite and all the staff are so kind and helpful. The staff were observed during the inspection going about their duties in a friendly and relaxed manner, and the interactions with the people who live in the home were genuine and caring. We were told that visitors are welcomed at any reasonable and that the staff like to get to know the family as well as the person they are looking after. It was evident that the staff team have a friendly relationship with the people who live in Whiteladies. Whilst the care provided at Whiteladies does not include nursing care, the staff team Care Homes for Older People Page 14 of 27 Evidence: would endeavour to look after any person who became unwell with an illness or who had reached the end stages of their life. The home would only be able do this with the support and guidance of the district nursing services and any other healthcare professionals as necessary. For people who have lived in the home for a period of time, it means that they will be cared for by staff with whom they are familiar, and would prevent a move to an unfamiliar care environment. Care Homes for Older People Page 15 of 27 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 who live in Whiteladies are encouraged to maintain an independent lifestyle but a range of social activities are available as well. They will be provided with a well balanced diet and good home cooked food. Evidence: The majority of people who are catered for in this home are independent and only need minimal assistance with tasks. A number of people are able to continue to take an active part in activities outside of the home. They are able to come and go as they please, although for some people, a timeframe is set so that the staff are able to monitor their whereabouts but still support the persons independence. One person told us I like to help out I lay the tables for lunch and do some tidying around. A number of people go along to the local library, or attend the local church. We were told that one person holds a regular pray meeting in the home. There has been a significant change in the culture of this home since the last inspection and the levels of activity amongst the people who live there has improved. People who completed our survey forms said that there was always activities arranged that they could take part in - I enjoy the activities very much and we are encouraged to remain mobile and independent were additional comments made. There is one member of staff who arranges a weekly plan of events. These events include quizzes, painting, craft Care Homes for Older People Page 16 of 27 Evidence: sessions, bingo and chair exercises. We were told that there are regular days out on a tuesday and this may involve a trip out for coffee, visit to a museum or an art gallery. There is an Old Timers Memory Show organised for the next month, and family are invited to attend. One person said We have been told about it and we are all looking forward to that. The home has an extensive supply of jigsaw puzzles and some board games. A hairdresser visits the home on a weekly basis. It is evident that people who live in Whiteladies are able to make choices about how they spend their time, what time they would like to get up and retire and where to take their meals. The home has an open visiting policy and visitors are able to call at any reasonable time. From observing the interaction between one regular visitor and the staff it is evident that the home see the input from friends and relatives as being important to the overall care of the person. We were told that people are asked each morning and evening what they would like for breakfast and for teatime. Breakfasts are served in peoples own bedrooms. The main meal of the day is generally served at midday and people are encouraged to have their meal served in the dining room. It is seen as a social event. People are informed was the meal being served is and alternatives can be provided upon request. Those people spoken to after lunch sid they had had a nice meal Fish and Chips, its Friday. The nine people who completed our survey form stated that the meals were always or usually liked - one person said the meals were well cooked whilst two others said the food is good. Copies of the menus are given to each person to keep in their bedrooms and also displayed in the dining room. The home has two cooks who each cover part of the week. Care Homes for Older People Page 17 of 27 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. The people who live in Whiteladies, and their relatives can be assured that any concerns or complaints they may have will be listened to and acted upon. They will be safeguarded from harm because the staff are aware of protection issues. Evidence: The homes complaints procedure is included within the service users guide and a copy of this is given to each person who lives in the home. A copy of the procedure is also displayed on the notice board in the dining room. All nine people who completed our survey forms said that they knew what the homes complaints procedure was and who to speak to if they were unhappy with anything. One person wrote I have no complaints and another I fee everything is OK. My needs are met. We have not received any complaints or concerns about this service. Since the last inspection the home manager has attended the local authority Alerters training for sfaeguarding vulnerable adults (SOVA) and demonstrated awareness of her responsibilities towards protecting those people in her care. The manager raised concerns with the appropriate authority when there were concerns regarding one particular person and also kept us informed of what was happening. We were told that all staff have had safeguarding training and this was confirmed in discussion with carers. Those staff who were spoken with during the inspection were aware of abuse issues and the homes whistleblowing policy and knew what to do in order to report concerns and safeguard people. Care Homes for Older People Page 18 of 27 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. Whiteladies Residential Care Home is an elegant period home that is safe, well maintained and very comfortably furnished. Evidence: Whiteladies Residential Home is a period, detached building, sited in the leafy suburbs of Redland in Bristol. It is within walking distances of a full range of shops and bus services to many other areas of the city pass the end of the road. It is an imposing property and accommodation is arranged over four floors. The home is well maintained throughout and suited to the purpose of a care home. Disabled access is available via the lower ground floor. There is a five-person lift available in the home so each of the four floors is accessible. There is one short stair lift between a half landing, and the main landing, but the staircase is still wide enough to walk in. The home is decorated and furnished to an extremely high standard, creating a comfortable and homely atmosphere. There is an ongoing programme of redecoration and individual bedrooms are generally redecorated in between occupation. There are two lounges - the larger lounge being referred to as the quiet lounge and the other the TV room. There is one dining room with a magnificent stained glass window, set up with tables for four - the majority of people take their midday meal in the dining room but can choose to have their meal served in their own bedroom if they so wish. The dining room leads out on to a roof top terrace, furnished with tables, Care Homes for Older People Page 19 of 27 Evidence: umbrellas and potted plants. There is a small garden area to the rear of the home that is well planted with bedding plants and established shrubbery. To the front of the property, there are shrubs and a small amount of car parking. A range of disability equipment is located throughout the home but the home is really only geared up for the active or semi-active older person. Equipment includes grab rails, bath seats, one small stair lift and a full passenger lift. No moving and handling equipment is available, although the home can access additional equipment for short term individual use. There are two communal bathrooms - the one in the basement floor has a bath fitted with a swivel bath seat, and on the top floor there is shower room complete with seating and grab rails. All but one of the bedrooms has en-suite facilities - some will have just a toilet and wash hand basin whilst others have either a shower or a bath. The bedroom without an en-suite has a dedicated bathroom along the corridor. There are more that enough bathing facilities for the people who live there. The home has 21 single bedrooms and two shared rooms - both are occupied by just one person. Most of the bedrooms were seen during the course of the inspection - all the rooms were pleasant, well furnished and had been personalised with peoples own belongings and small items of furniture. Lockable drawers are provided in each room, meaning that paeople can safely secure any valuables or their medications, where relevant. Those bedrooms on the lower ground floor have French windows that open out onto the garden area. The home was spotlessly clean, tidy and smelt fresh throughout, on the day of inspection. The housekeeping staff were observed working diligently throughout the inspection. The nine people who completed out survey forms said that the home was always fresh and clean. Care Homes for Older People Page 20 of 27 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 recruitment practices ensure that only suitable staff are employed to work at Whiteladies. The staff are well trained, meaning that people can be assured they will be well looked after. Evidence: The home currently has only 19 people in residence, but three more people are due to move in very soon. On the day of inspection there was the deputy, one senior care assistant, and and three other care staff on duty, as well as the home manager. In the afternoons there are generally two carers plus a senior care on duty. Overnight, there are two carers but one only provides sleep-in cover from 10pm. Of the nine people who completed our survey forms, six said that there was always staff available when they needed them, with the other three saying that they usually were available. Observations made during the course of the inspection were that staff attended promptly to peoples individual needs and requests for assistance. The care staff are supported in meeting the residents daily living needs by catering and domestic staff. We were told that the home does not use agency staff, and that any free shifts will be covered by the staff team or bank staff. This means that people who live in the home will be cared for b staff who are familiar with their care needs. Significant progress has been made in the numbers of staff who have acheived a National Vocational Qualification in health and social care. At the last inspection only Care Homes for Older People Page 21 of 27 Evidence: three staff had an NVQ level 2 and others were working towards the award. At the time of this inspection all staff have an NVQ Level 2 in health and social care and three staff have nearly completed NVQ Level 3. This is commendable and evidences the services committment to providing trained members of staff who will have the necessary competencies and skills to meet peoples needs.. The staff files of four care staff who have been recruited since the last inspection were examined, in order to determine the process followed to make sure they only employ suitable workers. The home have followed robust recruitment procedures and all staff have been properly vetted. Each employee had completed an application form and then attended for interview. The home had obtained two written references (at least one from a previous employer), and had received CRB disclosures. All four staff had not started work at the home until their enhanced CRB disclosure had been received this includes proof that the worker was not included on the POVA list. Staff spoken with during the inspection confirmed that they received an inductiontraining programme when they started work at the home, and that they were well supported by the staff team. The induction programme includes manual handling, health and safety, protection of vulnerable adults and fire safety awareness. We were told that food hygiene training is also a mandatory course that all staff will complete. New staff with no caring experience will have a couple of shadow shifts when they first start and will not work on their own until they feel comfortable to do so. New staff have a three-month probation period and their work performance is reviewed at the end of this time before being confirmed as a permanent employee. Staff training files evidenced that the team have received a range of different training as well as the mandatory subjects. We saw that staff had done infection control, dementia awareness, care of medicines, continence care and diabetes management. Half of the team have already completed First Aid training and the others will be doing this later on in the year. Care Homes for Older People Page 22 of 27 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. Whiteladies is a well managed care home that is run in the best interests of the people who live there. Evidence: Since the last inspection the home manager, Mrs Carolyn Goodyear, has been confirmed as the registered manager of this service. She has now been in post for 2 years and was previously the deputy manager in the home. She has many years experience in the care profession and has already achieved an NVQ level 2 and 3 in care. She is currently undertaking the Leadership and Management NVQ Level 4 qualification. A deputy manager and senior carers support the manager in the management of this care home. The manager has a very hands-on approach and is very involved with the daily care and support of the people who live there and works alongside the staff team as and when necessary. Staff meetings and resident meetings are held on a regular basis and there was evidence that everyone is encouraged to make suggestions about how Care Homes for Older People Page 23 of 27 Evidence: the home is run and what happens. This may include discussions about menus, meal time arrangements and social activities that are arranged. There is a very homely family atmosphere, amongst both the people who reside in the home and the staff that work there. The manager states in their annual quality assurance assessment that they have an open door management style, with clear lines of accountability, and this was backed up by observations and evidenced through the inspection process. An quality assurance survey is undertaken on a yearly basis and the proprietor visits the home on a regular basis and monitors the standards of care. Reports regarding these visits are completed but were not inspected as part of this inspection. We are assured that there is a real committment by the proprietor and home manager to provide a quality service that meets peoples expectations, and where we have issued requirements on previous inspections, these have been complied with. The home has good systems in place to manage any monies they hold on behalf of people. A number of the accounts were checked against the records held and they tallied. Only senior members of staff hold the key to access peoples money. Staff confirmed that they have formal supervision with the home manager or the deputy, on a regular basis, and some of the records were seen as part of the inspection of the homes records. Work performance and training needs are discussed during a supervision session. The manager and senior carer supervises the staff on a daily basis, and the staff team spoke of a good team approach to the care of the people who live in the home. All records that are required to be available for inspection were produced as requested. A visitors book is placed in both entrances to the home and visitors are asked to sign in and out. The information kept about people and their care needs is kept secure in a locked cupboard. The fire records were examined and were all in order. All the necessary weekly, monthly and quarterly checks had been completed. All staff received their fire training update in February 2009 and fire drills are organised on a regular basis. Any maintenance tasks required in the home are dealt with as and when needed. The home appeared to be well maintained both inside and outside. No health and safety concerns were raised as a result of this inspection. Care Homes for Older People Page 24 of 27 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 25 of 27 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 7 Care planning documentation, healthcare monitoring records and risk assessments should be reviewed on a monthly basis and not three monthly. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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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