Care Home: Whitgift Foundation The

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What the care home does well Staff have developed good relationships with the people who use the service. Comments from people who use the service included; `they look after all of us very well`, `it`s very good here`, there is a `friendly and caring atmosphere` and `they provide very good conditions`. When individuals were asked what they felt was the best thing about the service they told us; `they give the best care possible` and `most things`. Staff also made positive comments about working at this home and these included; `it has a caring and homely atmosphere`, `staff are well looked after`, `my role is valued` and there is a `community feel`. The health care needs of individuals are met and medication is well managed. People who use the service are happy with the activities on offer and staff are working to wards expanding the activities on offer inside and outside the home. Good training opportunities are available which assists in making sure that staff are knowledgeable and kept up to date with good practise. The environment is well maintained and comfortable. The organisation continues to invest in up dating the home to provide better facilities for those who live there. The home is well run and the manager has a clear understanding of the strengths and weaknesses of the service. What has improved since the last inspection? Staff have been provided with significant amounts of training over the last few months. Staff informed the inspector that the training has been of benefit in their day to day work with people and has improved their awareness of safeguarding issues. The manager stated that the training provided by the care home support team has been appreciated by the staff. The staffing hours for activities have been increased and the service now has a full time activities coordinator. Social profiles for each person using the service have been developed which can assist staff in better understanding the people they support and providing more person centred or individualised care. Significant improvements have been made to the environment with a new dining room, improved bathroom facilities and new lounge areas. The service has been extended and the new bedrooms are finished to a high standard with good quality furnishings. What the care home could do better: When we asked people who use the service what could be improved the majority told us `nothing` or `I can`t think of anything`. However comments from two people suggested they did at times feel lonely and would appreciate more time with staff. Discussions with staff and people who use the service along with our own observations indicated that staff work in a mainly task based way. Although this has produced good results in direct personal care, people are well dressed, clean and comfortable, there is a risk that the social and emotional needs of individuals can be overlooked. Care planning could be improved with more detailed information on how individuals should be and wish to be supported. More detail of personal preferences will assist staff in providing more person centred or individualised care. Care plan reviews should contain more detail of the outcomes of the support provided, what is working well, what may need to be changed and the views of the individual concerned. Where assessments indicate the use of equipment such as a hoist staff need to be provided with clear information on the type of hoist to be used, the type of and size of sling. If a pressure relieving mattress is used staff should be provided with information on the settings to be used for each person. These details will assist in ensuring the health and safety of people using the service and staff. If staff do not follow the plan of care for the treatment of wounds either in the dressings used or the frequency of treatment they should record why they have done this. Staff training opportunities are very good but the organisation should make sure that all staff take up these opportunities so that the whole staff team takes part in regular training. Final checks should be made before staff start work in the home to make sure that all the documents and records of checks are in place. Key inspection report Care homes for older people Name: Address: Whitgift Foundation The Whitgift House 76 Brighton Road South Croydon Surrey CR2 6AB     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: Elizabeth OReilly     Date: 2 6 1 0 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 29 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 29 Information about the care home Name of care home: Address: Whitgift Foundation The Whitgift House 76 Brighton Road South Croydon Surrey CR2 6AB 02087600472 02086811269 matron@whitgiftfoundation.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Whitgift Foundation care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Whitgift House provides residential and nursing care for up thirty six older people. The home is owned and managed by the Whitgift Foundation. The home shares its grounds with a secondary school and sheltered accommodation, which are both run by the same organisation. The home is well maintained and the extensive grounds are well kept, with trees, lawns and a cricket pitch. Shops and local public transport links are all within easy reach. Accommodation is provided in large single rooms over two floors. Each room has a doorbell and some have a letterbox, a small kitchenette and en-suite toilet facilities. Weekly fees currently range from £765 to £895. Care Homes for Older People Page 4 of 29 Over 65 20 0 Brief description of the care home Care Homes for Older People Page 5 of 29 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 unannounced inspection was carried out by one Regulation Inspector over two days. The inspector had the opportunity to speak with five people who use the service, six staff members and the Registered Manager. We received seven completed surveys from people who use the service and six completed surveys from staff. We looked at a sample of the records the home must keep. The manager sent us their own assessment of the service (AQAA) when we asked for this. We have used information from all of the above sources as well as our own observations of the service to reach the judgements made in this report. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: When we asked people who use the service what could be improved the majority told us nothing or I cant think of anything. However comments from two people suggested they did at times feel lonely and would appreciate more time with staff. Discussions with staff and people who use the service along with our own observations indicated that staff work in a mainly task based way. Although this has produced good Care Homes for Older People Page 7 of 29 results in direct personal care, people are well dressed, clean and comfortable, there is a risk that the social and emotional needs of individuals can be overlooked. Care planning could be improved with more detailed information on how individuals should be and wish to be supported. More detail of personal preferences will assist staff in providing more person centred or individualised care. Care plan reviews should contain more detail of the outcomes of the support provided, what is working well, what may need to be changed and the views of the individual concerned. Where assessments indicate the use of equipment such as a hoist staff need to be provided with clear information on the type of hoist to be used, the type of and size of sling. If a pressure relieving mattress is used staff should be provided with information on the settings to be used for each person. These details will assist in ensuring the health and safety of people using the service and staff. If staff do not follow the plan of care for the treatment of wounds either in the dressings used or the frequency of treatment they should record why they have done this. Staff training opportunities are very good but the organisation should make sure that all staff take up these opportunities so that the whole staff team takes part in regular training. Final checks should be made before staff start work in the home to make sure that all the documents and records of checks are in place. 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 8 of 29 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 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service or are considering moving in are provided with information on what they can expect from the home. Pre admission assessments are carried out to make sure that the service can meet the needs of each person and to make sure that staff have some information on the person from day one of their stay. Evidence: People who use this service told us that they were given enough information to make a decision about moving into the home. Each person is provided with a Service User Guide which gives some detail on what they can expect from the service. At the time of this visit we were informed that the Service User Guide was being updated to add information on the changes which have been made to the environment. We looked at a sample of care files and found that pre admission assessments were carried out for each person before they moved into the home. We found these assessments provided the service with good information on the physical needs of Care Homes for Older People Page 10 of 29 Evidence: individuals and the nursing report gave good information to staff on what support each person would require from them. Staff were seen to have made appropriate referrals to other professionals where needed. The manager informed us, through their own assessment of the service, that staff consult with GPs to ensure there is a multidisciplinary approach to admissions. The information gained prior to and at admission assists staff in setting up an initial plan of care for each person. This service does not provide intermediate care. Care Homes for Older People Page 11 of 29 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. Each person who uses the service is provided with a care plan. Care planning shows some good information but mainly care plans consist of a good practise guide rather than showing the individual needs and strengths of each person. Further work should be carried out to make these plans more individualised or person centred. Outcomes and actions taken in relation to individual care should be recorded more consistently. The health care needs of people who use the service are met. Staff provide care and support in a sensitive and discreet manner. Evidence: People who use the service told us, directly or through surveys, that:- they care for us very well, we get the best possible care and they look after me very well. When asked if they received the care and support they needed three people surveyed said usually and four people said always. Everyone spoken to and surveyed said they always received the medical care they needed. Staff told us they were kept up to date with the changing needs of the people they support. When asked what the service did well, one member of staff said that the Care Homes for Older People Page 12 of 29 Evidence: work the home was doing to achieve the Gold Standard Framework was having a positive influence on all care given to service users including end of life care. We looked at a sample of care plans. We found that the plans tended to comprise more of a good practise guide rather than an individualised plan which sets out the needs of each person along with how these are going to be met by staff. In some instances staff have added information about personal needs however this was not consistent across the service. There was little detailed information on the strengths of individuals or of their personal preferences in the way care is to be provided. We noted that care plans did highlight areas where individuals needed support but did not always give information on how the support would be provided. In one instance a person had been assessed as partially sighted but we could find no information on how staff would support the person with this in their day to day lives. In another instance it was recorded that one person suffered anxiety at night but how this was to be reduced was not recorded. Care plans were seen to be reviewed on a regular basis. Many of the reviews seen gave little or no information on outcomes for individuals. Daily recording was of a good quality with staff making detailed observational notes which were not judgemental. Staff were seen to be carrying out regular assessments which were of good quality. However the actions taken to reduce risks were not always recorded. We found instances where individuals were assessed as at high risk of pressure sores but actions to be taken were not available to staff in the care planning. Where moving and handling assessments indicate individuals need to be supported by the use of a hoist information on the type of hoist to be used and the type and size of sling to be used was not always recorded. To ensure the safety of people who use the service and staff clear information on the equipment to be used for each person needs to be available. When the use of pressure relieving mattresses is indicated staff should also be provided with instructions as to what level the mattress should be set for each person. Wound care plans were in place which ensures that staff have clear information on the treatment to be given. Where staff have not followed instructions on the frequency of wound treatment they had not recorded the reasons for this. Records showed that staff make referrals to other health care professionals such as Speech and Language therapist and Tissue Viability nurses when needed which ensures that people who use the service receive specialist advice on their care. Care Homes for Older People Page 13 of 29 Evidence: We looked at a sample of the records for the management of medication. These were up to date and well maintained. Medication was seen to be stored appropriately. Senior staff check the medication records at each hand over which ensures that any errors would be spotted quickly and not repeated. The service is working to wards the Gold Standard Framework which will improve the care provided particularly in relation to end of life care. We observed staff offering support and advice in a sensitive and discreet manner which respected the privacy and dignity of people using the service. Care Homes for Older People Page 14 of 29 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 who use this service have opportunities to take part in a variety of activities. The implementation of social profiles for each person should assist in further developing the social, emotional and cultural support provided. The quality of the food provided is good and the majority of people enjoy their meals. Further work could be done to make meal times less task based. Evidence: People who use the service told us that there were always or usually activities going on which they could take part in. When asked what the service does well one person highlighted the good activities on offer. We saw various activities taking place during our visits to the service. People who live in the neighbouring sheltered accommodation join in with and in some cases run activity sessions in the home. The weekly activities list was seen to be on display along with information on future events. The list of activities on display included a trip to a farmers market, guys and dolls video, poetry club meeting and video songs from the movies. A pat dog and hairdresser visit the service every week. The activities coordinator is developing Care Homes for Older People Page 15 of 29 Evidence: guidance for staff to continue with activities when she is not available in the service. She is also looking to developing internet access for people who use the service. The manager informed us that more opportunities for people to take part in trips out of the home were being planned. The activities coordinator has access to a mini bus whenever it is needed. Since the last inspection of the service a full time activities coordinator has been appointed. The coordinator is working to wards developing individual plans for everyone who uses the service. A social profile is also being put together for each person which includes a brief history, personal preferences, hobbies and interests, what people would would like to achieve, what they most enjoy in life and what they dislike most in their life now. This information was found at the back of the personal file for each person. Consideration could be given to putting this information at the front of each file along with a photograph so that staff see the person and their lives and preferences before their needs. The service has an active friends group which we were informed works hard in raising additional funds for the service. The manager informed us that the activities coordinator is planning to provide more one to one sessions for people who cannot or prefer not to join in group activities. Consideration could be given to providing more equipment for sensory stimulation for those people whos communication abilities have been impaired. Two people in different ways expressed some sense of loneliness and would like more time to talk with staff or go to the garden. This should be addressed through less task based care and improving care planning so that staff have a better understanding of individual social and emotional needs. Consideration could be given to providing more training on what the service, support and care might looks like from a residents point of view. It may be useful to staff to spend time observing the levels of interaction which take place over a set time with individuals in the service. People we spoke to told us they could have visitors at any time and could meet with their friends and family in private if they wished. People who use the service told us they enjoyed their meals. Comments included; the food is very good, I do like the food here, its very well done and I have no complaints about the food. Through surveys, the majority of people said they usually enjoyed their meals. One person told us they only enjoyed the food sometimes. Consultation on the menu and individual preferences should be continued to make Care Homes for Older People Page 16 of 29 Evidence: sure that the food provided meets the preferences and cultural needs of people using the service. We saw meals were well presented and individuals were given support at meal times in a discreet and sensitive way. The menu for the week was on display on each table. Considerations could be given to providing the daily menu on the table in a more accessible format. Staff should continue to look at ways of making meal times less task based and more of a social event. Since the last inspection of the service a new dining room has been provided. This room which is on the ground floor was seen to be bright and spacious with large amounts of space for people to get in and out. The manager informed us that plans were in place to offer a fully organic menu in the future. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that any complaints they may have will be listened to and investigated. Staff awareness of safeguarding people has been raised with the support and training provided with the care home support team from the local authority. Evidence: The organisation has a clear complaints procedure which is provided to everyone using the service. When asked through surveys if they knew who to speak to if they were not happy everyone who responded said yes. Individuals we spoke to during this inspection were also clear about who they would speak to if they had a problem. All but one person said they knew how to make a formal complaint. Staff were found to be clear about their role in reporting any complaints they receive to the management of the home. Since the last inspection of the service the manager has introduced a suggestion box in communal areas into which people who use the service or visitors to the home can leave comments. These can be anonymous if people wish. The manager reported that so far no comments have been received. Systems are in place for all complaints to be recorded along with actions taken to resolve problems and outcomes. Since the last inspection of this service a number of safeguarding investigations have been carried out by the local authority. The major concerns were related to moving Care Homes for Older People Page 18 of 29 Evidence: and handling practises. Since this time the staff in the home have been supported by the local authority care homes support team who have provided significant amounts of additional training for staff including training on safeguarding people. Staff we spoke to and who responded to surveys told us they were clear about their responsibility to report any suspicion or allegation of abuse and that they had been provided with clear information on who issues should be reported to. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a comfortable and well maintained environment. The organisation continues to invest in improving the facilities available. Staff work well to keep the environment clean and fresh. Evidence: Since the last inspection of the service the home has been extended and improved. The new rooms created have been finished to a high standard and fitted out with good quality furnishings. Bathroom facilities have been improved with new assisted showers and baths fitted and older bathrooms up dated. New lounge areas and a dining room have been created and the main kitchen for the service has been fully refurbished. The laundry area has been up graded. These improvements are continuing with plans in place to continue to up grade the older parts of the building, re carpet the first floor corridor, up grade the reception area and to provide a patio area from one of the new lounges. People we spoke to were pleased with their own rooms both in the new areas and the older parts of the building. Those people who have lived in the home for some time were seen to have added their own ornaments, photos and furniture which has provided a personalised space. The new lounge areas as yet have a fairly bare appearance and would benefit from the addition of more items which people can engage with. Care Homes for Older People Page 20 of 29 Evidence: All of the people who use the service who returned surveys or were spoken to during this inspection said the home was always fresh and clean. When asked what the service does well one person told us that the home was always clean and tidy. All of the areas we saw during this inspection were clean and free from offensive odours. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported by a knowledgeable staff group who can benefit from good opportunities for training. Comments received from people who use the service indicated good relationships between staff and the people they support. Evidence: When asked in surveys what the service does well three people highlighted the staff in the service. Comments included; the staff are very good, we have nice staff and that staff are very pleasant. People we spoke to also made positive comments about the staff, they told us; the staff are lovely, they are very kind and they look after me very well here. the staff are the best. When asked if staff were available when they needed them two people said always and five people said usually. People told us that they did not have to wait a long time for staff to respond when they rang the bell for assistance. One person told us if I need anything I ring and they are there straight away. Feedback from staff was positive. Staff told us they were given good opportunities for training and that there were always or usually enough staff on duty to meet the needs of people using the service. When asked through surveys what the service does well staff told us; excellent work relationships a long standing staff group, encouraging staff development and opportunities for training, friendly staff group and community Care Homes for Older People Page 22 of 29 Evidence: spirit and high staffing levels so clients needs can be met and there is time for attention to detail in care. We looked at the records of staff training. Over half of the care staff have achieved NVQ level 2 or above. Staff have been provided with significant amounts of training over the last year. This has been provided both in house, from the care homes support team and other outside agencies. This training assists in ensuring that people who use the service are supported by a well informed staff group who are kept up to date with current good practise. The staff we spoke to were enthusiastic about the training they had received and were keen to continue with further training. We were informed that the organisation provides a good budget for training. Senior staff have completed training to become assessors and trainers which helps staff access further in house training. Consideration could be given for further, more advance training, on care planning and dementia care. In order to assist staff in moving away from task based care consideration could be given to providing training on person centred care. Senior staff should also make sure that all staff are taking up the opportunities available to them for training. Although the majority of staff were seen to have joined in a number of training sessions in one file we looked at there was very little evidence of recent training. We looked at a sample of staff files and found evidence in the majority of these that pre employment checks, including Criminal Records Bureau checks had been carried out before staff had commenced work in the home. However in two instances two written references, including one from the previous employer were not on file. Plans are in place to increase the staffing numbers as the number of people using the service increase. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service benefit from a well organised and run home. Staff carry out regular checks on equipment and the environment to assist in ensuring the safety of people who use the service, staff and visitors. Evidence: People who use the service made positive comments about the manager and the way the service was organised. Individuals told us the service was very well run and that the manager was approachable and there if you need her. Feedback from staff indicated that they feel well supported in their role. Several members of staff informed us that the organisation and management look after their staff. The manager has the appropriate experience, knowledge and qualifications to run this type of service and continues to keep up to date with good practise through training. The manager informed us that the service has appreciated and benefited from the additional training and advice provided by the local authority care home support team. Care Homes for Older People Page 24 of 29 Evidence: People who use the service are consulted on how the home is operating through regular resident and relatives meetings. The organisation also sends out their own surveys to people who use the service to check that the quality of care and accommodation is being maintained. We looked at a sample of the records kept for money held in safekeeping for people who use the service. These records were well maintained, up to date and accurate. We also looked at a sample of the records kept on health and safety checks. These records showed regular checks by staff on equipment and the building to ensure the safety of people who use the service, staff and visitors. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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 2 7 7 Care plan reviews should include information on outcomes for individuals as well as any changes in needs. Care planning should include more detail on how the particular needs of individuals will be met. The personal strengths and preferences of individuals should be included to assist in providing support and care to people in the way they wish. Staff should be provided with clear information on the type of hoist to be used and the size of sling for all individuals who need this type of support. Where individuals are using pressure relieving matressess information on the settings to be used for each person should be recorded and available to staff. Where staff have not followed the plan of wound care they should record the reasons for this. Consideration should be given to including the social profile for each person at the front of their personal file. Consideration should be given to providing staff with further training to assist them in providing more person centred care which addresses the social, emotional and Page 27 of 29 3 8 4 5 6 8 12 12 Care Homes for Older People 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 cultural needs and wishes of the people they support. 7 8 15 29 Work should continue to make meal times a more social event and more of a highlight in the day. Consideration should be given to carrying out a final check of staff files before they commence work in the home to make sure that all relevant documents have been obtained. Care Homes for Older People Page 28 of 29 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. 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