Care Home: Willow Gardens Care Home

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What the care home does well The people living at Willow Gardens told us that they like living there with comments such as, I love it here. Its my life and It must be okay or I would leave. People like the staff team and during our visit we observed that staff have a good knowledge of the people living there and their support needs. We also observed that staff are respectful towards the people living there and take time to talk with them as well as meet their basic health and personal care needs. Before anyone moves into Willow Gardens they or their representative are able to visit and look around and are provided with information about how the home is run. This helps people to make an informed decision about whether they would like to live there. The people living at Willow Gardens receive good support to meet their health care and personal care needs. This is backed up with clear care planning to guide staff in how to support the person in the way they need and choose. There are a wide range of activities at Willow Gardens that people can access both within and outside of the home. This helps to ensure that people can live a varied lifestyle based on their choices. Good systems are in place for recruiting new staff, including carrying out a series of checks on the person. This helps to ensure staff are suitable to work with people who may be vulnerable. What has improved since the last inspection? Menus have been reviewed with the people at Willow Gardens to provide more options for people to eat healthy. Since the last inspection the following areas have all been redecorated eight bedrooms, two stairwells and foyer, the training room, dining room, upstairs lounge and six bathrooms and toilets. On the disabled unit people are being encouraged to make their own meals to become more independent. What the care home could do better: Information about how the fee structure in the home alters depending on how the person pays for their care is not as clear as it could be. This could lead to people not fully understanding the fee they need to pay before deciding to move into the home. Assessments carried out by staff for people considering moving into the home are not always as detailed as they should be. This could lead to not all of the information being initially available that would help staff plan how to successfully support the person. Parts of the environment at Willow Gardens would benefit from refurbishment or redecoration. In addition planned improvements to the environment should be acted upon in a more timely manner. This would help to provide a more pleasing and homely environment for people to live in. Staff do not receive the training they need to keep them up to date with current good practice, refresh their knowledge and ensure they are aware of new laws and legislation. This could lead to the people living at Willow Gardens not being supported as successfully as they could be. The home currently has no manager registered with ourselves. An application for the manager to register needs to be made as soon as possible, as this process helps to ensure managers are suitably qualified and experienced to operate a care service. Key inspection report Care homes for older people Name: Address: Willow Gardens Care Home St Edmonds Road Bootle Liverpool Merseyside L20 7AJ     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: Lorraine Farrar     Date: 0 6 1 1 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Willow Gardens Care Home St Edmonds Road Bootle Liverpool Merseyside L20 7AJ 01519224324 01519227437 willow@europeanwellcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: European Wellcare Homes Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 2 named female out of category service users, under pensionable age. The variation applies to the named service users only, should they leave the Home then the variation will cease to apply. Not accommodated in Willow View Unit. Bedroom number 24 to accommodate one named PD service user to be reviewed on the 01/06/06 One named service user accommodated on the unit known as Willow View. To be reviewed on 01/06/06 Service users to include up to 22 OP(N) Service users to include up to 24 PD to be accommodated within the unit known as Willow View. The age range between service users in the Willow View Unit should be no more than 25 years . Date of last inspection Care Homes for Older People Page 4 of 27 Over 65 22 0 0 24 Brief description of the care home Willow Gardens is situated in the Bootle area of Liverpool. It provides care with nursing for up to twenty two older people and twenty four younger adults who have disabilities. The building is purpose built and provides accommodation over two floors. The unit for younger adults is on the top floor with accommodation for older people provided on the ground floor. The younger adults unit is referred to as Willow View and has separate facilities and staff to the older persons service.All bedrooms are single rooms with many providing en-suite facilities and all having sinks. There are gardens to the rear and sides of the home that provide space for people to sit outside in good weather. These are easily accessible from the large ground floor lounge. The home is privately owned and the company have a variety of other homes within the UK, providing care for people with a wide range of differing needs. Willow Gardens is near to local amenities including a local shopping centre. There are bus and train stops nearby and car parking facilities within the grounds. It currently cost between GBP322 and GBP650.49 each week to live at Willow Gardens. Fees are based on the persons assessed support needs. 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: We gathered information for this inspection in a number of different ways. We carried out an unannounced visit to the home on 6th November 2009. This took place over nine hours and including reading records and looking at the building. We spent time looking at the support the people living at Willow Gardens receive. This included looking at the support they get with their daily lifes, care plans, medication, money, activities and environment. We talked with ten of the people living there and with eight members of staff including the manager. Any information we have received since the last big inspection of Willow Gardens in 2008 was reviewed and taken into account in writing this report. Care Homes for Older People Page 6 of 27 It currently cost between £330.00 and £849.45 to live at Willow Gardens. Fees are based on the persons assessed support needs. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Information about how the fee structure in the home alters depending on how the person pays for their care is not as clear as it could be. This could lead to people not fully understanding the fee they need to pay before deciding to move into the home. Assessments carried out by staff for people considering moving into the home are not always as detailed as they should be. This could lead to not all of the information being initially available that would help staff plan how to successfully support the person. Parts of the environment at Willow Gardens would benefit from refurbishment or redecoration. In addition planned improvements to the environment should be acted upon in a more timely manner. This would help to provide a more pleasing and homely environment for people to live in. Care Homes for Older People Page 8 of 27 Staff do not receive the training they need to keep them up to date with current good practice, refresh their knowledge and ensure they are aware of new laws and legislation. This could lead to the people living at Willow Gardens not being supported as successfully as they could be. The home currently has no manager registered with ourselves. An application for the manager to register needs to be made as soon as possible, as this process helps to ensure managers are suitably qualified and experienced to operate a care service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is provided to and obtained about people moving into Willow Gardens. However this is not always as detailed as it should be, which could lead to peoples needs and choices not being fully recognised and met within the service. Evidence: In discussions with the people living at Willow Gardens and with a relative they were all positive about the home and the service they receive. Comments included, I love it. Staff really friendly, I would recommend it to anyone and total satisfied with the quality of care, staff attitude, accommodation. A guide to the services provided at Willow Gardens is readily available in the foyer and a relative we spoke with confirmed that they had been given this information. This tells people about things such as how the home is run, staffing, the environment and how to raise concerns. The guides states that it can be made available in a number of different formats including audio, large print and pictures. This helps to ensure that Care Homes for Older People Page 11 of 27 Evidence: everyone can receive the information in a way they find easy to understand. Information about the range of fees in the home is also included and states that they can vary depending on funding and the type of support the person needs. However it does not make it clear how the fees charged will alter if someone is paying for themselves. In discussions with a visitor they explained that they did not feel the literature explained to them that the fee would increase once someone is paying for their own care. This could lead to confusion and concern for the person and for the people supporting them with their finances. Before anyone moves into Willow Gardens they or their representative are invited to visit the home and look around. A visitor explained that they had look around several homes and chosen Willow Gardens as it didnt have an odour and their relatives has everything she needs here. Staff from Willow Gardens visit the person to carry out an assessment of their needs, before offering them a place to live. A standard assessment form is used. We looked at forms for two people living there and found the contents variable. One form was well completed with information about the persons support needs, their hobbies and health. The form for the second person had not been completed in as much detail. As this information is used to decide if Willow Gardens can meet the persons needs and to plan their care, a lack of detailed information may impact on the initial support the persons receives. The forms do not have a section to record information about any diverse needs or choices the person may have, for example relating to their religion or culture. This may mean that staff are not fully aware of the persons choices and needs and therefore cannot plan how to meet them. Willow Gardens does not provide an intermediate care service. 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. The people living at Willow Gardens get the support they need and choose with their health and personal care. Evidence: The people living at Willow Gardens told us that they get the help they need with their personal care. They told us that they can have a bath or shower whenever they want, anytime, just ask them and that they can get up or go to bed when they choose, you do what you want. They also told us that if they use the buzzer to call for help staff respond quickly, they come right away to see what you want. People also told us that they get the support they need with their health. One person explained, They check on you by the minute and others that staff get the GP if needed, manage their pain well and ensure they get their medication on time. Individual care plans are in place for the people living at Willow Gardens and we looked at a sample of these. The people living there told us that they are aware of the plans as staff talk to them about it a lot. This is good practice as it supports people Care Homes for Older People Page 13 of 27 Evidence: to be as involved as possible in planning the service they receive. Care plans are up to date and reviewed regularly by staff with input from the person. They give clear guidance to staff about how to support the person with their health and personal care and contain information about the persons social and cultural needs and choices. In addition a series of assessments and risk assessments are completed regularly. These cover areas such as risk of falls, continence, mobility and condition of their skin. These assessments along with the care plans help to ensure people get the support they need to remain as healthy and well as possible. Records show that staff support people to attend routine health appointments such as the chiropodist and optician as well as seeking specialist. In discussions with staff they displayed a good knowledge of the support people need with their health and well being as well as with their everyday lifestyles. The people living there told us that they find staff helpful and polite. We observed throughout the day that staff take time to talk with people as well as meet their practical needs and they are polite and respectful, for example knocking on doors and waiting for a response. Information about advocacy services is available in the home and staff support people to obtain and work with an advocate if they wish to. The people living there also told us that they are able to make their own decisions, with one person explaining, I make my own mind up and another, you do what you want. Locked medication rooms are available on both units at Willow Gardens and we looked at a sample of medication management in the home. We found that medication was stored correctly and records well completed. A check of a sample of medication held in the home tallied with records of medication received and given to the person. Audit systems are in place for staff to check medication regularly. This also helps to quickly identify and deal with any issues that may arise. A recent error with medication in the home was noted by staff and action taken to deal with it, including seeking medical advice to confirm that the person would not be harmed by the error. Care Homes for Older People Page 14 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 living at Willow Gardens get the support they need to lead a lifestyle of their choice. Evidence: The people living at Willow Gardens told us that they usually like the meals provided. One person explained there is never anything left on my plate, and others described meals as varies lovely and cant fault them with the food. People also explained that the chief comes around daily to ask what they want to eat and if you dont like it you can have something else tell chef, they oblige if you ask. Records showed that people are offered a varied diet including healthier eating options. The kitchen will cater for any specialist diets based on a persons health or religious and cultural needs and have access to information about specialist diets. This all helps to ensure people are getting a real choice around the meals they are offered. Willow Gardens employs a full time and a part time activity coordinator to support the people living there. Activities are arranged on an individual and group basis and take place within and outside of the home. The people living there told us that they enjoy Care Homes for Older People Page 15 of 27 Evidence: the various activities provided explaining, I go out. Join in. Mini bus, outings and one person explained they can do anything we want with regards to activities. Discussions with the people living there and records confirmed that activities are available to suit everyones choices. For example a bonfire party had been held the previous night that families were invited to. At home activities in the past month included quizzes, bingo, art, using the Wii fit and exercise bike. There is also a visiting hairdresser and regular communion services for those who wish to attend. Visitors are welcomed at a reasonable time with a visitor explaining that they are informed of planned activities and welcome to join in if they wish. The home have arranged two holidays this year for people who wished to go, this included a holiday to Benidorm and one to Blackpool. Activities outside of the home include going to a local cinema and bingo club, trips to local places such as the safari park, shopping and attending local classes for art and computers. The range and amount of support provided with activities helps to ensure the people living at Willow Gardens get support to live an interesting lifestyle based on their choices. Care Homes for Older People Page 16 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 living at Willow Gardens are confident they can raise any concerns they have and staff will listen and support them. Evidence: The people living at Willow Gardens told us that they know who to talk to if they are unhappy or have a concern or complaint and they are confident the manager or staff would help them. One person told us they had, no complaints about anything its wonderful. Another person explained they would talk with the manager as, she would ask why and do something about it. A relative and the people living there also told us that the manager regularly asks them if everything is going well, explaining they have easy access to her and she comes and chat. Information about how to raise a concern or complaint is displayed in the foyer and is available in the guide to the home that people are given. This all helps to ensure the people living there feel confident in raising any concerns that may arise. Staff have had training in recognising adult safeguarding issues and in discussions were able to explain the indicators that would alert them to a potential issue. Care Homes for Older People Page 17 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. Willow Gardens provides a safe, clean environment which meets the needs of the people living there. However parts of the home would benefit from redecoration and repair in order to provide a more pleasant environment for the people living there. Evidence: Willow Gardens is a purpose built home providing accommodation over two floors, with a lift providing access to the first floor. Everyone living there has their own bedroom, fifteen of these have en suite facilities with other bedrooms having a wash basin. The younger adults who have physical disabilities live on the first floor known as Willow View, whilst the ground floor accommodates older people who need support with nursing care. Downstairs people share a large lounge and dining room. The dining room is nicely decorated and furnished providing a pleasant relaxing room for people to use. The downstairs lounge was decorated in 2008 and although at that time we were advised new chairs were being purchased, during this visit the chairs in this room remained mis-matched, causing the room to look less welcoming and homely than it could do. On the first floor people share two lounges and a kitchen that has been adapted for use by people with physical disabilities. The rooms on this floor have more of a welcoming homely atmosphere and we observed that the people living there used Care Homes for Older People Page 18 of 27 Evidence: both lounges and the kitchen as they chose. We noted at out inspection in 2008 that some areas of the home would benefit from redecoration and that although the organisation had identified work to carry out this had not commenced. At this visit we noted that although some of this work had been completed, for example painting woodwork in a bathroom, other areas appeared shabby. For example one bathroom had discoloured tiles, cracked floor tiles and no blind at the window, a toilet had a very rusty radiator and the frame around the upstairs shower room was chipped, which could lead to splinters. Some bedrooms had been redecorated but had no carpets so they could not be used. We were advised that one person was waiting to move back into their decorated room but no date had been given for the new carpet to be fitted. A number of aids and adaptations are available at Willow Gardens to support people to get around and with their mobility. This includes the lift, hoists, shower trolley, accessible baths and grab rails. One of the people living there explained that they felt another stand aid was needed. The manager was aware of this and advised that plans were in place to purchase one. It had been raised at a residents meetings by one of the people living there that they felt notice boards should be located lower on the walls so people who use a wheelchair can read them more easily, however this had not yet happened. Bedrooms are warm and comfortable and the people living there can personalise these. For example one person was drawing a mural on their bedroom wall and a relative explained that people are able to bring their own furniture and possessions with them. This is good practice as it enables people to feel more comfortable with their surroundings and that they have a personal space they can use. Outside there is a small car park and private gardens with places for people to sit. Willow Gardens was clean and tidy during our visit and one of the people living the explained, Its spotless. We have cleaners morning noon and evening. Policies are in place for the control of infection in the home and appropriate disposable equipment is provided. Our visit to the laundry room showed that infection control polices are carried out and staff are provided with the equipment they need to help prevent an outbreak of infection. We also noted that since our last inspection new towels and bedding have been provided, again these help to add to a more homely and welcoming atmosphere. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Willow Gardens are supported by a staff team in who they have confidence. However a lack of planned training for staff may lead to people not being supported as safely and well as they should be. Evidence: The people living at Willow Gardens told us that they like the staff who support them. Their comments included, staff are, very good. We get on well together and Staff are marvellous, I like them. We have a laugh. People also told us that there are enough staff to support them when needed. During our visit we observed that staff were able to respond quickly to requests for support and that they took the time to socialise with the people living there as well as meet their everyday support needs. Staff explained that this had been helped by the addition of extra staff to provide support during the evening. In discussions with staff they had a good understanding of the people living at Willow Gardens and how to meet their individual needs and choices. We also observed that staff had built good relationships with the people living there. Most of the staff team hold or are working towards a nationally recognised qualification (NVQ) relating to their job role. For example care staff work towards an NVQ in care whilst domestic staff are working towards an NVQ in services. This helps to ensure staff are aware of good practice in how to support people successfully. However we identified at our inspection in 2008 that some staff training was out of date and were advised that this was being addressed. During this site visit no overall training plan was in place to Care Homes for Older People Page 20 of 27 Evidence: plan training for the staff team although this had been identified at an audit carried out by the organisation in October 2009. In discussion staff were able to tell us that they had attended various training courses and staff explained they can request relevant training if they need it. However records showed that not all staff have undertaken training in basic areas of care such as fire and moving and handling people within the past twelve months. Although records showed that most staff had received some training in the past year we saw records for one nurse who had not had any training in 2009. It is important that a training plan is put into place based on both basic areas of care as well as the more specialist areas of support the people living at Willow Gardens need. For example although some relevant staff have had training in the Mental Capacity Act they had not had training in the new Deprivation of Liberty laws. As these may impact on some of the people living at Willow Gardens now or in the future it is important that staff receive this training. We looked at a sample of staff files and found that before anyone is appointed to work at Willow Gardens a series of checks are carried out on them. This includes obtaining references and a CRB (Criminal Records Bureau) check. These checks help to ensure that staff are suitable to work with people who may be vulnerable. In discussions with a newer member of staff they explained that they had a thorough induction to working at the home. This included shadowing experienced carers and being supported to go at my own pace to enable them to build confidence, as well as undertaking some training. This planned induction helps to ensure that new staff gain a good understanding of the people they support and of how to provide that support successfully. It also provides the people living there with the opportunity to get to known and trust staff who will be supporting them with personal care in the future. Care Homes for Older People Page 21 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. Willow Gardens has systems in place for safely managing the service. Evidence: Willow Gardens has an appointed manager who has worked there for several months. She is an experienced manager who holds a registered nurse qualification and keeps herself up to date with current good practice in supporting people safely and well. In discussion the manager explained that she intends to undertake a management qualification and is aware of the need to apply to ourselves to register as the manager of Willow Gardens. However as identified during our last inspection in 2008 there has been no registered manager at the home for some time. As the process of a manager becoming registered with ourselves helps to ensure that they are suitable, qualified and experienced to manage a care service, it is important that an application to register the manager is made as soon as possible. The organisation act as appointee for the benefit money of some of the people living there. They also provide storage within the home for people to hold smaller sums of Care Homes for Older People Page 22 of 27 Evidence: money. We checked a sample of records of money held in the home for people and found these tallied with receipts and bank statements. Internal audits of peoples money are carried out on a monthly basis, this helps to ensure that peoples money is managed safely and that any issues can be quickly noted and addressed. There are several systems in place at Willow Gardens for the organisation to audit and check the quality of the service they are providing. For example staff files have been audited to ensure they contain the required information and audits of the building and environment are carried out. In addition a monthly visit to the home is carried out by a senior manager from within the organisation. We looked at a recent audit from October 2009, this covered areas such as the environment, health and safety and staffing. A report of the visit is put together and lists actions to take to improve the service. For example the audit we looked at noted that training needed to be updated and a training matrix put into place. These audits provided a way for the organisation to check the quality of the service they are providing and plan future improvements. However as identified within this report identified areas for improvement are not always addressed in a timely manner. Records and certificates in the home showed that regular checks are made on the building and equipment to ensure it is safe. This includes contractors checks on equipment such as scales, fire and gas as well as in house checks on fire equipment and fridge and food temperatures. This all helps to ensure Willow Gardens is a safe place for people to live, work and visit. Care Homes for Older People Page 23 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 24 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 1 30 18 A training Plan must be 11/02/2010 complied and adhered to for staff. The plan must be based on both basic areas of care and the more specialist support people living at Willow Gardens require. This will help to ensure the people living at Willow Gardens are supported by a knowledgeable staff team 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 1 Information about how fees vary depending on whether people are funding themselves to stay at Willow Gardens should be clear in the service users guide. This will help ensure that people have as much information as possible about the fees they will be expected to pay before they make a decision about living at the home. A system should be put into place to ensure as much information as possible about the persons needs and choices is included in their pre admission assessment. Page 25 of 27 2 3 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 This will help to ensure the home can support the person and plan how to do so successfully. 3 19 A system should be put into place to ensure planned maintenance and decoration occurs in a timely manner. This will help to provide a more pleasant environment for people to live in. The manager must apply to register with the Care Quality Commission as soon as possible. This will help ensure she is a suitable person to manage a care service. Care plans should be put into place regarding supporting people to manage their finances. This should include where applicable an assessment of their capacity, why the company act as appointee and how they support the person to manage their money. This will help ensure that peoples money is safely managed in their best interests. 4 31 5 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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