Care Home: Windy Ridge Nursing Home

What the care home does well Prospective residents are given information about the home and can have a look round to see if the home meets their expectations. The home carries out comprehensive assessments of need of those referred for possible admission so that only those whose needs can be met are accommodated. Care plans are of a good standard and include guidance for staff in meeting residents` needs. The home works closely with community health services to ensure residents` needs are met. The home has an activities co ordinator and there is a programme of activities for residents which includes entertainment, arts and crafts and outings. Residents and relatives report that the food is of a good standard and there is a choice at each meal including a cooked breakfast. The home deals with any complaints or concerns that are raised. The environment is of a very good standard and improvements include redecoration based on guidance from a specialist in providing a suitable environment for those with dementia. Staff report that this has had a very positive effect on the lives of the residents. Sufficient numbers of staff are provided to meet residents` needs. There is a Registered General nurse on duty 24 hours a day. Staff have access to various training courses including training in dementia care, nursing procedures and National Vocational Qualifications (NVQ). Staff report that they are supported by the home`s management to complete training. The manager is motivated to develop the service and uses a number of audits and checks to monitor and improve the home. These include regular surveys, checks on aspects of the home`s operation and the training and performance of staff. The home promotes the health and safety of its staff and residents. Comments in surveys and from interviews, show that relatives, residents and health and social care professionals have a high regard for the service. One comment from a visiting professional states: `Windy Ridge is a very kind, welcoming, and secure home for very vulnerable people. The care and attention of all the staff from the manager down, is quite outstanding. They are to be commended.` What has improved since the last inspection? There is evidence from a variety of sources that the manager has had a very positive impact on the home. Redecoration of communal areas and bedrooms has taken place, including recarpeting of 8 bedrooms. Electric profile beds have been provided for 10 residents. Otherfurniture and fittings have been replaced. Signs are used around the home to help residents with orientation. Toilets and bathrooms have been refurbished. The home has continued to develop its assessment and care plan process. The home has introduced weekly `surgery` visits to the home by the local general practitioner. A system of using volunteers has been introduced to provide interaction and stimulation for the residents. These people have a connection with the home and undergo the same recruitment as other care staff and have an induction. The home continues to develop its activities programme for the residents. The complaints procedure has been improved. It is now more freely available and a record is kept of each complaint or concern that is raised. Staff training has developed and includes attendance at a dementia workshop for 14 staff. More staff have completed NVQ training. and distance learning courses are now provided. The manager has increased and improved the systems of checks and audits such as survey questionnaires to relatives and visiting professionals. What the care home could do better: Staff recruitment procedures need to be closely monitored to ensure each person has the required checks before starting work. Records of money held on behalf of residents needs to be improved. Access to and from first floor bedrooms could be improved as the stair lift only reaches the first floor landing leaving a further 4 steps for residents to negotiate. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Windy Ridge Nursing Home 32 Barton Lane Barton-on-Sea New Milton Hampshire BH25 7PN     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: Ian Craig     Date: 1 2 0 3 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 30 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 30 Information about the care home Name of care home: Address: Windy Ridge Nursing Home 32 Barton Lane Barton-on-Sea New Milton Hampshire BH25 7PN 01425610529 01425610929 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): MNS Care PLC Name of registered manager (if applicable) Anthony Yon Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 21. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Date of last inspection Brief description of the care home Windy Ridge Nursing Home is a care home offering nursing care and personal care for up to 21 service users that have dementia in the older person category. The home is situated in a quiet residential area of Barton on Sea with access to some local amenities and close to the seafront. Accommodation is provided on two floors. MNS Care PLC owns the service. Fees range from 585 pounds a week for a double room to 680 pounds a week for a Care Homes for Older People Page 4 of 30 care home 21 Over 65 0 21 Brief description of the care home single room. This information was obtained at the time of the inspection visit. Members of the public may wish to obtain more up-to-date information from the care home. Care Homes for Older People Page 5 of 30 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 inspection consisted of a site visit of approximately 5.5 hours, during which a tour of the home took place. Three staff were interviewed about their work at the home. Two residents relatives and two residents were also spoken to. Discussions took place with the manager. Surveys were sent by the Commission to residents, health and social care professionals and staff, asking for their views on the service provided by the home. These were returned by 9 staff, 5 health and social care professionals and 10 residents. The residents were given help by relatives and carers to complete the surveys. Information contained in the surveys has been used for this report. Care Homes for Older People Page 6 of 30 Records, documents and policies and procedures were looked at. Staff were observed working with the residents. Care services are required to complete an Annual Quality Assurance Assessment (AQAA). This was completed by the home and returned to the Commission. Information contained in the AQAA has been used for this report. What the care home does well: What has improved since the last inspection? There is evidence from a variety of sources that the manager has had a very positive impact on the home. Redecoration of communal areas and bedrooms has taken place, including recarpeting of 8 bedrooms. Electric profile beds have been provided for 10 residents. Other Care Homes for Older People Page 8 of 30 furniture and fittings have been replaced. Signs are used around the home to help residents with orientation. Toilets and bathrooms have been refurbished. The home has continued to develop its assessment and care plan process. The home has introduced weekly surgery visits to the home by the local general practitioner. A system of using volunteers has been introduced to provide interaction and stimulation for the residents. These people have a connection with the home and undergo the same recruitment as other care staff and have an induction. The home continues to develop its activities programme for the residents. The complaints procedure has been improved. It is now more freely available and a record is kept of each complaint or concern that is raised. Staff training has developed and includes attendance at a dementia workshop for 14 staff. More staff have completed NVQ training. and distance learning courses are now provided. The manager has increased and improved the systems of checks and audits such as survey questionnaires to relatives and visiting professionals. 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. 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 30 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 30 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. Prospective residents are able to make an informed choice about whether or not to move into the home. The home carries out comprehensive assessments so that it accommodates those people whose needs it can meet. Evidence: The home has a Service Users Guide and a Statement of Purpose, which give details of the service provided by the home. These have been updated by the current manager. The Service Users Guide and a brochure are supplied to prospective residents at the point of enquiring about a placement at the home. Residents relatives confirmed that they received enough information about the home to help them decide if it was the right place for their relative to move into and that they were able to visit the home to have a look round. Care Homes for Older People Page 11 of 30 Evidence: Records show that the home carries out its own assessment of the care needs of those referred for possible admission before they move into the home. The pre admission assessments are signed and dated by the person completing them and cover the following needs: mental health, physical health, medication, allergies, emotions/mood/behaviour, social activities, previous occupation, communication, nutrition and feeding, personal care, skin integrity, oral/vision/hearing, mobility, continence, catheter, sleep pattern, bed rails, pressure care and pressure care risk assessment. Records also contain copies of assessments and care plans by referring social services care managers as well as hospital discharge summaries. Care Homes for Older People Page 12 of 30 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 residents individual care plans are of a good standard. The home works effectively with community health services to meet residents needs. Residents privacy and dignity is promoted. Evidence: Following admission, the home continues the process of assessing residents needs. This includes completing a history of the persons background plus the following assessments: nursing needs, daily living needs, nutrition and diet, risk of pressure sores and moving and handling plus risk assessments for falls and use of bed rails. Care plans are recorded for each person and were found to include details of how staff should meet mental health needs, personal hygiene, help with feeding, socialising, managing pain, managing falls, continence, confusion, disorientation, care of pressure areas and sleep. Care plans are signed by the member of staff completing them and residents relatives also sign to acknowledge the content of the plans. Literature is held with care plans on the mental health needs of individual such as specific diagnosis of Care Homes for Older People Page 13 of 30 Evidence: dementia and other mental health symptoms. Care plans are reviewed and updated on a regular basis. Daily running records are maintained to show that residents individual needs are monitored. For those residents that prefer to stay in their rooms, an interaction chart is used to record and show that the person has regular contact with staff. The home employs an activities person who has the specific brief to spend time with residents on an individual basis. Records show that health needs such as blood pressure and weight are monitored. Mental health needs are monitored and records show that the home liaises with community mental health services so that specific medical input takes place for changing needs. Health care professionals state that the home always or usually meets the health care needs of the residents and that there is frequent liaison and joint working with community mental health services and local general practitioners. The home is reported to be pro active in seeking specialist advice. Comments from health care professionals include the following: The staff always work hard to provide individualised care to the residents. Another person said that the home is good at managing residents behavioural problems without drug therapy. Residents spoken to on the day of the visit said that their care needs are met. Relatives confirmed during interview, and in surveys, that the residents always receive the care and support they need and that they always receive the medical support they need. One relative commented that the standard of care is very high and another person said that everyone knows who their keyworker is. Relatives also said that they are kept informed of any changes to their next of kin living at the home. Care staff spoken to on the day of the visit said that the care needs of the residents are met. Staff described how medical and health needs are addressed, how the home works with community health services and that relatives are involved in decision making regarding care. Staff surveys confirmed that staff are aware of the care plans and that these are individualised according to each persons needs. Staff state that they receive training in caring for the residents including continence management, mental health needs, catheterisation and specialist nursing procedures. The home has training links with the Alzheimers Society and other national organisations providing courses in dementia. Health care professionals state that the home promotes residents privacy and dignity. Residents and relatives describe the staff as kind and helpful. Staff were observed to Care Homes for Older People Page 14 of 30 Evidence: treat residents with respect. Privacy screens are provided in shared rooms. The homes medication procedures were looked at. The home uses a monitored dosage system to handle and administer medication. Staff record a signature each time medication is administered. Stocks of medication show that residents receive medication as prescribed. Controlled medication is stored according to pharmaceutical guidelines and two staff witness and record their signatures plus the balance of remaining medication in a controlled drug register. Staff receive medication training, which was confirmed from training records and from staff themselves. Care Homes for Older People Page 15 of 30 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 living at the home benefit from a range of activities that meet their individual needs and wishes. The home provides nutritious and well balanced meals with a choice at each meal. Evidence: The home employs an activities co ordinator for 25 hours a week. This person is trained in reflexology and has National Vocational Qualification level 3 in health and social care. An activities programme is displayed in the hall and copies are given to residents. The programme includes music therapy, music and movement, arts and crafts, entertainment from visiting musicians and individual one to one with a staff member. Residents confirmed that activities are provided and that these are enjoyable. A relative said that there is always something happening such as arts and crafts or a music from a visiting singer. The home has a small team of volunteers who spend time with the residents and were observed interacting with the residents. At the time of the visit there was a religious service taking place in the lounge. A resident had a display of plants in his/her room Care Homes for Older People Page 16 of 30 Evidence: from a gardening class he/she attended. This person also said how much he/she enjoys reading and had a supply of books and magazines. Another person has a daily newspaper. A notice in the home gives details of a forthcoming trip out by mini bus to Milford on Sea. Photograph displays show residents taking part in activities such as gardening classes and parties. Residents said that they are able to spend their time as they wish. This includes taking part in activities or spending time reading or watching television in their rooms. The home has a 4 week menu plan. Residents are asked in advance what they would like to eat and this is recorded and passed to the kitchen staff for preparation. Cooked breakfasts are available.Residents said that they like the meals. Residents were seen eating the midday meal. Staff gave assistance to those that needed help. Care Homes for Older People Page 17 of 30 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 home deals with any concerns or complaints in an open way and takes steps to ensure that vulnerable people are protected from possible harm. Evidence: Each of the residents who returned a survey say that staff listen and act on what they say and that they are aware of the complaints procedure. One person said that the homes staff give me full time for listening. Another relative said that communication with the homes staff and management is good and that a recent concern was informally raised and dealt with satisfactorily. The complaints procedure is displayed in the hall and is also available in leaflet form in the home. The Service Users Guide also gives details of the complaints procedure. The AQAA states that the home has received 4 complaints in the last 12 months. A log of these complaints is recorded as well as the action that has been taken to look into the matters raised and the action being taken by the home. The home has its own abuse procedure as well as a copy of joint social services and health trust policy. Staff receive training from the Alzheimers Society in protecting people from possible harm, and via distance learning courses. This was evidenced from training records and discussions with the staff and the manager. Staff said in surveys Care Homes for Older People Page 18 of 30 Evidence: that they know what to do if any concerns are raised about the service. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and decorated to a very good standard. Residents benefit from improvements to the environment and the specialist input for providing living spaces specifically for those with dementia needs. Evidence: Improvements have been made to the environment. The manager described how the home followed the guidance of an expert in environments for those with dementia by redecorating communal areas with bright colour schemes, pictures, murals and using signs on and near doors. A volunteer said that the residents comment on how much they like the colour schemes and that it helps residents to find their way around. Residents relatives commented on how much redecoration has taken place and that the home is clean. A resident said how much he/she likes his/her room saying, I like my room. It is always clean and the colours are bright. I have my own things around me. Bedrooms were seen to be personalised with residents belongings. Screens are provided in shared rooms. Residents ave lockable storage space in their bedrooms. Call points are provided in each room so that residents can ask for assistance. Staff were observed responding to a resident using the call point system. Two residents relatives commented on how the environment has improved through Care Homes for Older People Page 20 of 30 Evidence: redecoration and the purchasing of additional equipment, which incudes 10 nurse profile beds. A relative described the bedroom of his/her next of kin as very very good. Visitors and residents were seen using the communal lounge and dining area. Toilets and bathrooms have been redecorated and refurbished. There is one bathroom on each floor. One has a walk- in shower and the other a bath with a hoist. Access to the first floor is via stairs or a stairlift. The stair lift does not extend to the final 4 steps up to bedrooms on the first floor. This was discussed with one person who didnt mind as he/she preferred to spend time in his/her room. The manager is aware of this restriction and considers this. For instance, a resident was offered a ground floor room which was declined. The home is clean with no unpleasant odours. Residents and their relatives commented on how clean the home is. Each one of the surveys commented that the home is always fresh and clean. Care Homes for Older People Page 21 of 30 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 home provides suficient numbers staff who are supported and trained to a good standard, which benefits the people who live there. Recruitment procedures protect residents although this needs to be monitored. Evidence: The home aims to provide the following staffing levels: 8am to 2 pm, 1 Registered General Nurse and 4 health care assistants; 2pm to 8pm, 1 Registered General Nurse and 3 health care assistants. The following waking night time staff are provided: 1 Registered General Nurse and 2 health care assistants. The staff rota and observation showed that these staffing levels are maintained. The following staff hours are also provided each week: 40 hours maintenance person, 15 hours administrative support, 25 hours activities co ordinator, 37 hours cook, 14 hours assistant cook, 14 hours kitchen assistant, 40 hours laundry assistant, 35 hours cleaners and a manager for 40 hours. The home also has volunteer workers who work in the home for a variable number of hours each week. Staff spoken to on the day of the visit said that there are enough staff to meet the residents needs. 8 of the 9 surveys returned by staff state that there are always enough staff to meet residents needs. One person answered usually to this question. Care Homes for Older People Page 22 of 30 Evidence: Residents described the staff as kind and helpful. One person said that he/she enjoyed having a laugh with the staff. Health care professionals state that the staff always or usually have the right skills and experience to meet social and health care needs. One relative and one professional commented that the numbers of overseas workers somtimes caused language and cultural issues. The home employs 4 Registered General nurses and 14 health care assistants. 9 of the health care assistants have National Vocational Qualifiaction (NVQ) level 2 in care and 3 of these are qualified at NVQ level 3 and one NVQ level 4. The cook is studying NVQ level 2 in catering, and a domestic assistant NVQ level 2 in housekeeping. The manager has a training programme to monitor that staff receive training in moving and handling, health and safety, abuse, infection control, food hygiene , first aid, contamination by substances hazardous to health (COSHH), legislation , communication and nutrition. Staff training records are also maintianed and show that staff also attend other courses such as handling aggression, swallowing difficulties and medication. Staff spoken to said that they receive regular training and supervision. The manager has a staff supervision plan in the homes office. Records and discussion with staff show that newly appointed staff have an induction. This was also confirmed in the staff surveys. Performance appraisals are held with staff records. Staff said that they are supported to develop their skills. One person said, The manager has really supported me in my personal development, helping me to improve and successfully completing my NVQ in health and social care. Another person said, I have been given a lot of training, which is regular, and very relevant to my job role. I find that it has boosted my knowledge of what I am doing, and what is expected of me. Staff said that the carers and nurses work as an effective team. Regular team meetings take place. Recruitment procedures were looked at for 3 staff who have started work at the home in the recent past. Each person had completed an application form. At least 2 written references had been obtained for each person. Criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks had been obtained before staff started work, although it was noted that this was not the case for one person who worked in the home for 3 months before a POVA or CRB check had been obtained. This has not been included as a requirement as the person now has these checks and because the person started work in the home over one year ago. Care Homes for Older People Page 23 of 30 Care Homes for Older People Page 24 of 30 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. The manager has taken steps to improve the homes performance for the benefit of the people who live there. The health and safety of the staff and residents is promoted. Evidence: The manager has been in post for approximately one year. He has attained NVQ level 4 in care and has the Registered Managers Award (RMA). As he is not a registered nurse, a lead nurse undertakes the clinical supervision of the nurses at the home. He also has 8 years experience in working with older people with dementia. In addition to this, he has a A1 Qualification in Assessing NVQs in Health and Social Care and is a manual handling trainer and risk assessor. Staff, residents, relatives and health care professionals made very favourable remarks about the attitude and commitment of the manager. A health care professional said, Care Homes for Older People Page 25 of 30 Evidence: The leadership, both managerially and clinically, is very good. Staff described the manager as approachable and supportive. One staff member said, I have a good manager, who supports me all the time, makes me aware of any changes in the home, and gives me guidance. Another staff member said, The manager is always finding different ways of improving the service for the staff and the residents. In the last year I feel the manager has moved the service forward and made all the relevant changes that were really necessary. The home uses various ways of auditting its own performance. These include the use of surveys for residents relatives and health and social care professionals; these are distributed once every 3 months. The results of the surveys are analysed and used to make improvements. Copies of completed surveys were seen. A number of different meetings take place where communication about the home takes place. These include staff meetings, residents meetings, nurse meetings and general meetings. A newsletter is produced every 3 months which gives information about current developments. There is a complaints and praise book for residents and relatives to complete if they wish. A representative of the owners visits the home each month and carries out an audit and report. Copies of these were seen. The home has a business and financial plan. The home looks after small amounts of residents money. The system of safekeeping of this was looked at for 3 people. Money is securely stored and a record is kept of any amounts being depositted or withdrawn plus a corresponding balance. It was noted that in two cases the amount recorded did not tally with the amount being held. This was a small amount in one case and for the second included a separate container for which there was no record. The home uses a log book to record any repairs that need to be carried out. This includes dates and entries to show that these faults are addressed. Staff receive training in moving and handling, first aid, health and safety, food hygiene and infection control. Covers are installed on radiators to prevent possible burns to residents. Water temperatures on baths and showers are controlled to prevent possible scalds and a check of any bathing water temperature is made and recorded each time a residents has a bath or shower. The AQAA shows that the homes appliances and equipment are serviced and tested as recommended by health and safety guidelines. Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 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 28 of 30 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 35 17 An accurate record must be kept of any monies or valuables depositted by residents for safekeeping by the home. So that residents valuables are looked after. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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