Care Home: Woking Homes

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What the care home does well The staff work hard to ensure that residents` needs are appropriately assessed and that their care is planned to ensure that these needs are met, whilst encouraging and enabling residents to maintain their independence where possible. Residents spoken with expressed their satisfaction with their quality of life at the home. Comments received from residents included: "Its like home from home here I like it very much" and "I feel very comfortable here, the staff are very caring". One visiting relative commented that: "I have nothing but praise for the care my mother receives at Woking Homes". All interactions observed between the management, staff and residents evidenced that the home has a close and caring staff team. One member of staff commented that "the best thing about working here is having a good working relationship with the staff and manager, the good environment, being friendly and caring for service users in the best way possible". As stated in the AQAA a holistic approach to care, taking into account people`s diversity and level of need either physical, social or spiritual. It has been a long term house policy, that resident`s that need a wheelchair in order to be transfered within the house, are always seated in a chair in the sitting room and in a dining room chair in order to have their meals. These residents are taken to the dining room first, so their disability is not witnessed by other, more able residents. Further changes will be made as the need arises, based on individual assessments. Woking Homes prides it self in providing care to individual residents, to the highest standards based on a holistic approach and involving every member of the multi disciplinary team. What has improved since the last inspection? The ongoing maintenance, redecoration and refurbishment programme provides residents with a comfortable and homely environment in which to live. There were four requirements made at the last inspection, which have been met. There were no requirements made at this inspection. What the care home could do better: All staff should ensure the recording in residents care plans and reviews is appropriate. All staff need to receive equality and diversity training to ensure they have a good understanding of the diverse needs of each individual resident. The activity programme could be improved so that it meets all the needs of residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woking Homes Oriental Road Woking Surrey GU22 7BE     The quality rating for this care home is:   three star excellent 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: Vera Bulbeck     Date: 2 3 0 2 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: Woking Homes Oriental Road Woking Surrey GU22 7BE 01483763558 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Woking Homes The registered provider is responsible for running the service care home 50 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 50 dementia old age, not falling within any other category Additional conditions: 50 0 The maximum number of service users to be accommodated is 50. The registered person may provide the following category of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age- not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Woking Homes is registered as a care home for fifty people of either gender within the categories of old age. The home is situated a short distance from Woking town centre on a bus route and a short distance from Woking main line railway station. The registered provider is a registered charity and the responsible person and the Trustees are very much involved with the smooth operation of the home. The home provides Care Homes for Older People Page 4 of 30 Brief description of the care home residential care and respite primarily for individuals and their spouses with railway or other transport backgrounds. The home consists of single storey accomodation apart from a meeting room on the first floor. All the bedrooms are single occupancy with ensuite facilities. The home can accommodate couples who wish to share in some of the larger bedrooms. There are a number of communal areas, which are spacious, well decorated and maintained. There are plans to expand the home and to rebuild and update the East and West wings of the premises. The gardens are well maintained and car parking facilities are available at the front and on the side of the building. 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: three star excellent 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 visit formed part of a key inspection and was carried out by Vera Bulbeck, Regulation Inspector. The Registered Manager was present as the representative for the establishment. An Expert by Experience was also present for the inspection and was able to speak with a number of residents and staff. A tour of the premises took place. On the day of this visit the inspector spoke with a number of residents and several members of staff on-duty. Prior to the inspection, survey forms were sent to residents, their relatives and/or advocates and to staff employed at the home. Survey forms were returned by eleven residents and some with the help of relatives. Some of the comments made to the inspector and the expert by experience and made on the survey forms are quoted in this report. There were eight Care Homes for Older People Page 6 of 30 surveys returned from staff and two professionals had completed surveys. The home had completed an annual quality assurance assessment (AQAA) and residents care plans, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector would like to thank the residents and staff for their time, assistance and hospitality during this visit and the residents, relatives, professionals and staff who participated in the surveys. The service users have requested to be referred to as residents, therefore the term of residents will be used throughout this report. The fees range from three hundred and sixty eight pounds for residents connected to the railway to four hundred and fifty two pounds for non railway persons. The fee does not include personal items. The previous key inspection undertaken in the home was on 11th June 2007. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Older People Page 8 of 30 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. Each resident is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the residents identified needs. The home does not offer intermediate care. Evidence: The inspector was advised that, on the first inquiry from a prospective resident or their representative, the resident or their representative will be invited to visit the home. Following the initial visit to the home, and if the resident wishes to continue, the manager will visit the resident and carry out a pre-admission assessment to ensure that the home can meet the residents needs and wishes. Three care plans were sampled during this visit. In each case comprehensive pre-admission assessments had been carried out to ensure that the home could meet the residents identified needs. The majority of residents entering the home have some connection with the railway. Data provided in the homes AQAA identifies the home is able to meet any resident Care Homes for Older People Page 11 of 30 Evidence: with specific religious, racial or cultural needs. From the evidence seen by the inspector and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. One resident informed the Expert by Experience she thought that her initial visit to the home for half an hour was too short, and that a whole days visit would have been better. In the AQAA to demonstrate what the home does well, the manager stated that for a week prior to admission, at every staff meeting during shift change over, every member of staff is familiarized with the prospective residents care plan. Families/representatives are asked to personalise the chosen bedroom, with items of furniture and personal effects for example photographs, paintings, bed covers etc. in order to minimise the impact of the change of environment. Family members are advised to treat the home as they would their parents own home and visit anytime they feel like, at any time day or night. residents surveyed all felt they had received enough information prior to moving to the home. 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. Personal care and health care support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. All records must be completed appropriately. Policies, procedures and practices are in place to ensure the safe administration of medication. Evidence: The home has a close care team and the staff demonstrate an in depth knowledge of each individual residents needs, abilities and preferences in how they wish their care to be delivered, resulting in all residents spoken to stating that they always receive the care and support they need. One resident commented I am very well looked after and another commented I have everything I need. The care plans sampled during this visit were all based on pre-admission assessments and had been drawn up shortly after each service users admission to the home and included appropriate risk assessments. These care plans set out the actions, which need to be taken by care staff to meet the health, personal and social care needs of Care Homes for Older People Page 13 of 30 Evidence: the residents. Care plans are reviewed on a monthly basis and daily notes are kept that reflect the care given. These daily notes demonstrated that any changes or new concerns are promptly acted upon. The manager stated the home is having problems with a resident who is losing weight and not eating, there are other health problems as well and a Community Psychiatric Nurse (CPN) is involved. The care plan states the resident to be monitored and a record to be undertaken of food intake and a weight chart to be kept up to date on a weekly basis. When the inspector checked the weight record the recording was spasmodic 9/2/09, 4/2/09, 30/1/09, 3/1/09 and 30/11/08. There is also a chart for monitoring falls and the last recorded fall was dated 23/11/08. However, there was an accident report on the file stating the resident had a fall 14/01/09. The policy states a risk assessment to be undertaken after every fall, this document was not seen on the care plan. The manager stated the staff are finding the resident very difficult to manage as the person refuses to let staff weight or even monitor the food intake. The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled and found to be in order. There are two residents who are diabetic and one resident self medicates and the other resident the senior staff have been trained by the community nurse to administer the daily injection of insulin. The Pharmacist inspects Woking Homes medication its procedures and protocols, including storage and documentation twice per year, and the reports are available for inspection. Those residents admitted to the home from out of the area will be given a choice of GPs, however Woking Homes retains a GP from a local practice in order to provide emergency cover to new admissions, which live out of the area. In order to save time to GPs, the receptionist from the surgery telephones ahead as to their arrival time and residents are taken to their own rooms to await the consultation. The Commission for Social Care Inspection (CSCI) received eleven surveys from residents and the following comments are taken from the surveys. One resident stated, they received good medical support following an operation. Another resident said I regard this home as outstandingly good, making residence in the home a happy experience. Two surveys were received from health Professionals and they were both complimentary to the home stating, the home always attends to clients needs, residents are always clean and tidy. The home provides a kind and caring environment, they treat residents with respect and individualised care. Another comment made was staff are always present when being treated or examined. A comment from another resident the Care and support is very good. From another resident staff are always available and act immediately. Care Homes for Older People Page 14 of 30 Evidence: During the tour of the home staff were observed to always knock before entering the residents bedrooms and all interactions observed between staff and residents were seen to be caring and respectful. All residents spoken to stated that they felt their privacy was always respected. In the AQAA to demonstrate what the home does well, the manager stated that the home promotes independence and high standard of care for the more dependant resident. Residents are offered a choice of using the homes G.P or will provide information of other G.Ps in the area. The home provides escort and transport for those needing hospital, G.P, Dental and Optician appointments. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities provided by the home could be more individualised to each resident, they include contact with the local community both within and outside the home. Contacts with family and friends are also encouraged. Meals are well-balanced and varied with individual choices and preferences catered for. Evidence: The routines of daily living are arranged to suit individual residents preferences and choices. This was confirmed by residents and a relative spoken with. However, some residents commented the activities could be improved. The activity programme was sampled at this visit. Activities provided included a range of arts and crafts, pub quizzes in the homes bar, musical evenings, garden parties, coffee mornings, jig saw puzzles, sewing and themed days. The inspector was also informed that the staff bring in animals for residents to see and hold and the manager very often brings in her dog. six of the surveys received stated there were always activities they could participate Care Homes for Older People Page 16 of 30 Evidence: in. One resident commented on how much she enjoyed the activities. Residents are able to choose which activities they attend or participate in. One resident stated we have a very good activity organiser. A number of residents spoken to stated they do not wish to undertake any activities, and would prefer to watch their own T.V. Their individual rooms were all seen to contain many personal possessions, which were arranged to suit their individual wishes. Some residents go out shopping to Woking town centre, and several residents like going on arranged outings, to places of interest for example the theatre. During the good weather the home arranges a number of outings residents are invited to go on, these include pub lunches visits to the garden centre and various places of interest residents choose to go on. In the surveys undertaken by the residents several made comments: one for example commented that, activities are mainly directed to those at a lower intellect. Another commented the food is quite good, but the service is institutional. And another resident commented would like to be introduced to all new staff. Menus sampled showed that the home offers a varied and well-balanced menu, with residents able to choose from two alternatives if they do not want the dish that is on the menu on the day. The lunchtime meal was taking place during this visit, the food was well presented, the atmosphere in the dining room was pleasant and relaxed and there were ample staff available to offer help and assistance as needed. The menu is four weekly and is displayed on the notice board in the dining area. The menu is also handed to residents the day before, to choose the dish of their choice, the menus are collected at breakfast time. The Expert by Experience who was present at the inspection sat with the residents and had lunch, the following comments by the Expert by Experience are Lunch was a social able occasion. Residents sat at their own designated numbered tables of three or four people. There was a list indicating the order of which tables would be served first, the food was served and presented well. Most residents were able to use napkins and a few residents were wearing protective clothing tabards, these had been left on the backs of chairs, and staff discreetly put them on and were discreetly taken off after the meal. There were sufficient vegetables on each table for more to be had if required. The serving of meat was plentiful and some residents commented there was too much, there was considerable wastage of meat, which was very tasty. However the meat was very tender but may be difficult for residents to chew with few teeth. There was a general buzz of conversation during the meal. One gentleman commented the food is exceptional, better than I could ever do. Another resident commented to the carers call this a small portion, its enormous, the meals here are the best thing since sliced bread. The weekend menu is very much enjoyed by the residents commencing with a full English breakfast, and a glass of wine with Sunday lunch. The chef knew all the Care Homes for Older People Page 17 of 30 Evidence: residents well and considerable banter goes on between some residents and the chef. The expert by experience asked one resident how she spent her day and was informed I join in anything otherwise I go to sleep. Another resident stated that she enjoyed the music and movement two days a week and another resident stated she had tried it but it had made her arthritis worse. The home has its own swimming pool, and four or five residents stated they enjoyed swimming. This is a big use of staff resources and sadly not enjoyed by many of the residents, despite encouragement by the staff. The activity organiser was off sick on the day of inspection and had been sick for two weeks. The staff had been undertaking activities with the residents. Several residents were in their bedrooms watching television and letter writing, they said they prefer to do this rather than sit and doze in a less comfortable chair in the communal lounge. Some residents also stated the activity room was at the other end of the building and was considered by some residents to be too far to reach easily. However activites also take place in the dining area, conservatory, one of the five lounges or the garden in the summer months. The heated swimming pool, which the residents are able to use is not fully taken advantage of and the manager stated they try and encourage residents to use it more often. Outside orgainisations also use the pool and a small revenue is made from this. Also the meeting room on the first floor is used by outside agencies, this has been used for this purpose for some considerable time and again a small revenue is made. On the day of inspection the meeting room was being used by an agency for the purpose of interviews. In the AQAA to demonstrate what the home does well, the manager stated that Woking Homes policy on maintaining relatives and friends involvement and support of the resident after the resident has moved into Woking Homes works very well. The annual quality assurance questionnaire reflects that the home does this very well by visitors always responding that they feel very welcome when they visit the home. The management and staff encourages residents to continue their involvement with community groups for as long as they want to. Visitors are also made welcome and invited to stay in guest house accommodation. The majority of residents surveyed, all said that they enjoyed the meals at the home. One resident commented the food is of good quality and the variety is good. There are no restrictions to visiting times and staff support and encourage residents to maintain family links and friendships inside and outside the home. Care Homes for Older People Page 18 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 has a simple, clear and accessible complaints procedure, which includes timescales for the process. Policies and procedures are in place to protect residents from potential harm or abuse. All staff have completed the vulnerable adults procedure training. Evidence: The home has a complaints procedure in place that is available to all residents and their relatives and is also included in the service users guide. No complainant has contacted the Commission with information regarding a complaint or allegation made to the service since the last inspection. The home received three complaints and have been dealt with appropriately by the manager. Two referrals were made to the safeguarding team, which are now closed. All residents surveyed said that they always knew who to talk to if they were not happy, with one resident adding that: the staff are very helpful. The manager stated that all residents have said that they felt safe in the home. In the surveys completed by the residents one commented that they did not know who to make a complaint too or how to go about making a complaint. This was fed back to the manager who stated there are ample notices about and all residents received a copy in their service user guide. However at the next residents meeting she will ensure this subject is discussed, to make all residents aware of the complaints procedure. Care Homes for Older People Page 19 of 30 Evidence: There is a whistle blowing policy in place and the home have a copy of the latest Surrey Multi-Agency Procedure for the Protection of Vulnerable Adults. Training in safeguarding adults is included in the homes staff induction and all staff surveyed confirmed that they had received the training and were aware of the procedures to follow. In the AQAA to demonstrate what the home does well the manager states we encourage discussion of issues before they become complaints. Structured complaints procedure is well publicised. Robust abuse policy, whistle blowing policy and staff training plan. And a good relationship with the local Social Care Team. The inspector spoke with a number of residents who were extremely complimentary about the home and one resident stating she felt very safe and another commenting I feel very happy and safe here. The Expert by Experience spoke with residents who confirmed they have free access to the manager despite the business of the day caused by the inspection and the rewiring of part of the building. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the residents with clean, pleasant and homely surroundings in which to live. Evidence: Residents spoken with expressed their satisfaction with the accommodation provided at the home. The residents refer to their bedroom as their home and are encouraged to feel at home, by having their own front door complete with door knocker, letter box and number. One resident stated she is moving house, this is because the home is in the process of moving residents before extensive building work begins on the home and in particular the East and West wings are to be pulled down. There are six lounges in the home for residents to choose from as well as a conservatory and lounge/bar in which the residents run and manage. Residents surveyed all said that the home was always fresh and clean. The home was toured during this visit and found the maintenance and redecoration programme for the home was seen to be ongoing. Since the last inspection there are plans to rebuild some parts of the home, many improvements to the communal and individual areas of the home are to be undertaken with new chairs on order for the communal lounge. The laundry facilities with washing machines and tumble dryers are Care Homes for Older People Page 21 of 30 Evidence: suitable for the needs of the residents. All residents have their own en suite bedroom, comprising of toilet, basin and shower. It is Woking Homes policy that no resident will share a bedroom unless they are a married couple and wish to do so. Most residents have a telephone in their own room. For those that do not there is a residents phone in the main hall that can be transferred to a private area where they can talk in private. Staff address residents by their preferred named. This is stated in the resident care plan. The expert by experience spoke to a number of residents who stated they were very satisfied with the home, they choose Woking Homes and are pleased with their choice. All the residents spoken too commented how pleased they were to be living in the home, with the exception of one person. In the AQAA to demonstrate what the home does well, the manager states the home is well maintained, secure, comfortable, clean and in a homely fashion. Accommodation provided ensures privacy and dignity and residents can exercise their choice and independence. Risk assessments are undertaken to make sure the home is covered in all areas of health and safety. Health and safety meetings are held to back up the process and minutes are maintained. The home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. Care Homes for Older People Page 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers and skill mix of the staff meets residents needs. The home has a comprehensive staff recruitment and training programme, which incorporates all areas needed to ensure, as far as reasonably possible, that residents are in safe hands at all times. Evidence: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the residents at the home. The morning (7am shift until 2.30 pm) is covered by five care workers, four care workers cover the afternoon/evening shift (1.30 pm until 9.30pm) and the night staff consists of two waking care worker and one senior on duty from 9.30pm until 7.30am and a person on call for any emergencies. Of the eleven residents who returned surveys, All stated that staff are always available when needed. One service user commented that: Staff are very supportive and nice. Fifteen staff hold a National Vocational Qualification (NVQ) level 2 and above in care, with a further seven staff with NVQ level 3 and above. One member of staff commented that she was very happy with the level of training provided by the home. During this visit the files of three recently recruited members of staff were sampled. All files were seen to contain proof of identity, two references, a completed application form and enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult Care Homes for Older People Page 23 of 30 Evidence: (POVA) list checks had been obtained. All staff surveyed confirmed they had been supplied with a copy of the General Social Care Council (GSCC) code of conduct and practice. Staff induction is in line with the new, mandatory Skills for Care common induction standards and the inspector was advised that staff are supervised until they have completed their induction. Staff are booked on additional training and updates as the courses become available. Of the eleven service users surveyed, ten said that the staff always listened and acted on what they said with one answering usually. Additional comments made included: I am very well looked after and the staff are very helpful and friendly. In the AQAA to demonstrate what the home does well, the manager stated that staff contracts, terms and conditions, appraisals, supervision is kept up to date. Records are well kept and training plans show the training needs of the staff. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents. Policies and procedures are in place to protect residents financial interests. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of residents and staff. Evidence: The registered manager completed the Registered Managers Award some time ago, also the deputy manager has completed the registered managers award in 2008 and is nearing completing of NVQ Level 4 in care. The management style of the manager is inclusive and the residents benefit from the ethos, leadership and clear management approach of the home. A total of eight care staff questionnaires were returned to the Commission for Social Care Inspection (CSCI). From observations made on the day and from comments made on the staff questionnaire it is clear that the home have a Care Homes for Older People Page 25 of 30 Evidence: close and happy staff team. Staff comments on the survey forms returned included: The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the residents and their relatives. The inspector was advised that the home carry out yearly residents and relative surveys, correlate the responses and then formulate an action plan to address any issues that are raised. Policies and procedures are in place to protect residents financial interests. The manager stated that the home does not handle the financial affairs for residents. However appropriate steps are taken when necessary to find the right type of assistance if required for example an advocate. Health and safety monitoring check sheets were sampled and found to be wellmaintained and up to date. All staff have received the required safe working practice training and updates. Staff were observed to be following appropriate health and safety practices as they went about their work. The manager to ensure appropriate comments on records are maintained, to ensure that staff do not write inappropriately in care plans and reviews. There are regular monthly Regulation 26 notifications undertaken. The home initiates regular staff meetings and residents meetings. There is also a residents committee meeting and one of the Trustees attends. The chairman who is a resident and five other residents meet on a quarterly basis. The manager and deputy are invited to observe the meetings so that they are aware of residents opinions and any complaints. All interactions observed between the staff and residents were inclusive, caring and respectful. In the AQAA to demonstrate what the home does well, the manager stated that the Trustees attend residents committee meetings and closely oversee the redevelopment of the home. Staff are invited to attend sub- committee and Trustee meetings. Comments made by the Expert by Experience Woking Homes has a thoughtful caring management and staff team who know the residents well. They enable residents to make their own choices and staff are available to take note of needs that may arise from day to day. The handyman, chef, cleaners and carers are all valued. This respect is reflected in the attitude of residents to one another. This is a large group of elderly able people who have been involved in their choice of home. Although not all residents have a railway connection, the larger number do and this has perhaps encouraged a hierarchical situation that seems to give security in the home. 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 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 37 Appropriate comments only should be included in all records including in residents care plans and reviews. 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. 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