Care Home: Woodside View

Similar services:

• Springfield House
• The Shelley
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well Residents live in an excellent, well maintained, clean and homely environment which has been refurbished to a high standard. Residents bedrooms had been personalised and decorated to a high standard with residents consulted confirming that their bedrooms provided everything they needed. Comments regarding the environment included "just done it up and it is looking very nice overall it is now very good" and "they have done wonders with the building". The home is able to clearly demonstrate that it can meet the range of residents physical needs with consistent feedback regarding the excellent standards of physical and health care support provided, which promotes and protects residents privacy and dignity. A sample of comments about residents and relatives experiences at the home included "care is excellent friendly staff" "caring attitude towards residents" "one of the most caring homes I have been to" and "it is a happy and caring home for all service users". A staff member fedback "it is a happy and caring home for all who use it and for those who work here. I am happy working here is one big happy family". Residents are able to exercise some choice and control over their lives with flexible routines being an integral part of daily practise at the home. A residents said "more or less I can go to bed whenever I want I just call for the staff to help me". A relative said "She can spend the day how she wants to it is not at all regimental". Links with families and friends are valued and supported by the home, with all relatives stating how welcomed they are made to feel when visiting and how they could visit at any reasonable time. The meals are excellent offering both choice and variety and catering for special dietary needs. Residents comments about food included "the home is very good about food the quality and variation are excellent the portions almost too large and the staff will serve them any time the laundry also deserves a word of praise". Resident`s benefit from a motivated and experienced manager who promotes good practises and is clearly respected by residents, staff, relatives and health care professionals who all spoke positively about the managers hands on nature of their management style, their approachability and knowledge of individual residents needs. The home regularly reviews aspects of its performance through a good program of selfreview and feedback. What has improved since the last inspection? All of the previous shortfalls noted at the last inspection have now been addressed. This has improves residents safety through more robust recruitment checks and residents being more familiar with the terms and conditions at the home by being provided with their own copy. Significant investment in the building through an ongoing refurbishment and upgrade has seen major improvements to the environment, creating a pleasant environment in which to live, work and visit. What the care home could do better: Some minor work is needed to the homes literature to ensure that it provides both prospective and existing residents, with a range of information about the home and what to expect when living there in order to help them make informed choices. The manager also agreed to review the homes assessment documentation in order to ensure that it can provide all of the information needed for them to make an informed decision as to whether a residents needs could be safely met. One statutory requirement is made as a result of this inspection which relates to the need for care plans to provide staff with the guidance they need to meet the range of residents needs including their social, emotional and behavioural needs to enable a person centred consistent approach. Subsequent to the inspection the manager notified the Commission of the work being done to improve and monitor standards of care planning. The organisation has also completed a development plan for the home which sets out areas for continuing service development. Key inspection report Care homes for older people Name: Address: Woodside View 2 Highview Caterham Surrey CR3 6AY     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: Jane Jewell     Date: 1 0 0 7 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 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Woodside View 2 Highview Caterham Surrey CR3 6AY 01883346313 01883341153 wraypark@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care Homes of Distinction Ltd care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 26. 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: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Woodside View Nursing Home is a converted Edwardian Manor House providing nursing care for up to twenty Six older people which was purchased by the current provider in December 2006. The home is located in a residential area on the outskirts of Caterham, with access to local amenities and facilities a short drive away. Woodside is owned by Care Homes of Distinction, which also own further residential and nursing care within the Surrey area. The home is presented across three floors with access to resident accommodation provided by stairs and a shaft lift. The top floor is used for staff accommodation. Care Homes for Older People Page 4 of 31 Over 65 26 0 Brief description of the care home Communal space consists of a large entrance hall, lounge and dinning room which opens out onto an enclosed rear gardens and patio areas. There is also a hairdressing area and treatment room. Residents accommodation comprise of twenty three single bedrooms with nearly half providing en-suite facilities. The home uses CCTV monitoring around the home and on the external of the building. The homes literature states that it aims to ensure the highest standards of care and support to service users and to provide an environment which is stimulating promoting independence and safeguarding privacy and dignity. The fees for residential care are currently £600 to £700 per week, depending on the services and facilities provided. Extra such as: newspapers, hairdressing, chiropody, toiletries are additional costs. Refer to the homes literature for the actual amounts charged for any additional costs. Care Homes for Older People Page 5 of 31 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 information contained in this report has been comprised from an unannounced inspection undertaken over six and half hours and information gathered about the home before and after the inspection. The organisation had completed an Annual Quality Assurance Assessment (AQAA) form and the information contained in this document has been used to inform the inspection process. The inspection was facilitated by the Washington Dass (Registered Manager) and in part by the registered provider Antony Coombs. The focus of the inspection was to look at the experiences of life at the home for people living there. The inspection consisted of being shown the communal areas, and being invited to view some residents bedrooms, examination of the homes documentation and observations of residents daily routines and in their interactions with staff during lunch time and over the afternoon period. Three residents, five staff and five relatives were interviewed as part of the inspection process. Care Homes for Older People Page 6 of 31 Feedback surveys were sent to the home for distribution, in order to obtain the views on the quality of the services and facilities being provided. Thirteen were returned in total, one from a resident who was supported to complete their form two from residents who independently completed it, five from staff and five from relatives. Their feedback is included in this report. There were thirteen residents living at the home at the time of the inspection. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? All of the previous shortfalls noted at the last inspection have now been addressed. This has improves residents safety through more robust recruitment checks and residents being more familiar with the terms and conditions at the home by being provided with their own copy. Significant investment in the building through an ongoing refurbishment and upgrade has seen major improvements to the environment, creating a pleasant environment in which to live, work and visit. Care Homes for Older People Page 8 of 31 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 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 31 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 31 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. The home provides both prospective and existing residents, with a range of information about the home and what to expect when living there, this information does need minor additions to help ensure residents have all the information they need to make informed choices. Although all new residents are assessed prior to admission, the admission procedure needs further action to ensure that new residents needs are properly assessed and planned for. The home is able to demonstrate that it can meet the range of residents physical needs. Evidence: The homes statement of purpose, which is a book that tells people who the home is for and the service users guide, which is the book that tells people how the home Care Homes for Older People Page 11 of 31 Evidence: works, provides a range of information about the home. These are made available at the home and given to prospective residents, representatives and other interested parties. A relative confirmed that they had been given some information about the home in advance, another relative fedback that they were given a brochure and could have asked any further questions we needed to. It was discussed that the homes information should fully reflect the range of placements, services and facilities offered by the home, including the use of CCTV and contain a copy of the homes terms and conditions. This is necessary in order to ensure prospective residents are enabled to make informed choices. The manager agreed to ensure that the information was updated promptly and therefore no requirement is made on this occasion. In accordance with the previous requirement the manager confirmed that all residents, once admitted, are now provided with a written contract of terms and conditions of residency with the home. This can be used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. The manager confirmed that prospective residents are assessed prior to admission to the home. This includes using needs assessment provided by the placing authority, where available, and the manager undertaking their own assessment. However new needs assessment documentation provided only limited information on the individuals needs and in one example not all of their primary needs had been considered as part of their assessment. The manager agreed to review the assessment process to ensure that the homes documentation enabled for a range of residents needs to be identified, including social and personal information. This would help to ensure that staff are aware of the range of recorded needs of new residents prior to them moving into the home. There is a range of residents needs being accommodated at the home with all residents primary needs being related to their older age and include residents who have complex nursing needs, learning disabilities and mental health needs. Through observation, looking at records and speaking with residents, staff and relatives, evidence was gathered that the home is able to meet this range of needs, however some further work is needed to the care planning process in order to promote continuity of care and to be identify the emotional and social needs of residents. This is discussed under standard 6 of this report. Consistent positively feedback was however received about the high standard of physical care provided to meeting residents needs. A sample of comments included care is excellent friendly staff caring attitude towards residents one of the most caring homes I have been to and it is a happy and caring home for all service users. A staff member fedback it is a Care Homes for Older People Page 12 of 31 Evidence: happy and caring home for all who use it and for those who work here. I am happy working here is one big happy family. The home has successfully become an approved provider for a large number of London boroughs following a vigorous assessment of their services and facilities by an external assessment body. This is to be commended. Residents and their relatives spoke of being provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home as many times as they liked. Intermediate care is not offered at the home therefore this standard is not assessed. Care Homes for Older People Page 13 of 31 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. There is a care planning system in place which provides staff with the guidance they need to provide excellent standards of physical care, however further work is needed to care plans to ensure that the emotional ,social and behavioural needs of residents are identified and guidance provided to enable a person centred consistent approach. Residents receive an excellent standard of health care support, including end of life care. Medication practices are generally well managed promoting good health. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Evidence: Three care plans were looked at and these contained a range of information on the needs of residents. Care plans provide clear guidance for staff on the physical care needs of residents with staff very knowledgeable on how to support these needs, however they did not always contain guidance on the emotional and social needs of residents. This resulted in lack of continuity between some staff on how they would Care Homes for Older People Page 14 of 31 Evidence: provide suitable stimulus and occupation for particular residents. A health care professional fedback in response to being asked what the home could do better was a more practice approach to person centred planning to ensure that residents individual needs are identified and catered for. However they were impressed that once they suggested ways to further enhance a residents live the home readily took on board this, but felt that this should have been identified as part of their care plan. A staff member was observed successfully using distraction techniques with a resident who was exhibiting some behaviour that could be described as challenging. How to support this resident was not recorded in their care plan in order to ensure that a consistent approach would always be used. It has been required that care plans provide staff with the guidance they need, on the range of residents needs so they can be meet in a person centred and consistent way. Individual risk assessments are in place, which covered core and specialist areas of risks and records the actions to manage any identified risks. Any risks faced by a resident that the inspector noted during the course of inspection had been recorded within an individual assessment. A system for regularly reviewing care plans demonstrated that any changes in the recorded needs and preferences of residents was highlighted on the care plan. None of the residents consulted said they wanted to be involved in the continuous development and review of their care plan but felt able to ask to see it at any time The home maintains a daily record for each resident on events and occurrences. However a significant example was noted whereby the daily log did not record the events described to the inspector that resulted in a decision to increase a residents medication. The manager agreed to address this promptly to ensure more accuracy and relevancy of recording system. Records show that prompt action is taken to address any medical concerns, including the involving of any additional specialist services including dieticians. Residents confirmed that when they have asked to see a GP staff have sought this promptly on their behalf. The staff nurse in charge confirmed that there are no pressure sores being treated at the home and spoke knowledgably about good practices they undertake at the home to promote good pressure care management. A health care professional fedback everything is excellent professional caring atmosphere good at analysing what is wrong with patients. None of the residents accommodated are assessed as safe to administer their own medication. Medication profiles are in place which provides information on how much medication is provided, how medication should be administered, side effects and any Care Homes for Older People Page 15 of 31 Evidence: allergies. Good practices were noted in the use of a double signature to confirm the accuracy of any handwritten prescribed instructions. One example was noted whereby it was not clear if the prescribed instructions had been followed as no record had been maintained of medication being carried forward from the previous month. This meant that there were additional amounts of unaccounted for medication. The manager confirmed they would ensure that clear records are maintained of all medication held on the premises. Observation in the home confirmed that residents privacy and dignity is being respected by staff. Staff knock on doors before entering, speak to residents in a courteous manner, provided any personal care in private and used good practices when using hoisting equipment. Residents were observed to be dressed in well laundered clothing and residents enjoyed the regular input from the visiting hairdresser. There are CCTV cameras in operation around the home in communal areas which is recorded and monitored by the staff and the provider. Work has recently been undertaken by the provider to ensure that residents and their representatives are more aware of their presence and their purpose to help ensure that they can make informed decisions about the home and be aware of their rights. The provider has confirmed that they are registered with relevant governing bodies who monitor the data protection act and follow their code of conduct on the use of CCTV. Staff spoke sensitively about the care and support provided to residents and their families when residents have become terminally ill. Staff gave examples of how well the home manages end of life care and have a range of equipment and access to specialist medical support. The home is currently in the process of working with a local hospice to provide additional training on end of life care to further promote excellent practices in this area. Care Homes for Older People Page 16 of 31 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. Residents are able to exercise some choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are valued and supported by the home. Some meaningful activities and opportunities for stimulation are made available to ensure that residents have a good quality of life, with some further work needed to identify and record residents individual social needs. The meals are excellent offering both choice and variety and catering for special dietary needs. Evidence: Residents views regarding activities varied between those who enjoy socialising and others who were not so interested, however all residents confirmed that their preference was respected by staff. Staff are mainly responsible for providing suitable occupation and stimulus for residents and they spoke of providing sing-alongs, nail painting, exercise session, going for walks, reading magazines and games. A health care professional fedback that the home was responsive to suggestions on further Care Homes for Older People Page 17 of 31 Evidence: activities for a particular resident. Consistent feedback was received from residents and staff of creating opportunities for residents to go out. The manager was aware of this and felt that during clement weather this is now possible. As previously noted care plans must include residents social needs to ensure that staff have the knowledge and guidance on how to further enhance residents well being by providing individual means of occupation and stimulus. All relatives spoke positively about how welcomed they are made to feel when visiting the home which included being offered refreshments and how they could visit at any reasonable time. Feedback was received regarding the generally good standard of communication between the home and relatives. One relative fedback their experiences of not all messages being passed on onto residents. The manager spoke of a upcoming barbeque to be held with neighbours and staff to celebrate achievements at the home. The organisation has developed a news letter to keep relatives and other stakeholders involved in residents care updated on news, events and achievements across the organisation, which is to be commended. Observation of the daily routines and discussion with staff confirm that staff accommodate residents personal wishes with regard to meal times, going to bed, rising and bathing. A residents said more or less I can go to bed whenever I want I just call for the staff to help me. A relative said she can spend the day how she wants to it is not at all regimental. During the inspection residents were observed to move around the home choosing which room to be in and what level of company they wanted to enjoy. For a few people living at the home, being able to exercise their choice was difficult due to their level of dementia. However staff were seen to use their acquired knowledge of a resident to help them make choices with regard to food and drink. Consideration has also been given to new legislation (Mental Capacity Act) which affects residents rights to make decisions in their lives with the organisation introducing mental capacity assessments to identify residents individual capacity to make decisions. Staff were knowledgeable about residents cultural or religious beliefs and spoke of offering alternative health therapies in accordance with residents cultural beliefs. The inspector observed the lunch being served which was presented well with residents individual choices and preferences respected. Residents confirmed that they are provided with an alternative if they did not like what was on the menu. A resident spoke of how well their specialist diet is catered for. Thought had gone into the seating arrangements to promote the dignity of some residents whos eating habits may have been off putting to others. Good practices were observed in the positive encouragement by some staff when Care Homes for Older People Page 18 of 31 Evidence: assisting residents to eat, including anticipating residents needs who were not able to ask for further drinks and describing the food. One resident over the course of the meal had three different staff assisting them. The manager felt that this was not confusing for them but by each staff offering different encouragement prompted them to eat more. It was discussed that this approach should therefore be recorded in their care plan as a recognised technique to encourage this individual. The chef serves the meals personally in the dinning room and is therefore able to gain instant feedback on residents preferences which is then used to inform future menu options. Much positive feedback was received regarding the excellent standards of meals with three residents consulted stating the best bit about life at the home is the meals with one resident commenting the home is very good about food the quality and variation are excellent the portions almost too large and the staff will serve them any time the laundry also deserves a word of praise. Care Homes for Older People Page 19 of 31 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. An effective complaints procedure and appropriate adult protection policies helps to protect the rights and interests of residents. Evidence: There is an accessible complaints procedure for residents, their representatives, and staff to follow should they be unhappy with any aspect of the service. All residents and relatives consulted with said that they felt able to share any concerns they had with the manager and where they have raised minor issues with them, this has been addressed promptly. The manager reported that there has been one complaint received which was managed in accordance with the homes procedures. The home has written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. The majority of staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed a good understanding of their roles and responsibilities under safeguarding adults guidelines. It was previously required that the all senior staff undergo specialist training in safeguarding adults. One senior staff was yet to undergo this formal training but upon interview with the inspector they demonstrated a sound understanding of their responsibilities as the person in charge and the manager confirmed that they would arrange for this training to be undertaken as a matter of priority. The manager reported that there have not been any Care Homes for Older People Page 20 of 31 Evidence: safeguarding referrals made. Care Homes for Older People Page 21 of 31 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. Significant investment in the building has created an excellent well maintained, homely environment in which to live. Residents have a range of specialist equipment and adaptations to aid mobility and independence around the home. Standards of hygiene remain good creating a pleasant odour free environment in which to live, work and visit. Evidence: The home continues to undergo a gradual refurbishment since the previous inspection. This has included the further redecoration of some bedrooms, the creation of four further en-suite facilities, replacement of many bedrooms carpets and redecoration of the lounge and new flooring, which have all been undertaken to a high standard. Vinyl flooring has also been fitted to some bedroom floors to help in the management of odours and the promotion of residents dignity. The standard of maintenance is high with onsite maintenance staff available. A sample of comments about the environment included just done it up and it is looking very nice overall it is now very good excellent lovely old building which they have converted well hardly any smell and they have done wonders with the building. Care Homes for Older People Page 22 of 31 Evidence: Communal space consists of a large lounge which is layout to creatively make smaller seating sections. A new larger TV has recently been purchased to aid residents ease of viewing. It was described that one resident was seated on their own as they liked to view outside, however this had been significantly obstructed for the previous two weeks by a large notice board which the manager agreed to relocate immediately. The lounge overlooks a well maintained terraced garden which is laid to lawn, with flower beds, paths, potted plants and seating areas creating a very attractive secure and accessible space for residents to look out upon and use. Residents consulted said that their bedrooms provided everything they needed including height adjustable beds. Bedrooms seen had been individualised by residents who confirmed that they could bring any small items of furniture and personal effects. The style of some bedroom door locks meant that they could not be accessed in the event of an emergency from the outside. The manager explained that currently no residents have requested a lock on their bedroom door but agreed to fit appropriate locks should this situation change in the future There is sufficient number of toilets and bathrooms located around the home, including nearly half of bedrooms now providing en-suite facilities and assisted bathing facilities. There is a range of individual aids and adaptations to assist residents mobility and independence, including raised toilet seats, pressure relieving mattresses, walking aids, hoist ramps and grab rails. Fitted throughout the home are call points, which enable assistance to be summoned when pressed. The call bell of a chair bound resident was extended and placed by their chair so they could easily call for assistance. They confirmed that when they have used it staff always attended very quickly. All areas inspected were observed to be cleaned to a high standard with residents and relatives confirming that the home is always kept clean with no unpleasant odours present. The home employs sufficient staff to ensure that standards of hygiene and cleanliness can be maintained. Systems were in place for the control of infection and staff said that they have been trained in this area and were observed to be working in ways that minimised the risk of infection. Care Homes for Older People Page 23 of 31 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. Staff make a positive contribution in residents lives as they benefit from a well trained and experienced staff team that know them and who are robustly recruited and employed in sufficient numbers as is necessary to meet their needs. Evidence: The staffing structure is currently for a minimum of three care assistance and one nurse in charge during the morning period and two care staff during the evening period. Staff, relatives and residents felt that there was always sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. The home is an approved nursing home for students on the overseas Nursing adaptation Programme and satisfy the educational requirements of the Nursing and Midwifery Council following an audit carried out by City University of London, which is to be commended. One the day of the inspection one staff member had recently successfully completed their nursing adaptation and a small celebration was being held to mark this achievement. Although residents and relatives commented on there being some regular turnover of staff they felt that this did not significantly impact on care practices at the home. Many Letter of complement were seen which praised staff and their kindness. Much Care Homes for Older People Page 24 of 31 Evidence: good practice was observed when staff were interacting with residents this included using humour to successfully communicate with one resident, being sensitive and gentle during physical contact and anticipating residents physical needs. A resident said of staff very obliging, night staff are good they are always checking on me during the night which is reassuring. A health care professional described staff as staff very nice naturally caring as nurses they provide more expert care very courteous good competent staff. A sample of comments by relatives included generally they are ok communication can sometimes be difficult Staff all very helpful they keep us well informed communication is not a problems and staff are very helpful to us and my mother. The personal files of three staff were inspected and these showed that a robust recruitment process is now followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing to help ensure that only staff who are suitable to work with vulnerable people are employed. The home has been proactive in ensuring that the majority of staff have completed a National Vocational Qualification in care. There is a commitment to improving staff skills through an ongoing comprehensive training programme both in practical matters and the broader aspects of working with older people. Including dementia care, diet and nutrition, mental health and skin care. The home as won several industry awards for its good employment opportunities. The manager reported that new staff undertakes the industry recommended minimum inductions standards. This is designed to help ensure that all new staff entering into the care industry have a minimum level of initial training. There is a staff notice board which contains comprehensive information not only about the homes policies and procedures but also industry wide recognised good practices in the care of older people. Care Homes for Older People Page 25 of 31 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. Residents benefit from a motivated and experienced manager who promotes good practices and provides a clear sense of leadership and direction enabling staff to provide good quality care. The home regularly reviews aspects of its performance through a good program of self-review and feedback. A range of regular health and safety checks helps to promote the health and safety of residents and staff. Evidence: The manager has been in post since late 2007. They are a trained nurse and reported that they have undertaken the recommended management qualifications and have experience in managing services for older people. They demonstrated a clear understanding of good practices in the care of older people and the daily running of a care service for older people and were motivated to ensure that any areas for Care Homes for Older People Page 26 of 31 Evidence: improvement were addressed. Consistent feedback was received regarding the hands on nature of their management style, their approachability and knowledge of individual residents needs. A health care professional fedback generally I have been impressed in the service provided by this service. I have found the homes manager to be very responsive and have observed that the service users I have placed there likes the manager and they have a good relationship. A resident said Washington very good comes in at least once a day to say hello to me. Relatives commented management very professional very helpful knowledgeable and experienced Washington takes a lot of time making sure the residents are happy and comfortable and manager very good lets you know what is happening very kind to mum he has improved the home no end as to how it was. The manager is supported by the provider who visits the service most days and senior organisational staff that are based at the home and who provide practice managerial support/advice and supervision. There are several formal mechanisms in place for the home to obtain feedback on the quality of the services provided and whether it is achieving its aims and objectives. This includes annual feedback surveys, residents and relatives forum. The manager reported that in response to feedback, changes to the environment have been undertaken. The provider undertakes the required monthly audit of services and facilities and completes a written report on their visit. This is in accordance with their responsibilities under the National Minimum Standards and also helps to ensure that standards are regularly being monitored. Staff are in the main supervised by the manager working along side them each shift and all staff consulted with felt well supported by the manager. The manager reported that they undertake some formal supervision, one staff member feedback in regard to what the home could do better was to supervise all staff more often. Staff said that the provider also gives direct feedback to them when they visit with regard to their performance and any areas for improvement. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The manager stated that they do not manage the personal finances for any current residents. Written guidance is available on issues related to health and safety. Records submitted by the home prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken including regular internal Care Homes for Older People Page 27 of 31 Evidence: health safety checks. Systems are in place to support fire safety, which include regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that they had undertaken a fire risk assessment has been completed which records significant findings and the actions taken to ensure adequate fire safety precautions in the home. This included individual fire risk assessments for residents. Care Homes for Older People Page 28 of 31 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 29 of 31 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 7 15 That care plans provide clear 04/09/2009 guidance for staff on all aspects of the health, personal and social care needs of service users and which provide staff with clear guidance on how to meet these needs. To ensure that the range of residents needs are identified and catered for in a person centred and consistent way. 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 30 of 31 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!