Care Home: Yockleton Grange

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What the care home does well Yockleton Grange is effectively managed by a manager who is open and approachable and clearly committed to providing a good standard of care and accommodation to the people living there. Comments from all people living working and visiting the home have been very complimentary in relation to how the home is managed. On this occasion Yockleton Grange more than met minimum standards we expect to see provided for a service of this type. One person who recently moved into the home told us, `A better place you could not find.` People living at the home continue to be supported by a stable, enthusiastic and committed staff team who have a clear understanding of their individual needs.The staff were seen to have excellent relationships with the people living there and spoke to them naturally, with empathy and supporting them as they wish. This gives people a sense of wellbeing. Staff are recruited and selected in ways that ensure safe, skilled individuals are employed. Staff have the training they need so they know how to support the people living there.The care team have a high percentage of staff who have attained the minimum expected care qualification,resulting in people receiving a consistent service from a knowledgeable competent team at all times. People are provided with a nice clean and homely place to live, which is furnished to a good standard and is well maintained. The service have recently been commended for its high standards in food hygiene and good, well balanced meals they offer. Yockleton Grange also provides people with a good variety of therapeutic and leisure activities both in house and as part of the local community which are available and planned to meet their needs. The home have robust processes in place to monitor the quality of care and support they offer which is based on seeking the views of the people living there so they decide how improvements are made. What has improved since the last inspection? The home has been proactive in addressing the previous requirements and recommendations we made at our last inspection. Changes to admission procedures now show that Yockleton Grange have the paperwork to confirm they fully assess the needs of anyone thinking about living at the home before they actually move in. Staff training has improved so that any new recuits get a good start to working at Yockleton Grange.The number of people who have attained a qualification in care has also increased, which means people can be confident they received the support theyneed by experienced and trained staff. Recordkeeping now makes sure people agree they would like assistance from the home to help them take their medications, and support them with any financial matters. What the care home could do better: It is considered that Yockleton Grange continues to raise its standards and is setting its own objectives for continual improvement with the full involvement of the people who use it.However, as a result of our inspection findings a total of four good practice recommendations have been made in order to improve standards at the service, which will further benefit people living and working there. Although the health needs of the people living there are met and people get the care from other professionals they need, the quality of details in the care plans of people living there need to be expanded.This will make sure that staff know how to support individuals to meet their needs. Care paperwork lacked details about the specific levels of assistance required in relation to personal care, dietary needs and keeping people independent. A variety of paperwork lacked dates to confirm how old it was.This meant it was not possible to confirm whether the information the home kept about people was up to date. The home needs to consider a system which confirms hot water is tested before a person who lives in the home uses it,especially in cold weather conditions. Home safety assessment paperwork could also be further expanded to make sure it accounts for any potential infection control hazards for the laundry. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Yockleton Grange Yockleton Grange Yockleton Shrewsbury Shropshire SY5 9PQ     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: Janet Adams     Date: 0 2 0 1 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. the things that people have said are important to them: They reflect 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 28 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Yockleton Grange Yockleton Grange Yockleton Shrewsbury Shropshire SY5 9PQ 01743821284 01743793020 yockletongrange@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Elizabeth Garner Type of registration: Number of places registered: Springcare (Yockleton) Limited care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: The home may accommodate a maximum of 30 service users. No person whose needs fall into the category of learning disability may be admitted under the age of 55. Places registered for people with a learning disability between the ages of 55 and 65 (LD) may be used flexibily to provide accommodation for older people (OP) when required. Date of last inspection Brief description of the care home Yockleton Grange is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for up to 30 Older people to include seven people with a learning disability over the age of 55. The Registered Provider is Springcare Limited and the Registered Manager is Ms Susan Garner. The home is located in Yockleton and is easily approached from Shrewsbury and surrounding villages and Welshpool by car.There is ample parking on site. The original house was a Care Homes for Older People Page 4 of 28 Over 65 6 20 6 0 Brief description of the care home former rectory, which has been extended to provide additional accommodation with en-suite facilities. The home stands in three acres of landscaped gardens. The home seeks to provide a positive homely environment for service users affording the appropriate levels of support required to meet their individual needs. The aims of the home is `To provide all service users a life that is as normal as possible, given their individual health and needs in homely surroundings. To provide all service users with care which will enable them to live as independently as possible with privacy, dignity and with the opportunity to make their own choices. Individuals thinking about moving into this home and any of their representatives are able to gain information from the Statement of Purpose and Service User Guide available from Yockleton Grange. CSCI reports for this service can be obtained direct from the provider or are available on CSCIs website at www.csci.org.uk The reader is advised to contact the service to confirm the fees they currently charge. Care Homes for Older People Page 5 of 28 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 home was last inspected by us on January 5th 2007. This inspection was carried out by one inspector and lasted five and half hours. Some time before the inspection, we wrote to the home to request some up to date information to assist with this process. This meant that although Yockleton Grange knew the inspection was imminent, they were not aware of the date or time the inspection would take place. The inspection included observing activity within the home, inspecting the premises, an in depth look at records for residents and staff, as well as observing, talking and listening to over half of the 28 people living there. The aim of the visit on the inspection day was to have a good look round the home, Care Homes for Older People Page 6 of 28 and to spend time observing people living there.Some of the staff on duty at the time of the inspection also shared their views about working at the care home. Discussions with people were carried out in private with people on their own, or together in groups in the lounges. Everyone was happy to share their comments, which are included in the main body of the report. As part of the inspection process, CSCI circulated questionnaires and stamped addressed envelopes to people living visiting and working at the home, so their views and opinions could be included in this report.A total of 4 people using the service 4 staff members and 2 relatives also returned their written comments about the service to us. The Registered Manager was thanked for the very useful nformation provided before the inspection and her assistance on the inspection day.Feedback about the conclusions of the inspection was given at the end of the inspection. What the care home does well: What has improved since the last inspection? The home has been proactive in addressing the previous requirements and recommendations we made at our last inspection. Changes to admission procedures now show that Yockleton Grange have the paperwork to confirm they fully assess the needs of anyone thinking about living at the home before they actually move in. Staff training has improved so that any new recuits get a good start to working at Yockleton Grange.The number of people who have attained a qualification in care has also increased, which means people can be confident they received the support they Care Homes for Older People Page 8 of 28 need by experienced and trained staff. Recordkeeping now makes sure people agree they would like assistance from the home to help them take their medications, and support them with any financial matters. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive all of the necessary information to make a fully informed choice about what living at Yockleton Grange can offer. People have their needs assessed prior to moving in the home.This means they can be confident the home will be able to meet their needs. Evidence: Springcare, the Registered Providers for the service, produce a corporate styled information folder for prospective residents, which contains the homes Statement of Purpose and Service User Guide, the information we require them to have by law. Sue Garner, the Registered Manager for the home provided us with copies of this information.She told us that up to date information about fees was completed on the relevant information page by herself when they were issued to anyone thinking about living at the home. Care Homes for Older People Page 11 of 28 Evidence: One of the requirements we made at our last inspection was for Yockleton Grange to make sure they carried out a full assessment of a persons needs before they moved into the home. Before the inspection, information the home had sent us stated that they had improved the admission procedures to make sure this happened. The home stated they now obtain more detailed information which also explores any mental health issues,and they carry out a more detailed social assessment which, Gives us more information of past and current interests Peoples needs are now fully explored before they are offered the opportunity of living at Yockleton Grange. However, one set of this information lacked the dates of when the assessment had been done. This means the paperwork could not confirm whether this assessment had been carried out before the person was admitted.In the other set of records, two pages of the four page pre-admission assessment were missing.These were found by the end of the inspection.The above issues were fully acknowledged by the manager at the time of inspection and she confirmed that systems would be improved for these matters with immediate effect. The manager stated that intermediate care is not provided, therefore it was not possible to assess key Standard 6 on this occasion. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The support and personal care provided at Yockleton Grange promotes the dignity, independence and good health and for all of the people who live there. Medication management systems makes sure people safely receive their medication as prescribed. Evidence: The people who live at the home that responded to our satisfaction survey all commented they received the right care and support , and that staff listen and acted upon what they say. One person wrote, It is nice to live here.People are so kind. People we spoke to confirmed they are treated with dignity and respect.We saw staff knocking on peoples bedroom doors before they entered and they were seen to approach the people they offered care and support to in a respectful manner. Before we carried out the inspection visit, the home told us they had improved the care they provide to people living at the home by, Having better more comprehensive care plans, and by more invovement with the local adult learning disability team. In Care Homes for Older People Page 13 of 28 Evidence: order to confirm this,the records of two of the people living at the home were looked at. These included individual care plans that stated how staff are to support the people to meet their needs and help them achieve their goals. Records showed that people had been involved in their care plan. Staff had signed peoples care plans to say that they had read them and know how to support the individuals. Records also included individual risk assessments that stated how staff are to support individuals to take risks in their day -to-day lives whilst ensuring that they can be as safe as possible. However, it was seen that some of the records did not have all the details they needed. Several documents were not dated therefore it could not be confirmed whether the information was up-to-date or relevant to the current needs of the individual. Some details about how the care team dealt with hygeine needs like hair and nail care were missing. More importantly, the records of a frail person who had recently lost weight did not have this situation properly accounted for to show the home was doing all it could to make sure the persons nutritional needs were being met. Although the person had moved from another home which had accounted for this need, this had not been continued following her admission to Yockleton Grange. The home have already identified recordkeeping for care is an area where they wish to improve.They told us their plans for the coming year that they intended to , Continue to update and monitor all care plans and encourage all staff not just seniors to become involved in the updating of care plans. The manager also told us of her plans to introduce falls diaries to improve recordkeeping for people who were prone to falls which would increase staff awareness of these incidents. We reviewed the medication management systems in the home with the assistance of a senior carer, who had demonstrated her expertise for this aspect of care when she carried out the lunchtime administration of medication. Although in general, satisfactory standards reported at previous inspections have been maintained, some medication storage and recordkeeping issues were identified and acted upon immediately to ensure people were receiving their medication as safely as possible at all times. It was seen that some of the medicines the local chemist had dispensed had not been labelled properly.The Registered Manager promptly telephoned the chemist to get this issue rectified by the end of the inspection.Other actions also carried out included relocation of storage facilities for refrigerated and Controlled Drugs, as well as improvements to recordkeeping to account for drug allergies, and drug fridge temperatures. Care Homes for Older People Page 14 of 28 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 daily life and social activities arranged for people living at Yockleton Grange takes into account the differing expectations, preferences, lifestyle and capacities of each individual that promotes their self esteem and wellbeing. People are offered a healthy diet and enjoy their meals. Evidence: Feedback from all of the residents who took part in our survey confirmed there are always activities planned that they can take part in. Everyone commented they especially enjoyed going on the outings the home arranged, and that a recent trip to Blackpool had been successful.Photographs and records showed that individuals celebrate the cultural festivals relevant to the people living there.People that we met during the inspection all commented they had enjoyed the celebrations of the recent festive season.An activity diary seen in the reception area listed 18 different communal activities planned for the coming month.The activity coordinator for the home also makes sure any individuals who are too frail to join in the group activities have one-toone time with staff so they can continue to enjoy their own hobbies and interests. Care Homes for Older People Page 15 of 28 Evidence: Records sampled showed and people said they can keep in touch with their family and friends if they want to. This ensures that people can maintain relationships that are important to them.One relative confirmed this and stated, The residents lead a very fulfiled and happy life. People we spoke to were in agreement that they were fully involved in making choices about their lifestyle, and records sampled showed that individuals are encouraged to be as independent as possible and participate in household tasks. We met one person helping out in the kitchen during the inspection. The home continues to have strong links with the local community,and receives regular local newsletters to keep people up to date with whats on.One person is a regular attender at the nearby church, and the local rector visits those who cannot attend to offer them the opportunity to receive Holy Communion. One health professional who has recently been involved in the care of the younger individuals living in the home wrote, People are encouraged if they so wish to join in with local community which gives them a real sense of purpose. Individuals who have previously been opposed to moving into the residential setting of a home have appeared to have developed a sense of belonging and become more sociable, talkative and settled. Our findings also confirmed this. Some residents enjoy keeping pets and the home currently has three caged birds. We were also told about the pleasure two lambs brought to the residents when the local farmer had loaned them to the home last summer. All residents who made comments about the meal provision were in agreement that the food at Yockleton Grange was very good.One person wrote, The meals are excellent and nutritious. Several people commented there was plenty of variety and choice.Observation of meals being served in the larger dining room confirmed this.People were also offered drinks, fruit and snacks in between meals on a regular basis. Although some people rely on staff to be assisted with their meals, discussions with staff on duty confirmed they were knowledgeable about peoples dietary needs, and the best way to serve their residents meals so they can dine independently. The catering staff continue to use their Safer food, better business paperwork recommended by the local environmental health officer, who recently visited and awarded the home a gold healthy eating award.This award confirms the home has good food hygeine standards with the range of food on their menu to be nutritionally balanced, making sure people are offered a healthy diet whatever their needs. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the views of the people living at Yockleton Grange are listened to and acted on. Systems in place make sure people are protected from abuse so ensuring their well being. Evidence: All comments received from people living, visiting and working at the home were unanimous in that people knew what to do if they had to make a complaint. Springcare, the company who owns Yockleton Grange actively welcomes comments in order to improve the service they provide. The home complaints procedure on display in the entrance area to the home clearly describes what people have to do if they are not happy. This information is also contained in the Springcare resident information folder mentioned earlier in the report. The home has fully implemented the company monitoring systems for this matter and a company area manager checks these on a monthly basis. We have not received any complaints about this service or had any referrals to the local safeguarding adults team since the last inspection in January 2007.Management improvements have continued to make sure people feel comfortable to raise any concerns they are unhappy about.Up to date policies and procedures for safeguarding adults are freely available in the home for staff to refer to. Before our inspection the home told us staff training had improved for this sensitive issue, and new starters now Care Homes for Older People Page 18 of 28 Evidence: get an improved in depth session on abuse as part of their introduction to working at Yockleton Grange. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Judgement Good The physical design and layout of the home enables people who use the service to live in a clean,safe, well-maintained and comfortable environment, which encourages independence. Evidence: All individuals who made comments to us about the home were in agreement that the home always smelled fresh and had a welcoming, clean and tidy appearance. One person wrote that the home was, Perfect. A tour of the home was carried out with the manager, and over a dozen bedrooms were seen. All were personalised, furnished and equipped to meet peoples needs. Completion of the new conservatory, upgrade of furniture in one lounge, along with the provision of some new carpets means the home offers a variety of welcoming well furnished areas for its residents to congregate for activities and meetings or just to relax in peace. The home has also had a new kitchen refitted which resulted in a temporary mobile kitchen being used .The manager is to be commended for organising this and keeping in touch with the environmental health people so they knew what was happening. Random testing of hot water in the communal bathrooms established that the recent Care Homes for Older People Page 20 of 28 Evidence: freezing weather had affected the plumbing at the home and resulted in hot water temperatures being higher than recommended.This was dealt with appropriately by the handyman who was in the home during the inspection.He also double checked them the following day. The manager took appropriate action by using emergency signage so people were aware not to use the bathrooms until there was a satisfactory hot water supply. This issue had not been noticed until we carried out our checks. During the tour of the home the laundry door was seen to be open three times.This is an area where chemicals are stored.It is also in close proximity to the main kitchen, which also had its door propped open, meaning there could be a potential infection control hazard.This was discussed and a lock was organised to be installed on the laundry door as part of remedial action taken to resolve this. Externally the home appeared to be in good order.A clinical waste bin had its lock repaired during the inspection.People commented that they were looking forward to having the walkway installed from the main building to the new part of the home to make it easier to get to during poorer weather conditions. Care Homes for Older People Page 21 of 28 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 arrangements for staffing, their support and development ensure that the needs of the people living there are met. The recruitment practices help to ensure that the people living there are safeguarded from abuse. Evidence: Favourable comments received from people living at the home confirmed that they receive the care and support they require. One person commented, You get the best care from friendly conscientious staff. Examination of past, present and future rotas during the inspection confirmed the home is adequately staffed and takes into account the dependency needs and numbers of people living at the home.Comments from staff confirmed they are clear regarding their role and what is expected of them.One employee stated, We have a very good staff team.There are enough staff on each shift to meet the individual needs of the people we care for. Others wrote to inform us that they appreciated the staff meetings the manager organised. The home is proud there is a very low turnover of staff and this means they do not use agency carers.As a result people get looked after by a staff team that knows them.The home currently has no vacancies, however, due to internal promotion three carers are Care Homes for Older People Page 22 of 28 Evidence: moving to another home owned by the owners of Yockleton Grange. These vacancies have already been filled as a result of a successful overseas recruitment drive. Examination of the files for two recent new starters showed that suitable recruitment procedures are in place. Each file was well-organised and contained references, proof of criminal record bureau disclosures and confirmation of identity and qualifications. At our last inspection we made a requirement that the way new staff were introduced to working at Yockleton Grange needed to improve.Records seen show this to have been carried out and a new starter we spoke to stated, I had a very good induction when I started my job at Yockleton.I cannot think of any suggestions to make to improve it for any other new staff. Many aspects of staff training improved, and almost 80 of the carers have the minimum expected care qualification.The home benefits from being able to access the services of two trainers the company employs.This helps keep staff up to date with the training they need to do their job properly. The files of two staff members who have worked at the home for some time confirmed they continue to receive training to keep them up to date and have received additional safety training for issues such as bedrail safety, and infection control. Good tracker systems have been set up by the manager so she has an at a glance picture of the training staff have had and what they need.Several people have also received further training for medication, learning disabilities and dementia. Care Homes for Older People Page 23 of 28 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. People who use the service receive a safe,consistent and good quality service.This means they can be confident that their needs will be fully met. Evidence: Ms Susan Garner is the registered manager of Yockleton Grange and has worked at the home for over twenty years,and over half of those have been in her manager role. She has obtained the Registered Managers Award and NVQ 4 in Care. Since the last inspection she has undertaken any necessary courses appropriate to her role to keep her skills and knowledge up to date. She has developed an effective system to monitor and develop her team which is much appreciated. Everyone living at the home, staff and visiting relatives were very complimentary in relation to the registered manager and her leadership skills.They commented, Our manager is very supportive towards all staff. The manager has regular meetings with staff to discuss work practices training and problems staff may have. Prior to our inspection,the manager submitted an excellent annual quality assurance assessment (AQAA) to tell us about Yockleton Care Homes for Older People Page 24 of 28 Evidence: Grange. The AQAA is a self-assessment that focuses on how welloutcomes are being met for people using the service. The AQAA contained comprehensive information with a wide range of supporting evidence, some of which was seen during the inspection. The AQAA demonstrated a high level of understanding about the importance of equality and diversity and a range of evidence showing howthey have listened to people who use the service and the staff team. Through this information the service have demonstrated self-awareness and identified the areas in which it still needs to improve. Discussions with the manager during the inspection gave evidence of how the improvements were to be achieved, including the issues we have recommended be prioritised in this report.There is an ongoing programme of monitoring and auditing all aspects of the service at Yockleton Grange, in line with the policies and procedures of the company who owns the home.Spot checks of reports completed by the area manager for the company after her monthly visits confirms issues like complaints, accidents and staff development are monitored. The home is currently in the process of conducting their annual satisfaction survey, and excellent commments have already been received in response to this. Safe working systems in the home have improved to ensure good management of monies and valuables kept in safekeeping for people using the service. A consent form is now used to manage finances and keep the money of four individuals in safekeeping. All service and maintenance records for essential equipment used in the home were seen to be up to date and complied with necessary health and safety legislation.Examination of the fire safety records confirmed All regular checks made have been made to the alarm system and equipment.However the home fire risk assessment was not available to check at the time of the inspection. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 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 7 Additional details specific to individual needs of people need to be considered for inclusion in care plan records,in order to ensure record keeping accounts for all actions staff take to keep people safe and well especially with regard to their medication and dietary needs. It is advised the home considers reviewing the recordkeeping for hot water temperatures to ensure they have records freely available to confirm they have been checked before use by people living at the home, especially with regard to cold weather conditions.This will assure people in the home that the service is doing all it can to safeguard their well being. It is recommened the home environmentlal risk assessment is reviewed to take into account any infection control hazard posed by the laundry and kitchen doors being left open. This will assure people in the home that the service is doing all it can to safeguard their well being. It is advised that all records with regard to the home health and safety management including the fire risk assessment are available for inspection at all times. 2 21 3 26 4 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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