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Key inspection report

Care homes for older people

Name: Albion Court

Address: Albion Court Care Centre Clinton StreetWinson GreenBirminghamB18 4BJ

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: Date:

Amanda Lyndon 1 8 0 1 2 0 1 0

Care Homes for Older People of 32

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 stars - excellent• 2 stars - good• 1 star - adequate• 0 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. They reflect the things that people have said are important to them:

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.


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 Inspection report

Author Care Quality Commission

Audience General public

Further copies from 0870 240 7535 (telephone order line)

Copyright © Care Quality Commission 2010This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010.

Internet address www.cqc.org.uk

http://www.tso.co.uk/bookshop


Information about the care home

Name of care home: Albion Court

Address: Albion Court Care Centre Clinton StreetWinson GreenBirminghamB18 4BJ

Telephone number: 01215547261

Fax number: 01215513121

Email address: [email protected]

Provider web address:

Name of registered provider(s): Restful Homes (Birmingham) Ltd

Name of registered manager (if applicable)

Ms Yvonne Manton

Type of registration: care home

Number of places registered: 89

Conditions of registration:

Category(ies) : Number of places (if applicable):

Under 65 Over 65

old age, not falling within any other category

0 89

Additional conditions:

. The registered person may provide the following category of service only: Care Home Nursing (Code 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-Code OP maximum number of places 57 Dementia Code DE maximum number of places 32 2. The maximum number of service users to be accommodated is 89 3. The minimum age on admission for Dementia category shall be from 50 years

Date of last inspection

Brief description of the care home

Albion Court provides care and accommodation for up to eighty nine older people. This includes people requiring general nursing and residential care. This includes people who have additional dementia care needs.The date of registration for this service was 21st July 2009.


Brief description of the care homeThe home is located in a residential area less than half a mile from City Hospital. It is close to local shops, the City Centre, and public transport links. Ample off road parking is provided for visitors to the home. At the front of the building there are electronic gates that can only be accessed from inside the building. External CCTV is provided for security purposes. The home is a non-smoking environment.There is a secure garden that is suitable for all people to use. The home is purpose built. Accommodation is provided over three floors, and upper floors are accessed via a passenger lift or stairs. All bedrooms offer single accommodation and have en suite bathroom facilities including wet room style assisted showers. In addition communal assisted baths and showers are available for all people to use. The home offers communal dining and lounge areas. Plans are in place for a cafe to be created on the ground floor. There are two hair salons and kitchen and laundry facilities are based on site. Corridors are spacious and allow people to move around freely with any mobility aids required. The home employs activity workers. This means that there are opportunities for people to take part in activities both within and outside of the home. In the reception area there is information that may be of interest. This includes the statement of purpose and service user guide.All people living at the home are funded by Birmingham City Council. The home does not accept people that are privately funded. Items excluded from the accommodation fee include chiropody, toiletries, hairdressing and newspapers.


SummaryThis is an overview of what we found during the inspection.

The quality rating for this care home is: two star good service

Our judgement for each outcome:

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 focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care home's capacity to meet regulatory requirements, minimum standards of practice, and focuses on areas that need further development. The inspection was carried out over one day by two inspectors. The home did not know we were going to visit. There were eighty three people living at the home. Six of these people were living there on a temporary basis, and four people were in hospital. Prior to the visit taking place we looked at all of the information we had received or asked for. This included any complaints made or notifications received from the home. These are reports about things that have happened in the home that they have to let us know about by law. We received an Annual Quality Assurance Assessment (AQAA). This tells us how the home think they are performing in order to meet the needs of


people living there. It also gives us some numerical information about staff and people living at the home. This was completed by the manager in good detail and returned to us within the deadline. We sent out random surveys to eight people who live at the home, eight relatives, and eight staff members in order to obtain their views about the service provided. These had not been returned to us at the time of writing this report. Four people were case tracked. This involves talking to them and discovering their experiences of living at the home. We focus on the outcomes for these people. We also spent time observing care practices and speaking to six staff members about the care and support they provided to these people. We sampled care, staffing, and health and safety records. We looked around the areas of the home used by people case tracked to make sure it was warm, clean and comfortable for them. We gave all people living at the home the opportunity to be involved in the inspection. We spoke with nine of these people. We also spoke with three relatives that were visiting the home.


What the care home does well:

People have the majority of the information that they need to enable them to decide if they want to live at the home. Prior to coming to stay there, people can be confident that the home will be suitable to meet their needs. People told us that they were happy with how the home support them to meet their personal hygiene needs. People have access to a range of health and social care professionals and this ensures that the appropriate advice is sought to meet their health needs. People can be confident that they receive their medication at the prescribed times. People are encouraged to lead fulfilling lives that meet their needs, interests and expectations. People are offered a variety of healthy meals that meet any special dietary requirements. People benefit from being cared for by a staff team that are supported in their job roles. People can be confident that they are supported by people who have received training in order to meet their individual and collective needs. People have some opportunities to be involved in the running of the home People can be confident that they can choose how they spend their time. The home is sensitive to people's cultural and religious needs so that they are supported to live their lives pursuing what is important to them. People are supported to keep in touch with their families and friends so that they can maintain relationships that are important to them. People are provided with a clean and comfortable place to live that meets their assessed needs. There is a robust system for checking that people's money is held at the home in a safe manner. People told us: "I came and looked around before I moved in". "We were able to choose which bedroom we wanted".


"My relative always looks well groomed". "We are pleased that he is being looked after so well". "I get up at 6am as I like to get up early". "The food is good. I have no complaints". "It is home from home here". "I can get around the home using my walking frame". "I have a call bell and the staff answer it". "You can't ask for more. The staff are lovely".

What has improved since the last inspection?

This is the first key inspection undertaken at this home since registering with us.

What they could do better:

Each person must have an up to date care plan so that care and support is provided in the way they require and prefer. Arrangements should be in place so that people have the opportunity to put forward their views of the service provided at the home during group meetings.

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 [email protected] or by telephoning our

order line 0870 240 7535.


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


Choice of home


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.


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.

Some systems are in place so that people can make informed decisions about whether to live at the home or not. Prior to admission people can be confident that their care and support needs will be met at the home.

Evidence:

A statement of purpose and service user guide had been produced and these had been distributed to people living at the home. These included information about the majority of services and facilities provided at the home.We saw that these had been produced in a large print format. However the management team stated there were no plans for them to be produced in other formats or languages. We were told that the need for this had not arisen. However we would recommend that consideration is given to this based on the diverse cultural backgrounds and abilities of people looking to come to stay at the home. This means that the information will be available in a way that more people will find it easier to understand. In addition the organization has produced a web site with information about the home. This includes an email a


Evidence:

resident function. So that people can stay in contact with those important to them. All people living at the home are funded by the local authority as part of a block contract. People who are privately funded are not accepted at the home. All referrals are made via social services. We saw that comprehensive assessments of people's needs are undertaken prior to coming to stay there. This is to ensure that their care needs could be met at the home. We sampled four of these, and found that not all had been dated or signed. This means that we were not always able to determine when the assessment was undertaken and who completed it. All people had recently come to live at the home, and we were able to speak to a number of people about their experiences of the pre admission process. They told us that they had the opportunity to view the home prior to coming to live there. This is in order to sample what life would be like to live there. People told us "I came and looked around before I moved in." and "We were able to choose which bedroom we wanted". Intermediate care is not provided at the home. However, there are currently eleven interim care beds funded by the primary care trust. This means that following assessment people can come to live at the home for a short time. This is usually following discharge from hospital. This gives them the opportunity to regain their health and independence prior to returning to their own homes. It is also a period of time to assess whether a person requires extra support on a long term basis. Details about this are not included within the statement of purpose and service user guide. This will prevent people from having this information when deciding whether to live there or not.


Health and personal care


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.


Judgement:


Systems in place ensure that the health and personal care needs of people living at the home are met.

Evidence:

We saw that assessments of people's individual physical, emotional, and social care needs are undertaken on admission to the home, and are reviewed periodically throughout their time there. Care plans are written from this information. These are individual plans written with the involvement of people and their representatives about what people can do for themselves, and in what areas they require support. We found that the vast majority of care plans were personalised included people's preferences regarding their daily lives, and identified what the person could and couldn't do for themselves. They also gave instructions for staff about the support to be provided. It was evident from our discussions with people living at the home and their visitors that people were involved in writing and reviewing these. This is important so that people are encouraged to maintain their independence. It means that their preferred routines can be maintained whilst living at the home.


Evidence:

We saw that a care plan written for a person who had diabetes had not been updated to reflect their current care and treatment regime. This is despite their diabetes being poorly controlled at the current time. Specific instructions for the nursing staff to follow in an emergency were not available, and there was confusion about whether emergency medication was available at the home should this person's blood sugar fall too low. There was however, evidence that this person's health is regularly being monitored by the doctor and that the home was meeting this person's health care needs. Care staff met during the visit had a good knowledge about the dietary requirements of this person in order to promote their health. It was of concern that staff had failed to write a short term care plan following a person's return to the home after surgery. Following the visit the manager advised us that information about this had been recorded elsewhere in the person's care notes. However the failure to write a care plan may result in staff not following the care instructions given by the hospital. In addition we saw that the mobility care plan and falls risk assessment relating to this person had not been updated following the surgery, despite the person experiencing two falls recently. This may compromise the person's health and safety. It was noted, however, that since coming to live at the home, the general health and well being of this person had improved greatly. We saw that the home complete risk assessments for people so that consideration is given to supporting them to take responsible risks and promote their independence. We saw that moving and handling assessments identified the specific support and equipment required for each person. In addition the majority of staff had undertaken recent training in this area. This should mean that with the exception of the example above people are supported to transfer in a safe manner. Risk assessments are completed about the risk of people developing pressure sores (sore skin), whilst living at the home. We saw that the assessment tool being used to calculate the risk of this, was incorrect and this could have potentially resulted in a person not receiving the pressure area care they required. Despite this, at the time of our visit, we did not identify that this had been the case and the assessment tool was amended. The manager told us that with the exception of one person who was currently in hospital, no one living at the home had pressure sores. Care records sampled identified whether people had a preference for the gender of staff member supporting them with their personal care needs. People told us that they were happy with the level of personal and health care provided by the home. They said "My relative always looks well groomed". and "We are pleased that he is being


Evidence:

looked after so well". We saw that people were clean, hair was neatly styled, and people were wearing clothing appropriate to their age, gender, culture, and the time of year. Arrangements are in place so that a doctor visits the home on a weekly basis. However we saw that people can retain their own doctor on admission to the home, if the doctor is in agreement. Medical advice is also sought in between the weekly visits as required. In addition we saw that advice can be sought as needed from a range of other health and social care professionals. There is a good system in place for the management of medication and we saw that records in relation to this were well maintained. An audit of this had recently been undertaken with a positive outcome. This should mean that people receive their medication as prescribed.


Daily life and social activities


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.


Judgement:


Opportunities for social stimulation meet the needs and expectations of people living at the home.

Evidence:

The home employs two activity coordinators and are currently recruiting a third person to join the team. This should mean that there are enough staff to support people in this area. The activity plan on display on the day of the visit identified that it was a "pamper day" and we saw that a number of people had chosen to take part in this. The hairdresser visits each week and there are two hair salons so that people can enjoy the experience of having their hair done. We saw that in addition a number of people had chosen to have manicures. This should promote their well being and self esteem. From records sampled and from our discussions with people living at the home, it was evident that there was a range of activities for people to join in with. This included one to one support, arts and crafts, mini bingo, movie night, quizzes and shopping trips. It was evident that people living at the home were involved in arranging activities and had a choice about which they participated in. The manager told us that she was


Evidence:

developing links with the local community for the benefit of all involved. We saw that one person was sitting reading a newspaper and said "The home orders newspapers for us if we want them". People told us that the home is sensitive to their religious and cultural needs. Religious worship services are regularly held at the home. In addition staff can help make arrangements for people to worship at a local place of their own choice if preferred. This means that people have the opportunity to worship and practice their own faith and pursue what is important to them. People are encouraged to maintain contact with their family and other people important to them. People told that there is an open visiting policy and that they can meet with their visitors in private if they wish. In addition we saw that some people go outside of the home with their friends and family at any time that they choose. One visitor said "Everyone knows us. It is first name terms". From discussions with people living at the home and from our observations, we saw that people have a choice of how they spend their time, where they are served their meals, and the time that they are served their breakfast. One person said I" get up at 6am as I like to get up early". Menus identified a variety of nutritious meals and special diets are prepared for reasons of health, culture, and religion. A choice of meals is always available, and in addition people have the option of choosing snacks at other times. We saw that staff speak to people about what is on the menu so that they can choose which they would like to eat. People told us "We get good grub here. You get a choice more or less. The food is never cold. We had a good Christmas dinner" and "The food is good. I have no complaints". We saw that lunchtime was relaxed and the majority of people were being assisted by staff in a respectful manner.It was of concern, however, that we saw that one person's urinary catheter bag had been left in view of other people during their meal. In addition, another person had been left to eat his meal with a spoon despite his care plan identifying that he required his food to be cut up and he ate with a knife and fork. Following the visit the home manager looked into these issues and confirmed with the people involved that support was being provided to them in the way they preferred. In addition she stated that measures are now in place to ensure that the dignity and wishes of all people living at


Evidence:

the home are maintained.


Complaints and protection


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.


Judgement:


There are systems in place so that people can be confident that outcomes will improve as a result of raising concerns. Systems in place protect people from harm.

Evidence:

An easy to read complaints procedure was on display in the home and was included in the service user guide. In addition we saw that there was a suggestions box and "compliment, comment and complaint cards" available at the home. This should mean that people know how to make a complaint. People told us "It is an open house. If we are not happy everything is acted upon. No worries there" and "I've got no complaints here. I would not change anything". Since registering with us we have received one complaint about the service provided at the home. This was investigated by both the home and social services and the issues raised were not upheld. Details of the comprehensive investigation into this were available at the home. From records held at the home reviewed during our visit, we found that they had recorded two low level concerns in various records held at the home. We would recommend that the system for recording these be improved so that people can clearly identify that actions have been taken in response to these for the benefit of people living at the home.


Evidence:

Shortly after the visit, the home and social services told us about three safeguarding referrals involving people living at the home. One of these was also regarding care afforded to a person whilst in hospital. The safeguarding referral about this had been raised by the home manager. These are ongoing and investigations into the concerns raised are currently being undertaken by our partner agencies. The staff training matrix identified that all staff had undertaken training about safeguarding. Care staff met with during the visit had a good knowledge about this.


Environment


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.


Judgement:


People are provided with a clean and homely living environment that meets their assessed needs.

Evidence:

We saw that there is an attractive and secure garden for people to enjoy. This is suitable for all people living at the home to use. We saw that there is a train line directly behind the home. Positive comments were made about this. The relatives of a person living at the home said "The trains are a focal point". Details about this are included within the statement of purpose so that people have this information when deciding whether to live there or not. We sampled the areas of the home relevant to the people case tracked, and found that it was furnished and decorated to a high standard. One person said "It is home from home here". Accommodation is provided on three floors with each floor having communal dining, lounge and assisted bathing facilities. We were told that people are able to move freely around the home as they wish. People told us "I can get around the home using my walking frame" and "I like to sit here by the front door. It is sociable to see people coming and going". Plans are in place to complete a cafe area on the ground floor of the home for people to enjoy. The home is a non smoking environment and


Evidence:

arrangements are made for people who choose to smoke outside of the building. Information about this is included in the statement of purpose so that people are aware of this when choosing a care home. People told us that they had chosen their bedrooms. All bedrooms offer single occupancy and all have en suite facilities of a toilet wash basin and wet room style assisted showers. We looked at the bedrooms of people case tracked and saw that they have personalised their bedrooms to reflect their age, gender, interests and culture. People met during the visit stated that they were very happy with their rooms. They said "The bedroom is warm not cold and there is lots of space. I have a call bell and the staff answer it". People told us that following assessment they had the option of having a key for their bedroom door. This promotes their privacy and means that they can keep their personal items safe and secure. There is equipment available to assist staff to deliver personal care to people living at the home in a safe manner. We found that the home was clean and fresh throughout our visit, and effective and hygienic laundry systems were in place.


Staffing


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.


Judgement:


People can be confident that staff have the majority of skills and knowledge they need to meet their needs.

Evidence:

In addition to care staff, administration, cleaning, maintenance, laundry and catering staff are employed. This means that people living at the home receive some support in these areas. Positive comments were made about the staff team. The relatives of a person living at the home said "The staff are lovely". We saw that they were spending time talking with people living at the home. This promotes a homely and inclusive living environment for the people living there. The manager told us that the staff team is developing, staff turnover is low, and agency staff are not used. This should promote continuity of care for people living at the home. The cultural backgrounds of the staff team reflected that of the people living at the home. This means that support could be provided in an understanding manner. We saw that this had a positive and calming effect on people living at the home.


Evidence:

People living at the home and the staff team told us that there were enough staff on duty to meet people's needs. People told us "There are enough staff. They help you" and "We have enough staff and I am very happy here". We were, however, unable to determine the actual number of staff on duty over a period of time as the staffing rotas did not always identify people's surnames and job titles. We sampled the recruitment files of three staff members who had recently come to work at the home. These included the majority of information required. However we saw that on one occasion, despite two references being in a person's file, one of these was not an employment reference. This was brought to the attention of the home manager who arranged for a further reference to be obtained for this person without delay. We saw that staff do not start working at the home until satisfactory criminal records checks have been obtained. This is to protect people living there. Due to the high volume of staff being recruited at the home over a short period of time, a number of people told us that they had come to work at the home via a recruitment agency. They told us that they had received training in health and safety matters prior to starting work at the home. We saw that new workers then complete an induction training programme also covering health and safety matters. This is in order to gain the skills and knowledge in preparation for providing care and support to people living at the home. New workers told us "I had a two day induction at the home following the training provided by the agency. I was confident when I started here" and "We have a lot of support from the nurses". Other staff members also confirmed that this was the case. The staff training matrix identified that staff had recently undertaken training in health and safety matters. Training about caring for people with dementia and tissue viability are planned. The manager told us that they do not accept people with behaviour that can be challenging to others. However during our visit we saw that two people with dementia care needs were arguing in one of the communal lounges. Despite there being eleven vulnerable people in the lounge, there were no staff present at the time of the argument. We did note, however, that there were two members of staff present in the lounge prior to the argument and a thrid staff member was located directly outside of the lounge. This was brought to the attention of the management team and was addressed without delay. In addition the manager told us that plans are in place to provide staff training about how to prevent further incidents of a similar nature whilst supporting people with dementia.


Evidence:

As this is a new service they told us that they aim for at least 50% of care workers to achieve a nationally recognised care award (NVQ 2) within the first twelve months. New workers met during the visit told us that they were to start working towards this in two week's time. We asked to sample the minutes of recent staff meetings. The manager told us that only registered nurse meetings had been held recently, however the minutes of only one of these was available. However arrangements were in place for all staff to be involved in meetings so that they have the opportunity to put forward suggestions about the service provided. This should in turn result in improved outcomes for people living at the home.


Management and administration


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.


Judgement:


People living at the home can be confident that the home is being run in their best interests.

Evidence:

The home manager has been in post since the home opened and is registered with us. She is a registered mental health nurse and has had previous management experience of working in a care home environment. She works extra to the rota and this means that she has dedicated management time. From our discussions with her she appeared to have good knowledge of the care and support needs of the people living at the home. Positive comments were received about her management style. People told us "Everything is in order. The managers are here for us" and "The manager is very supportive. She is the sort of manager we could go to if we had any problems". They told us that they were in the process of recruiting a deputy manager who would work alongside the care team. This person would provide support to both the manager and the rest of the staff team. This should ensure that people living at the home


Evidence:

receive a good standard of care. In addition a senior external manager and the directors of the Company visit regularly. It was evident that they had a good knowledge of the people currently living at the home. Prior to the inspection the manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This included comprehensive details about the home, staff, and people who live there. It also included information about what the service hoped to achieve for the benefit of the people living there. We found that the information included within this was consistent with the findings of our visit. This means that it gave us a reliable picture of the service provided at the home. There are some systems in place to capture the views of people living at the home and those people important to them. We saw that senior external managers undertake regular quality monitoring visits at the home, and that people living there are involved in these. We saw that service satisfaction questionnaires had recently been sent out to the relatives of people living at the home in order to seek their views about the service provided there. We saw that positive feedback had been given about the service provided including "Staff very helpful and friendly" and "Couldn't ask for better. Mom is very happy". The home manager told us that a report will be written based on the findings of the surveys so that people know that their views are valued. Arrangements in place for group meetings of people living at the home need to be further developed, so that people have the opportunity to put forward suggestions about the service provided on a regular basis. The minutes of these meetings should be on display so that people who did not attend the meeting were made aware of what was discussed. There is a robust system in place for the safekeeping of small amounts of money held on behalf of people living at the home. Receipts were available and this means that it was possible to establish what people's money had been spent on. From records sampled we identified that regular checks are taken on equipment to ensure that it is safe to use. We saw that accident forms are completed and that the manager regularly audits these. We discussed one accident report with the manager as the information indicated an incident of a possible safeguarding nature that we had not been aware of. The manager told us that the information on the report was not an accurate account of the incident and that the incident was not of a safeguarding nature. She said that she had addressed this with the staff team to ensure that they were aware of the


Evidence:

importance of keeping an accurate record of events.


Are there any outstanding requirements from the last inspection?

Yes £ No R

Outstanding statutory requirementsThese 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


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 Each person must have an up to date care plan outlining their current long and short term care needs. This is so care is provided in the way they require and prefer.

15/03/2010

RecommendationsThese recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.

No Refer to Standard Good Practice Recommendations

1 1 The statement of purpose and service user guide should identify all facilities provided at the home so that people have this information when choosing a care home.

2 1 Arrangements should be in place so that the service user guide and statement of purpose can be produced in different formats and languages. This is so that more people can access the information.

3 3 Systems should be in place so that pre admission assessment documents are signed and dated. This is to determine when assessments were undertaken and by whom.

4 16 A system should be in place so that people can clearly identify what actions have been taken in response to any


RecommendationsThese 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

low level concerns they raise.

5 27 A system should be in place so that it is possible to establish the number and skill mix of staff on duty at any given time.

6 29 Systems should be in place to ensure that two valid references are obtained for all staff members prior to coming to work at the home.

7 32 Minutes of group meetings should be accessible to all people including those unable to attend. This is so that they are aware of matters discussed and any actions to be taken as a result of this.

8 32 Arrangements should be made so that people living at the home have regular opportunities to take part in group meetings. This is so they can put forward their suggestions about the service provided.


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