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Key inspection report

Care homes for older people

Name: Phil Mead House

Address: Phil Mead House240 Bredon AvenueBinleyCoventryW MidlandsCV3 2FD

The quality rating for this care home is: three star excellent 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:

Yvette Delaney 0 5 0 1 2 0 1 0

Care Homes for Older People Page 2 of 31

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 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.

Internet address www.cqc.org.uk

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


Information about the care home

Name of care home: Phil Mead House

Address: Phil Mead House240 Bredon AvenueBinleyCoventryW MidlandsCV3 2FD

Telephone number: 02476636166

Fax number: 02476636618

Email address: [email protected]

Provider web address:

Name of registered provider(s): The Abbeyfield Society

Name of registered manager (if applicable)

Mrs Linda Freeman

Type of registration: care home

Number of places registered: 25

Conditions of registration:

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

Under 65 Over 65

old age, not falling within any other category

0 25

Additional conditions:

The maximum number of service users who can be accommodated is 25

The registered person may provide the following category of service only, Code PC, to service users of the following gender, either, whos primary care needs on admission to the home are within the following categories, Old Age, not falling within any other category, Code OP

Date of last inspection

Brief description of the care home

Phil Mead House is a purpose built home in the Binley area of Coventry and is registered for 25 older people. Accommodation is mainly on the ground floor and consists of two lounges a large


Brief description of the care homedining area and a conservatory. There are 23 single bedrooms on the ground floor with and en suite toilet and wash-hand basin and there are two bedrooms located on first floor, one of these has an en suite toilet and the other has a bathroom directly next to the room. There are ample parking facilities to the front of the home and there is a large well-maintained garden with summerhouse to the back of the home. Phil Mead House is readily accessible to amenities such as shops, places of worship and public transport. The fee charged for staying at this service is £495.60 per week. Residents also have to pay for hairdressing, chiropody, some outings and other personal items.


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

The quality rating for this care home is: three star excellent 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 quality rating for this service is 3 Star. This means that people who use the service experience excellent outcomes. This was a key unannounced inspection visit. This is the most thorough type of inspection when we look at all aspects of the service. We concentrated on how well the service performs against the outcomes for the key national minimum standards. We find out how people living in the home experience the service and we also check that staff practice safely. Our inspection visit involved looking at all the information we have about this service such as information from other professionals, surveys from people using the service, notification from the home about incidents and other things that happen that may affect the people who live in the home.


During our visit we 'case tracked' three people, this involved looking at their daily life in the home and matching this to the outcomes they experience while using the service. We also randomly examined the care plans and monitoring records of other residents. We looked at other documents related to care practices and the management of health and safety. These include care plans, complaints records, staff training records and fire safety and other health and safety records were also sampled for information as part of this inspection. Examining these documents together with observing practice helps us to make a decision about the level of risk to the people living at the home. The inspection included meeting some of the people living at the home, including the three people whose care was being examined. Discussions took place with some of the residents and members of their family in addition to care staff and managers for the service. People we spoke to were happy with the services the home has to offer. Ten questionnaires were sent to the home to be distributed to people living in the home. Nine of the questionaires were returned to us. The information provided and the comments made in the questionnaires have been used to inform this report. We found at this inspection visit that the home continues to provide an excellent service and a safe place for older people to live. Our assessment of the quality of the service is based on all this information plus our own observations during our visit. Throughout this report, the Care Quality Commission Inspection will be referred to as 'us' or 'we'. At the end of the visit we discussed our preliminary findings with the manager.


What the care home does well:

The home is run by a competent management team, who have experience in the care sector. Prospective residents are assessed before admission, so that the home is able to make an informed decision about their ability to meet their needs. The home receives regular visits from a member of the organisation to monitor the performance. Staff are trained to carry out their roles and can meet the needs of the people they care for. The home is clean and free from unpleasant odours, which helps to provide a pleasant environment for people to live. A resident told us in their questionnaire that the home is "always fresh and clean with very welcoming staff." There is a good chose of meals at lunch time for people who need special diets and residents who have normal diets. This helps to make sure that people are given appetising and well presented food which will help to improve their appetite and help them enjoy their food. Suitable equipment such as walking aids, hoists and special beds are available for people to use. This will improve their day to day life and support their care needs. People using the service told us: "Phil Mead is a true home and not an institution." "I can only repeat what I have said in previous surveys. I am very well looked after and cared for in every department. I am very happy and contented with peace of mind. What more can a man ask for. I am 95 years young. Thank you." "The home is very good. Staff and management are very pleasant, honest, clean and tidy." "They (the home) have been able to create and maintain a caring and friendly family atmosphere in the home which mediates through to the residents and families. My mother has been at Phil Mead for 5 years and has been really well looked after 100 percent of the time, which is a great comfort to myself and all the family. Well done to Linda and all the staff at Phil Mead."

What has improved since the last inspection?

Improvements made in the home since our last inspection visit includes: Making changes to care plan documentation and the way care plans are written so that they are written in a way that supports staff to deliver a person centred and also promote equality and diversity in the homes approach to care.


Some staff have completed distance learning courses in nutrition, palliative care, dementia and medication which will help to deliver appropriate care to people living in the home. Residents have a larger screen television in the main lounge with access to a wider range of digital channels. This makes watching the television easier for people living in the home. Additional wheelchairs have been purchased for residents' use. Carpets have been replaced in the corridors of the home.

What they could do better:

We have not made any requirements following this inspection visit. We found that the manager and her staff continue to provide a safe environment for people to live in.

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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.

People wishing to use the home have access to up to date information. This will help them make informed decisions about using the home. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs.

Evidence:

A copy of the homes Statement of Purpose and Service User Guide were seen at this inspection these have been updated. Both documents contain information that will help potential residents and their representatives make a decision about using the services provided by the home. Family members visiting the home told us that they were able to visit the home before they decided that it was the right place for their relative. Other residents and relatives spoken with told us that staff had visited them from the home. The admission process was assessed at this inspection. A pre-admission assessment form is available to support staff in making a comprehensive assessment of people's needs before they are offered a place in the home. The form is


Evidence:

detailed and all the information collected would support staff when developing care plans for people deciding to move into the home. Twelve new people have been admitted to the home since our last inspection visit. Three residents' care files were examined and pre-admission information was available. All files contained sufficient information to ensure that the home could meet their needs before admission.


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:

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.

Improvements in care planning show that resident's health, personal and social care needs are identified. Residents have access to health care services so that their health and personal care needs can be met. Staff show respect for people in their care.

Evidence:

Three residents were identified for case tracking, this includes the residents whose pre-admission records we looked at. These residents were seen and the interaction between them and staff were observed. Observations made during the inspection showed that residents were relaxed in the house and integrated well with staff and other residents. Speaking with relatives they said that they had been involved in planning the care needs of their family member. Residents looked well groomed and dressed. One of the residents whose care we followed is dependent on care staff to support them in meeting all their care needs. We observed good interaction between staff and this resident and a positive awareness and knowledge of this person's health, personal and social care needs. We observed staff showing respect for residents in their care. Staff were noted to speak to people politely and in a friendly manner. People had their care needs in the privacy of their own bedroom. The way staff


Evidence:

approached residents showed that they promoted maintaining their privacy and dignity. Examination of the three care files showed that new documentation had been introduced into the home. The new care plans enable care staff to consider the individual likes and dislikes of people living in the home when planning their care. The care plan process also involves developing personal risk assessments for each resident. Examination of the care files show that some of the care plans developed for the three residents contained sufficient information and directions about the care required to ensure that the care needs of the three residents are met. There were areas however where improvement was needed to show that all care needs identified provided clear written guidance to support staff to meet people's needs. Our discussions with the registered manager demonstrated that she was aware that in some cases more detail was required in the care plans. For example one care plan provided a list of the person's medical conditions but did not identify the person's needs or provide specific directions for staff on what care to provide for this person as a result of their medical conditions. The inspection of Phil Mead House took place over two days. On the second day of our visit improvements had been made to the care plan. The manager and her deputy assured us that they plan to review and update all the care plans of people living in the home. Risk assessments completed include an assessment of the risk of residents' acquiring pressure area damage, falls, nutrition and continence. Assessments had been completed and the information used to develop care plans. This practice will ensure that staff provide appropriate and safe care to people living in the home. One of the residents whose daily life in the home was looked at by us showed that they were at risk of developing pressure sores. This person had a risk assessment carried out and it was clearly identified that they needed special equipment which includes a special bed to help meet their care needs. Observations in the resident's bedroom showed that the resident was being cared for on a suitable bed and mattress. Entries in residents' health records, discussions with residents, visitors and comments by staff confirmed that people are supported to gain access to relevant health professionals where required, such as the GP, Optician, Dentist and Chiropodist. Comments received from residents and their family in questionnaires returned to us told us that people were happy with the services the home provides. One response said:


Evidence:

"Generally the staff here are always pleasant and helpful. They treat dad with respect and loving care. Although he has difficulty with mobility, motor skills and is hard of hearing I feel he still has his dignity and individuality." The home stores their medication in a locked room. Concerns were shared with the home manager as blister packs containing medicines are stored hanging on one of the walls. The home has two metal trolleys in which they put the medicines they require for each section of the home when doing the medicine rounds. Further discussions with our pharmacist inspector showed that this form of storage is acceptable as long as only medicines are stored in the room and only staff who have been trained in the safe handling of medicines have access to the keys to this room. The home has assured us that this is the case. Our discussions with the manager at the time of inspection advised that it would be good practice to store the medicines in locked cupboards in the designated temperature controlled medication room when not in use. The manager has obtained one further metal medicine trolley from their supplying pharmacist. The home stores surplus medication in locked cupboards and also has a controlled drug cabinet that complies with current regulations to safely store Controlled Drugs. The deputy manager spoken with had a good understanding of the medicines handled in the home. If they had any concerns about the medicines they would be able to discuss these with the GP or supplying pharmacist. This practice helps staff to provide suitable support for people living in the home when handling their medicines. Audits indicated that all the medicines had been administered as prescribed. There were no gaps seen on the medicine administration records (MAR) charts. This indicates that care staff are following the homes policies and procedures. A system had been installed to check the prescriptions before they were dispensed and to check the dispensed medication and MAR charts against a copy of these. Care staff recorded the quantities of all medicines received and carried over balances from previous cycles. This would help the home to carry out audits which will assess staff practice and demonstrate exactly what medicines had been administered and recorded as such. The medicines for one of the residents we looked at had been put into a weekly plastic medicine box. These had been put into the containers by care staff and were unlabelled. It was not possible to demonstrate exactly who they were prescribed and dispensed to. All medicines should be administered from a pharmacy labelled


Evidence:

container at all times to reduce the risk of any errors. Some good practice was seen. Medicines prescribed to administer on a "When required" basis had supporting protocols detailing their use. Care staff had clear directions to follow when to actually administer them.


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:


People living in the home are supported and encouraged to maintain their independence, interests, and take part in activities, which would enhance their quality of life. People benefit from a varied and nutritious diet in a comfortable and social environment.

Evidence:

The AQAA tells us that the planning of entertainment and events in the home is discussed at resident's monthly meetings. This allows the home to arrange suitable events which cover a wide range of people's preferences and abilities. This includes trips for people outside the home in small groups with one to one escort where required. Details of all planned events and entertainment are displayed on the resident's notice board. Activities taking place in and outside the home continues to vary to help meet the needs of people living in the home. On the afternoon of our visit four residents were actively taking part and enjoying playing bowls. Activities are promoted through an activity programme, which is regularly updated. Residents are happy in the home, entertaining themselves in their own bedrooms, watching television in the lounge.


Evidence:

Resident's files show their religious preferences and that attendance at services vary for some of the residents we looked at. Some of the residents attend the services where they enjoy the singing. Staff helped residents to maintain their independence, giving support where it was needed. Residents were also supported to interact with each other through conversation and games. This helped people to socialise and engage in conversation. Residents have access to various games played in the home, magazines, newspapers, books and various planned events. Residents walked around the home with ease. It was snowing on both days of our inspection visit and the garden area available could not be fully assessed. There is a large conservatory where people can sit and look out onto the garden. Residents told us that they like sitting in the conservatory and the garden is a nice area to sit and walk around in the summer either by themselves, with their family or with a carer. Relatives, friends and other visitors are encouraged to visit throughout the day and maintain contact and involvement in the care of their relative. Visitors were observed to visit the home at the time of inspection. Conversations were held with two relatives and their comments told us that they were very positive about the quality of service provided in the home. Times of visiting were varied throughout the day and there were no restrictions. Residents enjoyed their family visits and a number of residents were able to take part and enjoy frequent trips outside of the home with their family. One of the residents we spoke to made frequent visits out into the community on their own. This enabled them to maintain their independence, contact with family and friends and also do some personal shopping. It was good to hear residents refer to Phil Mead as their home. Two gentlemen we spoke to said that they had a good Christmas with their families but it was nice to know they were coming home at the end of the day. In our conversations with these and other residents they consistently referred to Phil Mead House as their home. We had a meal with the residents at lunch time. Our observations and conversations with people living in the home showed that residents enjoyed their meal. The meal offered was lamb, potatoes and vegetables followed by apricot crumble. An alternative main meal was offered to those residents who did not want the lamb. Residents were able to eat at their own pace and staff were attentive to their needs when they needed to be. Reading the menus indicated that varied and appealing meals are offered to people. For a small fee family members and friends are able to eat a meal with their relative if they choose. Snacks are available at any time of the day or night and fresh


Evidence:

fruit was freely available in bowls around the home. Residents were given the opportunity to make a choice at breakfast time. The cook maintained a list of residents daily breakfast preferences which showed choices of cereals, toast and varied cooked breakfasts were offered. Some residents chose to have their breakfast in their bedrooms others ate in the dining room. This practice shows that choice is offered to people who live in the home and helps to make sure that a nutritious and balanced diet is provided. Our discussions with the cook showed that she was very knowledgeable about the residents. She was aware of people's likes and dislikes and lists of their food and meal choices and preferences. A list was available titled 'Smooth Texture Food' provides some meal and snack ideas for residents to show ideas on foods people who required a soft diet could eat without having to make the food unappealing. Information examined showed breakfast ideas such as ground rice, ready brek or instant oats, liquidised or stewed fruit which also states do not include skin or fibrous core. Comments made by a resident on the meals provided in the home told us that they felt there could be "More variety for meals."


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:


People living in the home can be confident that their concerns will be listened to and taken seriously by the home. There are appropriate policies, procedures and training opportunities to safeguard residents.

Evidence:

A copy of the complaints procedure is displayed in the home and a copy is available in the statement of purpose this makes sure that it is accessible to people living in the home, their families and staff. The complaints leaflet for the organisation is also available in Braille. Relatives told us in their questionnaires that they would know who to speak to if they were not happy. Most people would speak to the manager about their concerns. People we spoke with were confident that their complaints are listened to and always acted on promptly. The home has not received any formal complaints and therefore records were not available for inspection. We discussed verbal concerns that the home may have received and the manager told us that these are handled immediately. The manager suggested to us that she realises that it would be good practice for the home to record any verbal concerns they receive. This would provide details on the issues that concern residents and their families and the action staff working in the home have taken to address peoples concerns. The residents we reviewed and their family had not had any cause to raise concerns about the home and were happy with the services the home provided.


Evidence:

The home has a policy for adult protection. The procedures give staff direction on how to respond to suspicion, allegations or incidents of abuse. Training records show that staff have received training in recognising signs and symptoms of abuse. We spoke to staff who were knowledgeable about what they would do if they suspected abuse and were able to confirm that they had attended protection of vulnerable adults (POVA) training. The home has a copy of Coventry City Council's 'Vulnerable Adult Protection Policy and Procedures.' This will support staff in knowing what the local procedures are for reporting any concerns about suspected adult abuse.


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:


The residents live in a clean, homely, well-maintained environment with attractive communal and personal areas.

Evidence:

We looked around the home with the registered manager. We looked at some of the personal bedrooms of people living in the home which includes the bedrooms of people whose care we reviewed. The home was clean, bright and tidy. There is a large central dining room, two lounges and a conservatory where people can sit. Two of these areas allow space for people o sit quietly, read or receive visitors. The main lounge has a large television which means residents can view TV programmes they enjoy much easier. Residents told us that they liked having a larger screen TV saying that "The picture is much clearer." The bedrooms of residents and communal areas contain suitable furniture to help make their day to day life comfortable. The home is easily accessible for residents to walk around freely and there is access to the garden area. The bedrooms we looked at showed that people are encouraged to personalise their rooms with their own belongings such as photos, small items of furniture and ornaments. Bedrooms on the ground floor have access to en suite facilities. Comments from residents we spoke with said of their bedrooms that "My room is comfortable, I have all my things around me." There are two bedrooms on the second floor one of which has access to a


Evidence:

bathroom. These bedrooms are accessed by a stair lift. Systems are in place to manage the control of infection. There were no unpleasant odours noted in areas viewed during the inspection. Protective clothing such as plastic gloves and aprons were available and arrangements are in place to help minimise the risk of cross infection. We spoke to one of the laundry staff who was very knowledgeable about her work and was able to tell us about the management of dirty laundry. The kitchen was clean, well organised and there was a sufficient supply of all foods required. We were able to examine the cleaning schedules and records which showed that checking of the temperatures of food and fridge/freezers were maintained and were within safe limits to support the safe storage of foods.


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:


Staffing levels meet the needs of people living in the home. Resident's can be sure that competent and qualified staff are caring them for. Procedures for employment, induction of new staff and ongoing training ensure that residents are protected and safe.

Evidence:

It was evident from the well kept appearance of people living in the home that there were sufficient staff on duty to meet their personal care needs. The manager's full time hours are supernumerary. The home also employs laundry, catering, cleaning, maintenance and administrative staff. This helps to make sure that care staff do not spend time undertaking non-caring tasks. A resident did comment in their questionnaire that: "I think the home would benefit with perhaps another member of permanent staff." However generally people living in the home felt that the staffing numbers were good. Training records and information in the AQAA show that 70 percent of the permanent care staff employed in the home have a qualification in care at NVQ (National Vocational Qualification) level two or above. This shows that the home continues to exceed the National Minimal Standard for the number of qualified staff on each shift in older people services.


Evidence:

The personnel files of three recently recruited staff were examined. The files showed that they contained evidence that satisfactory pre employment checks such as Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (PoVA) had been carried out. Two references were obtained for all staff. Ensuring consistent and robust recruitment procedures are followed before staff start working in the home helps to make sure that people living in the home are protected from the risk of abuse. All staff have an initial induction to the home and are supervised for the first week, after which they complete an in depth induction that meets the Skills for Care Induction Standards. Completed induction forms were seen in staff records examined. Topics covered include 'Equality and Diversity.' Existing staff have attended training sessions on equality and diversity. Staff who have completed their NVQ training at level 2 have an awareness of Equality and Diversity included as part of the course work. Staff receive a variety of training related to their role such as moving and handling, first aid, food hygiene and training in the Protection of Vulnerable Adults.


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:


Residents live in a home, which is run and managed by a person who is fit to be in charge and discharges her responsibilities fully. The home is run for the benefit of the residents and they also benefit from the ethos and leadership of the home. The safety and well being of the residents, visitors and staff are promoted and protected.

Evidence:

The registered manager was present on both days of the inspection. The management team and other staff show a commitment to providing an excellent service which is run solely for the benefit and safety of the people they serve. The manager, deputy manager and all staff showed us that they are enthusiastic and committed to continuously improve the services offered by the home. The home has support from an administrator who helps in the day to day running of the home. Staff spoken with said that the management team are approachable. The organisation uses a formal quality assurance system to assess the services provided by the home. Action plans are developed for making improvements and are


Evidence:

reviewed to monitor progress. Residents and relatives meetings are held and the outcome used to support improvements in the home. Residents are consulted about changes that occur which include areas such as food, activities, routines and the general running of the home. We read some of the minutes for residents, relatives and staff meetings. The minutes provided information on the topics looked at but were not detailed to demonstrate the discussions that took place. Detailed minutes would give an idea on the input made by residents, relatives and staff at the meetings. This which would evidence residents involvement in the outcome and decisions made. Residents, relatives and staff told us that they were involved in some of the changes made in the home. Questionnaires are sent out to residents and visitors. The information is shared and used to make changes in the home where appropriate. Residents told us that they are listened to at meetings and have seen changes made in the home as a result of their discussions. For example residents expressed concerns about the noise levels at night due to banging doors and this has been listened to and addressed by staff. The evaluation of Phil Mead House 'Annual Visitors and Service Users' questionnaires carried out March 2009 was seen. The evaluation was based on the return of 13 visitors and 15 residents questionnaires. The outcome showed that comments from both groups were positive, complimentary and encouraging. Areas for follow up include decorating of individual room, care review, helpful comments regarding activities were made but the evaluation report does not give details of what was actually said about these areas. The personal monies of people living in the home are kept securely in separate bags and accurate records of income and expenditure are maintained. An audit of the personal monies of residents followed through the case tracking process was found to be correct. The Quality Assurance Manager for Abbeyfield undertakes Regulation 26 visits on behalf of the organisation. The outcome of these visits was recorded, and copies of the report have been forwarded to us. Areas looked at include residents and their representatives comments and the quality assurance manager's observations regarding standards of care in the home. Information sent to us in the AQAA tells us that equipment is serviced or tested as recommended by the manufacturer or other regulatory body. Evidence was sampled


Evidence:

at random to confirm this. For example, PAT testing of electrical equipment used in the home, disposal of clinical waste, hoists, fire risk assessment and checking of fire equipment had been made. The fire alarm is tested weekly. Examination of policies and procedures in the home show that these have been updated for example, accidents and incidents to people living in the home, disposal of clinical waste and moving handling. Staff were asked questions related to procedures used in the home and showed that they had knowledge and understanding of safe practices in the home.


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

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 7 The home should continue to make sure that all care plans are reviewed to clearly identify the care needs of people living in the home. This will help to make sure that staff have all the information available to them to meet peoples needs safely.

2 9 All medicines should be administered from a pharmacy labelled container at all times to reduce the risk of any errors.

3 33 Minutes of meetings held in the home for residents and staff should give some indication of the discussions that took place. This will help to demonstrate the involvement of residents and staff in how the home is run.


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Documents

Key inspection report › sites › default › files › ...Care Homes for Older People Page6 of 31 Summary This is an overview of what we found during the inspection. The quality