At our opening session of the Birmingham NEC Care Show in October 2023, ‘Have an Outstanding Inspection Day. Climbing the (CQC Single Assessment) Framework.’ the Outstanding Society Director, Ruth French, was joined on the panel by CQC Inspector Debbie Ho, Pia Rathje-Burton from Skills for Care and Frederick Palmer, a resident of The Close Care Home, Burcott in Oxfordshire.

Frederick Palmer, known to his friends as Fred, an 84-year-old retired architect, town planner and magistrate, was born and raised in Toronto, Canada. He graduated in Architecture from McGill University in Montreal and then in Town Planning from Edinburgh University.

For the last 25 years of his working life, he was a Planning Inspector for the Central Government, where he held public inquiries into planning appeals throughout England and Wales. These were cases where a District Council had refused to grant planning permission, and the applicant lodged an appeal. His decisions on these appeals were final. In 1986, he was appointed as a Magistrate to sit on criminal cases.

Fred with his late wife, Helen, have 2 daughters and a granddaughter. In 1982 Fred and Helen bought a Victorian Old Vicarage, with 3 acres of land in Wiltshire. Instead of getting a job, Helen wanted to see if she could feed their family for free, which she largely did. On the smallholding they kept sheep, a beef cow, a variety of poultry, a vegetable & fruit garden, an orchard and a woodland which they planted to feed their wood burner. Helen was able to sell surplus meat from the smallholding to buy what she could not produce herself.

In 1998 at the age of 59, Fred suffered a stroke which left him with mobility, hearing, and speech issues. However, he believes it did not affect his mind! Fred had always wanted to learn to fly. He was determined not to allow the stoke to ruin his life and made up his mind to try. He qualified as a licenced pilot in 2009, aged 70 and has now flown hundreds of hours solo or with passengers.

Because the stroke meant he could no longer function as Helen’s farm labourer, they decided to move. Looking back on it, they thought their 24 years on the smallholding were the best.

Sadly, after nearly 59 years of marriage, Alzheimer’s took Helen in May 2022. Fred and Helen, together, lived in 2 Care Homes and, after Helen’s passing, Fred moved to a third, The Close. Until Alzheimer’s struck, they travelled extensively.

Fred’s current past times include his family, his computer, films, current affairs and trying to stay fit to the extent that his restricted mobility allows.

Residents will normally be interviewed as part of a CQC inspection. As a resident who has been interviewed, and with the experience of having lived in 3 different ‘Luxury’ Care Homes, Fred set out below, under each of the CQC inspection categories, what he regards as some key requirements for having contented residents, himself included:

I. SAFE

1. Where possible, bedrooms and bathroom should large enough so that residents in wheelchairs can avoid bumping into walls or fixtures.
2. Everything in the wardrobe should be reachable from a sitting position in a wheelchair.
3. Residents should be permitted to have pictures hung wherever they want them even if this requires extra fixings to overcome any risk if them falling, say, onto the bed.
4. The Maintenance team should be willing to assist with personal ‘DIY’ problems e.g. squeaky wheelchair wheels.
5. Rooms should be deep cleaned daily, including the removal of carpet stains.
6. In case of fire, residents having rooms with doors to the outside should be able to open them without the need to call a Carer to unlock the door.
7. Where residents have call buttons which they carry with them, and the button is pressed, a Carer should be able to immediately locate the resident anywhere on the site, even outdoors.
   

II EFFECTIVE

1. The meals should be of restaurant standard, including having the correct tableware and the presentation of the food on the plate.
2. When a meal is ordered in advance, residents should be shown photos of the choices.
3. A printed ‘a la carte’ menu should be available in each bedroom, for residents who do not wish to order from the set menu.
4. To ensure that quality is maintained, Management should regularly eat from the residents’ menu and also be satisfied as to the appetising appearance of the food on the plate.
5. In the dining room, chatty residents should be seated together.
6. Every effort should be made to avoid running out of items, just as you don’t allow your car to run out of fuel.
7. TV sets should be ‘smart’ TVs, connected to the Home’s wi-fi.
8. Where there is no fire or similar risk, residents should be permitted to bring their own familiar furniture with them to the Home.
9. Residents’ meetings should be held at regular intervals. They should be set up in such a way that residents are encouraged to speak candidly and without fear of recrimination. Management should keep residents informed of any action taken.
   

III CARING

1. All residents should be treated as individuals and with respect. Never say ‘You just have wait your turn’ or ‘Don’t press the call button. It upsets the Carers’ routine.’
2. Carers must accept that they are there to assist residents and are doing a job for which they are paid. They should not normally expect to be treated by residents as is if the Carer is being put to a lot of inconvenience in order to do the resident a favour.
3. Even for residents who do not require much care, a Carer should pop into the resident’s room several times each day to check that everything is satisfactory.
4. Regular visits should be made to the Home by a GP, not by the Practice Nurse or a Paramedic.
5. All the Carers and Nurses [day & night] should have read & be familiar with each resident’s Care Plan, including any updates.
6. Carers should be both male & female. Some residents take exception to being given personal care by a member of the opposite sex.
   

IV RESPONSIVE

1. A common question from the Inspector is ‘How long do you have to wait for a Carer to respond to a call for assistance?’. The shorter the period, the better.
2. If a Carer responds to a call request but cannot assist the resident at that moment, an explanation should be given. The Carer should not just come onto the room, switch off the call and walk out.
3. Residents should be permitted to use any means of communication, including email, in order to message Management or Department Heads directly.
4. It should be a simple, straight-forward process for residents and guests to immediately access wi-fi in the Home.
5. Laundry should be collected daily, with the laundered items returned the same or following day. Socks should be bundled up in pairs. The return of single socks should be avoided.
   

V WELL-LED

1. All staff should have a ‘can-do’ attitude.
2. Where a Home is part of a Group, the Home Manager should be given as much autonomy as possible. The requirement to refer matters to Head Office for decision should be kept an absolute minimum.
3. The Management structure should be set up so that Managers have time to mix informally with residents on a regular basis and in an unhurried way.