Please wait

Inspection on 25/11/09 for Adelaide Nursing And Residential Care Home

Also see our care home review for Adelaide Nursing And Residential Care Home for more information

This is the latest available inspection report for this service, carried out on 25th November 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides residents with a good standard of care supported by the multidisciplinary team. Health and social care are well addressed by a competent and well supervised staff team. The premises were well maintained, kept clean and tidy. Residents and relatives stated that they satisfied with the way the service was managed. There are a low number of complaints which indicates the service is working well.

What has improved since the last inspection?

Since the last key inspection medication administration had improved, namely charts had countersignatures and medicines were signed for at the time of administration. Medicine storage areas were clean. The dining room chairs and carpet on the residential unit had been addressed. The baths on the residential units had been repaired as had the ceiling in bathroom 2, on the nursing unit. Quality assurance measures had improved.

What the care home could do better:

The Criminal Records Bureau checks should be undertaken every three years this is a recommendation.

Key inspection report Care homes for older people Name: Address: Adelaide Nursing And Residential Care Home 35 West Street Bexleyheath Kent DA7 4BE     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: Rosemary Blenkinsopp     Date: 2 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Adelaide Nursing And Residential Care Home 35 West Street Bexleyheath Kent DA7 4BE 02083043303 02083010133 adelaide@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Palace Chivero Type of registration: Number of places registered: care home 76 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 76 The registered person may provide the following category of service only: Care home with nursing (CRH - 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: 42) Dementia - Code DE (maximum number of places: 42) Date of last inspection Brief description of the care home The Adelaide Care Centre is a purpose built nursing and residential care home. It was first registered in July 1997 and was then purchased by Southern Cross Healthcare in September 1998. The home is situated in a side road off Bexleyheath Broadway near Care Homes for Older People Page 4 of 28 Over 65 0 34 42 0 Brief description of the care home the railway station, bus services and the shopping centre. There is car parking space to the front of the property. The home is registered to provide care and accommodation to 76 older people. The home has two floors divided into four separate units providing care for the different categories of service users. On the ground floor, there are 20 general nursing beds and 14 beds for conventional residential care. On the first floor, there are 25 nursing beds and 17 beds for residential care, all for older people with dementia. All of the bedrooms in the home have en-suite facilities. The laundry is sited in a separate building to the side of the home. At the rear of the building there is an enclosed garden. The current fees range from £482.00 - £820.00. Residents pay privately for personal items such as hairdressing, newspapers and chiropody care. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was conducted over a one day period by two inspectors. The manager facilitated the site visit. Periods of observation were undertaken on the ground floor and on the Dementia nursing unit. Prior to the inspection the manager had completed the AQAA and forwarded this to the CQC on the 12 November 2009. This was well completed with comprehensive information including the updates in respect of the issues and requirements specified at the last key inspection. Five residents comment cards were returned during the inspection as well as six from staff. Several relatives met with the inspectors. The comments are included in the different sections of this report. Staff were interviewed as part of the site visit. All of the information obtained from the sources identified above has been incorporated into this report. Care Homes for Older People Page 6 of 28 A selection of documents were inspected including care plans, staff personnel files as well as health and safety records. Feedback was provided to the Manager at the end of the inspection. Other information which has been considered when producing this report and rating, is the information supplied and obtained throughout the year including Regulation 37 reports and complaints. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are admitted based on an assessment of care needs and receive written confirmation, that based on the assessment, the home was suited to meeting their needs. Residents are provided with information on the home, and have opportunities to sample the service prior to any decision on placement being made. Evidence: Residents are assessed prior to admission and this was confirmed at the site visit by staff. On the residential unit the manager said that she had visited a resident in her own home to assess her needs, and to make sure that the home could met them; there was a lot of discussion relating to how the prospective resident wanted to be cared for and what personal things she wanted to bring to the home. On visiting her in her room she said that she was settling in nicely, that everyone was very kind she was very happy and was waiting for the telephone to be put in her room. Care Homes for Older People Page 10 of 28 Evidence: The comment cards received from residents provided variable information as to whether the had received a contract, or terms and conditions, some indicating they had, others they had not. This may be because relatives had dealt with this aspect of their admission. There was a Statement of Purpose available and Service User Guides in each of the bedrooms that gives information about the home, staff and Southern Cross. The AQAA told us the following We do send out brochures and information about the home to prospective clients and also invite them to visit the home. We carry out holistic preadmission needs assessment incorporating Social Services and relatives views. Continuing Care needs assessment documentation is also received. Assessments are comprehensive and carried out by either the home manager and unit leader, or the deputy home manager. Formulation of individual care plans are based on residents needs led assessment. We ensure all risks are identified, fully assessed and documented with appropriate preventative measures put in place. We also ensure that the required equipment and training is in place prior to residents being admitted to the home. The home also provides respite care. The files that we sampled were completed using the standard format used in all Southern Cross homes. Some of the information obtained during the assessment was to a good standard and would be helpful for staff to deliver personalised care. It was evident that all residents are assessed prior to admission by a senior member of staff. In addition the home receives the Community Care Assessment from the placing authority and all of this information can then be used to deliver the care needed. There was a dementia assessment completed on those files seen in the Dementia Unit, and the content was reasonable. Draft care plans are developed from the information at the assessment . Residents have an opportunity to visit the service prior to admission, and on the dementia residential unit, because of room availability, they can stay overnight to give them an opportunity to sample the service. Residents received written confirmation to show that following assessment, the home was suited to meeting their needs. There has been an embargo on admissions on the Dementia Nursing Floor since November 2008, as there was concern over five residents who presented with unexplained bruising. The investigation into this is almost concluded and it is expected Care Homes for Older People Page 11 of 28 Evidence: admissions will resume in the near future. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive good care and supporting records to evidence this are to a good standard. Medications are safely managed to ensure residents receive the correct medications at the correct time. Evidence: During the tour there was evidence that residents were treated with dignity, and privacy was afforded during personal care. Comment cards from staff said that all necessary equipment was provided and recently a lot of new equipment had been purchased including new weighing scales. A total of four care plans were viewed overall, two on each unit. Care plans were standard formats covering the activities of daily living, they were generally well written. It was nice to see that they were written in the first person i.e - I need , I want etc. Each care plan identified residents needs and showed how these were to be met. The interventions section, which is the record of care that staff have to provide, Care Homes for Older People Page 13 of 28 Evidence: was comprehensive in content. There was evidence that care plans were kept under review, these notes were also to a good standard. A number of care plans seen were personalised for example to show resident preference in relation to hair, nail care and personal appearance, allowing residents to choose what to wear and reminding staff to encourage residents to be involved with care and with making choices. One area for consideration is the care plans are cumbersome and they would be difficult for new staff to get to grips with them quickly. A short summary care plan may be useful in this situation. The majority of residents looked well cared for, although on the dementia nursing unit, several of the residents hair needed attention and the use of pop socks for ladies should be reviewed as they seemed to cut into their calfs and were visible below dresses. Care records seen included risk assessments in relation to areas such as pressure area care, safety, prevention of falls, use of bed rails, moving and handling and nutrition, these were reviewed monthly. Residents dependency was assessed and reviewed monthly this information needs to be utilised to ensure there are an adequate number of care staff on duty. There were separate records for visits by members of the multidisciplinary team including tissue viability staff, GPs and Optometrist. Male and female care staff are employed to address gender care issues. We met with several relatives all of whom expressed their satisfaction with the care their loved ones received. They felt that they were well looked after and the staff were kind and pleasant. Staff comment cards indicated that residents were well cared for and this was borne out in residents comment cards as well. The AQAA told us the following :We assess, plan and implement individualised care plan that reflects residents health and social care needs during initial assessment. This will ensure appropriate care in line with our Statement of Purpose, promoting and maintaining good health, independence, dignity, privacy and choice. Medications were inspected on the Dementia nursing floor. Medications were stored at the correct temperature with supporting records for the fridge and room temperature. Medication charts were accurately completed with no gaps evident. Residents photographs were attached and allergies recorded on the charts. Those medications received into the home and those disposed of, had supporting records in place. Staff Care Homes for Older People Page 14 of 28 Evidence: told us that they received medication training for the suppling company as well as in house. They had received specific training for the administration of rectal Valium, which one resident was prescribed. Medication audits are conducted monthly on different units, these showed a high score which indicated good systems were in operation in the service. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A selection of activities are provided that residents can participate in. Residents have choices in their day and are encouraged to be as independent as possible and excercise control over their lives. Evidence: As we arrived at 10 20 am the breakfast on the ground floor was still in progress. There was choices available including juice, cereal, bread and a hot cooked breakfast. There seemed no hurry to rush residents to finish their meal and a relaxed atmosphere prevailed. The home had an open visiting policy to make it possible for residents to maintain contact with family ans friends. Residents seen, said they enjoyed family visits and relatives were encouraged to attend social functions and relative meetings. Many relatives were seen to visit the home during the course of the site visit. Relatives spoken with stated they were made to feel welcome when visiting and found care staff approachable, helpful and informative. One gentleman visits his relative daily and has lunch with them, which he enjoys. He felt the staff were kind and the food was good. Overall he was very pleased with the care his relative received. The mid morning drink was served with a selection of biscuits. Specialised drinking vessels were used for Care Homes for Older People Page 16 of 28 Evidence: some residents. Tables were nicely laid in preparation for lunch. Staff have been instructed on how to lay a table properly, and this is monitored. There were two choices of meal and alternatives could be ordered from the kitchen if needed. Four weekly menus were provided and a computer system used to assess the nutritional value of the meals. The new manager has introduced smoothies for residents and these have proved popular. In addition the morning porridge has fruit added to give it variation in flavour. Bowls of fresh fruit were available in the units. Residents had water jugs in their bedrooms. Homemade cake is available every day with afternoon tea - something that the current manager has introduced. On the dementia floor soft Christmas music was playing in the background whilst two staff attempted to engage with residents in an activity. On the dementia unit, (Rowan House), one carer is allocated to do activities in the morning On the ground floor the activities organiser was coordinating a group activity. The activities coordinator was very enthusiastic to ensure residents participated and enjoyed the session. Different activities are organised and a record kept of this as well as who attended. The hairdresser was in the home - she has attended the home weekly for several years and knows the residents well. The residents enjoyed their hair being done and proudly showed it off. During the afternoon a clothes show was taking place where residents were assisted to choose clothes from a selection brought in by an outside retailer. Again many residents seemed to enjoy this. There was a lot of different activities equipment available much of which has been recently purchased. Daily newspapers and magazines are provided. The AQAA said the following We ensure our services are reflective of individual choices of how service users choose to live their lives. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory systems were in place to manage complaints and ensure residents are protected from harm. Evidence: The complaints procedure was on display and available in several other documents such as the Service User Guide. Systems were in place to record complaints made about the service. The complaints register was viewed, it showed only one complaint raised in April 09 from a neighbour. Currently there is one complaint, which the manager is investigating and the records of the investigation were retained . There was information on safeguarding including leaflets as well as the Local Authority inter agency guidance. A policy and procedure was in place in relation to safeguarding adults. During our site visit we spoke to staff about abuse and safeguarding procedures. Staff had a good understanding of their role in safeguarding adults and understood the term whistle blowing, and were aware of the action they should take. They were aware of the need to report such matters and indicated that there were several layers of management whom they could approach. They were less knowledgeable about external avenues for reporting such, although did refer to Social Services, and many said the CQC as well. The manager investigates all complaints, and has an open door policy where any person can talk to her in private. The manager works many hours and this serves as Care Homes for Older People Page 18 of 28 Evidence: an opportunity to meet with day and night staff, as well as relatives, who may only be able to visit at weekends or evenings. The AQAA told us the following :Our overall aim in providing such a valuable service in Adelaide Care Centre, is to provide a safe and nurturing environment that puts residents welfare first, as stated in our policy documents. All staff are regularly trained on the issue of abuse and are aware of the whistle blowing policy. All service users have a copy of the Service User Guide in their room. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a clean, comfortable well maintained accommodation which is safe and homely. All necessary equipment is provided to address residents needs . Evidence: A tour of home was completed as part of the inspection. The premises were clean, tidy, well ventilated and oudour free. The standard of decor was good with ongoing refurbishment of areas to maintain it to a good standard. There were fresh flowers and bowls of fruit in many areas, which gave a homely feel. On the ground floor there was a bar which has many items reminiscent of years gone by, and this was a great talking point. Bedroom windows are opened during the morning to air the rooms, although this did make the rooms and corridors feel cold, attention should be paid to this with the winter approaching. There was a lot of equipment in use including pressure relieving mattresses, walking aids and bathing equipment. Each unit has bathing and toilet facilities as well as assisted baths and showers. The standard of cleanliness was commented upon by all of the relatives interviewed Care Homes for Older People Page 20 of 28 Evidence: many saying the had never detected any oudour and the home was always clean and fresh. Bedrooms were in the main individualised, many residents had TVs, radios and personal items. Call bells were in all bedrooms. The bedrooms have different coloured street doors with door knockers, which makes it feel more like you are entering someones home not simply a bedroom. All areas of the home were maintained in a homely fashion, pictures, ornaments, with individually decorated areas all added to the impression. The visitors toilet was very pleasant. On the dementia unit the bathroom was congested with many items which would have been better stored in another area. Sluice rooms are provided to store waste and staff had access to protective clothing, hand washing facilities and hand cleansing gel. Ample supplies of these were seen in all areas during the tour. Staff said they had access to adequate supplies of protective clothing. Two new washing machines had been purchased with a sluice cycle to prevent cross infection of contaminated clothing. . The home has a team of domestics and recently the home had employed an evening domestic from 6 p.m. - 8 p.m. This persons role is to clean all dining rooms, lounges and visitors toilets. In addition there have been three new bank domestics employed to cover sickness and holidays. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are supplied in sufficient numbers to meet residents needs and supported in their role with regular updates and training. Staff are safely recruited which offers protection to residents. Evidence: The home employs 10 Registered Nurses, 46 care staff and a team of ancillary workers. The total number of staff employed is 80. Staff rosters seen were clear with amendment kept to a minimal and an accurate reflection of staff on duty. There appeared to be enough staff to meet residents needs and staff interviewed felt that there were enough staff. In staff comment cards they indicated that usually there were enough staff to meet residents needs. Another staff felt that this had provided them with a good learning experience, although wanted more qualified nursing cover due to the record keeping and time taken with medications. This staff member added that things had significantly improved with the new manager in post. The AQAA told us that the majority of staff had achieved NVQ level 2 or were working toward this. Mandatory training is provided to all staff and training statistics provide the manager with the information on what percentage of staff have attended each session. The staff training statistics indicated 64 had attended a fire drill, and 55 had attended manual handling training. Other topics such as customer care, challenging behaviour and Dementia awareness also had a good percentage of staff Care Homes for Older People Page 22 of 28 Evidence: attendees. Four staff recruitment files were inspected in relation to recruitment and training. Records seen showed recruitment procedures were followed and complied with the Regulations to ensure residents living in the home were protected and staff were safe to work there. Some of the Criminal Record Bureau checks were five years old, it is recommended these are revisited every three years. One staff comment card stated that they would appreciate more time from management to meet and talk with them. Staff supervision is conducted and records are retained in personnel files outlining the discussion. Supervision is structured to deal with a topic each session to help reinforce knowledge of it. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed by a trained and experienced individual. The home is safely maintained with ongoing and regular maintenance and servicing. Evidence: The manager has been in post for approximately six months having worked in another care home setting . She has held a management role for approximately fifteen years, and worked in the care home setting since 1994. Ms Cheviro is a qualified nurse with a Diploma in Management Studies. She is in the process of finishing her Masters in Human Resources and has attained a Health & Safety Certificate for managers. Systems were in place to review the service. These included Regulation 26 visits, relative/resident meetings, staff meetings, in-house audits and getting residents and relatives views of the service through the use of satisfaction surveys. The last annual audit of the service had taken place January 2009. The report in respect of the findings demonstrated a good service where residents and relatives satisfied with the service. Care Homes for Older People Page 24 of 28 Evidence: In addition the manager is in the home for many hours and has a mobile telephone for contact when not in the home. On call arrangements are in operation for senior management cover. The manager advised us that regular audits on medications, pressure sores, falls and residents weight were undertaken . Regular meetings are held with staff from all departments. These meetings are minuted and circulated. The manager holds residents and relatives meetings and plans to further develop these forums. One comment which was made by several relatives was the changes in management and how unsettling this was. Their anxiety was further compounded by the lack of communication on the matter. This was referred to the manager for action. Safety records seen showed attention was given to providing a safe environment for residents and others. Records seen were up to date and showed that service checks had been done when due. Records seen included service those for gas and electrical testing, legionella and the hoists. The procedures for fire were inspected. The fire risk assessment had been updated earlier in the year. The fire alarm is tested weekly as are emergency lights and fire escape routes. Fire training takes place regularly and staff signatures confirm attendance Separate drills are organized for night staff . Staff attend regular mandatory training to refresh their knowledge on key subjects such as health and safety. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 29 Some of the Criminal Record Bureau checks were five years old, it is recommended these are revisited every three years. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!