Inspection on 08/12/09 for Brookfield Care Home

This is the latest available inspection report for this service, carried out on 8th December 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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Key inspection report Care homes for older people Name: Address: Brookfield Care Home 8 Nab Wood Drive Shipley West Yorkshire BD18 4EJ     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: Valerie Francis     Date: 0 8 1 2 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 29 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 29 Information about the care home Name of care home: Address: Brookfield Care Home 8 Nab Wood Drive Shipley West Yorkshire BD18 4EJ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Allyson Butler Type of registration: Number of places registered: care home 40 Czajka Properties Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 2. The maximum number of service users who can be accommodated is 40. The registered person may provide the following category of service only: Care home only: Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia: Code DE, Physical disability: Code PD, Old age, not falling within any other category: Code OP. Date of last inspection Brief description of the care home Brookfield is a converted and extended property situated in a residential area of Shipley, close to local bus routes and shops, and within easy reach of the main road to Bradford and Bingley. The home is part of the Czajka Care Group, and provides Care Homes for Older People Page 4 of 29 Over 65 5 29 6 0 0 0 Brief description of the care home personal care for up to 40 people over the age of sixty five, of both sexes. Accommodation is provided mainly in en-suite single rooms, there are also two double rooms and one single without private facilities. People have a choice of four lounges, the home also has a conservatory which is the designated smoking area. There are two dining rooms, and people may take their meals in the garden area in good weather. There is car parking and extensive gardens. People also have access to the grounds of the care home adjacent, which is under the same ownership, and to bowling and putting greens and the club house where there is a restaurant, bar, swimming pool and a pool room. The weekly fees charged at the time of the inspection are 459 pounds and 23 pence and 515 pounds per week. Additional charges are made for hairdressing, chiropody and magazines. The inspection report is displayed in the entrance hall and discussed at resident and staff meetings. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of Brookfield care home that took place on the 8th December 2009. The visit to the home was completed by one inspector who spent over seven hours at the home. Before the inspection we asked the homes management to complete a written self assessment form; an Annual Quality Assurance Assessment (AQAA). This inspection took place before the due return date. However, it was sent back before this report was written. We also sent out some surveys for people who live in the home and staff to complete. Five people and seven staff completed and returned them to us. We looked at any other information we had received about the service since reregistration, to help us decide what we need to look at when we visited the home. During our visit we spent time talking to people, their visitors, staff, the acting and area manager. We also spent some time observing staff interaction with people and how care task were being delivered. We looked around the building and looked at records that must kept by the home. This included looking at the arrangement for storing, administering and recording of medications. This report is a summary of our Care Homes for Older People Page 6 of 29 findings on the information gathered during the inspection process. We have reviewed our practices when making requirements, to improve consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the service are not being put at significant risk of harm. In the future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 29 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 Care Homes for Older People Page 8 of 29 order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good information about Brookfield care home and the service provided. An assessment of needs is carried out before a place at the home is offered. Evidence: People wanting to use the service and their representatives have access to information about the home which is current and gives them enough information, to enable them to make a choice if they wanted to use the home. In the AQAA the home said If it becomes necessary to provide any of the homes information in a different format for an individual resident, we will do so. Anyone wanting to move into the home have their care and social needs assessed before they are offered a place at the home. We looked at one persons care file, this showed that the person had been assessed before they were offered a place at the home. We saw that additional assessments for moving and handling and skin integrity had been carried out to make sure that there were plans in place to manage the risk. Care Homes for Older People Page 11 of 29 Evidence: In the AQAA the home said Prospective residents and their families are encouraged to visit the home as many times as they like in order to make what we recognise as a very important decision. There is the opportunity to look around the home, meet staff and other residents, have a drink or a meal, and ask any questions that might occur to them. Prospective residents who are unable to come to the home personally are visited by the manager and often one of the care team, either at home or in hospital. We find that this process reduces the anxiety that residents will naturally feel when coming to live in our home. A named senior in charge and a key worker are allocated as soon as possible after admission to the home, this we were told would be a member of staff who the person and their family have already met. People told us that they received information about the home before they moved in the home or decided that the home is a place they would be happy to live in. Staff said that they are given up to date information about the needs of the people they care and support. Care Homes for Older People Page 12 of 29 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. Peoples privacy and dignity is protected and they are treated with respect. There are good systems in place to ensure that peoples health care needs are met. The monitoring systems for the home need to be more robust to make sure that controlled drugs are kept in accordance to the Royal Pharmaceutical Society Guidance (RPS) and Care Quality Commission (CQC) guidance. Evidence: We looked at the care files of three people. These provided good information about peoples care and support needs, including some good details about peoples preferences and their individual needs. The care plans included various assessments including risk assessments, nutrition, manual handling, falls and prevention of pressure area damage; we saw that, care plans set out what help and support people need and the daily records of the care provided. We saw that care plans and assessment had been reviewed regularly. We also saw records of the involvement of health care professionals and services, such as the GP, district nurses and specialist Care Homes for Older People Page 13 of 29 Evidence: nurses. We were told that there are systems in place to monitor peoples records to ensure they are personal and individual for each person. We found that care plans looked at were up to date and provided good information to help staff to provide people with the care and support they need. People and their visitors we spoke to and who returned surveys said that the home call health care professionals when they needed them. Most people said that usually they get the care and support they need, some said they always get the care they want. Peoples comments were, they always have time to listen and are helpful. The staff will always listen to you and assist me if I need help in any way. Peoples relatives who were visiting at the time of our visit told us that they have the opportunity to be involved in their relatives care and they are invited to attend care reviews and can make comments on their relatives care. We looked at how medications are stored in the home. We saw that there are systems in place to make sure that medications are stored safely and securely, with a secure fridge available for storage of medication that need to be kept cool. We watched staff administering medication at tea time and saw that this was done in accordance with the Royal Pharmaceutical Society Guidance (RPS) for care homes. We checked medication administration records (MAR) and the medication available, including controlled drugs. Although we found that medication was being given appropriately, We saw that the home had excess stock of some peoples medication, this need to be closely monitored to make sure people are getting their medication as prescribed. We found that for one person the number of controlled drugs recorded in the controlled drug records book did not tally with the stock found. We did not see any documentation that showed that controlled drugs and all medication are monitored regularly. This would make sure that the homes policy and legal requirement for staff handling of medication is adhered to. The acting manager and the area manager started to investigate these matters immediately. The day following this inspection a telephone call was made to the acting manager to remind her to investigate the matter and send us a report of her findings. A letter was also sent to the registered owner regarding these issues. When we looked at care plans we saw that people had a medication agreement if they wanted to self medicate. This is good practice as it helps people maintain their independence. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to a range of leisure and social activities and can maintain contact with their family and friends. Food and nutrition is given a high priority. Evidence: The home employs a member of staff two days a week as activity coordinator. We were told that a programme of activities are produced after discussions with people about their preferences. We were shown records of the activities people had taken part in and the planned activities for the coming weeks and over Christmas. We saw events such as trips out and the film night. We were told that the coordinator makes sure that people get the opportunity to have one to one time. This makes sure that people who do not take part in group activities do not get isolated. The home provide people with planned occupational activities such as painting and craft work. People are also given the opportunity to take part in music and exercise from the physiotherapist. The acting manager said care staff are also involved in people social recreational activities.This is to make sure people do not get missed. People told us that they enjoyed playing quizzes and games which is part of the occupational activities arranged by the home. One person said I think every resident are well looked after; they do arrange outings for the residents, exercise classes, Care Homes for Older People Page 15 of 29 Evidence: singers and television in each room, I am never bored. We saw that peoples care plans included information about their interest and activities they would like to take part in. Peoples life histories were available in their care file, we were told that relatives are asked to complete this information with or for people who live in the home. On the day of our visit we saw that the coordinator was having out one to one sessions with people in their rooms and planing trips out for Christmas shopping with others. Some people were engaged in board games with each other, some spend time in their rooms, watching television or reading. We spoke to several people who spent most of their time in their rooms. They were complimentary about the activity coordinator and the activities she arranges with them. People told us that there is a regular entertainer who visit the home and they were able to take part in the entertainment which they said was very good. Staff told us that there are no restriction on visiting times. Visitors told us that they were able to take their relative out for a meal or a drink at the club house. There were information in peoples care plan about their food preferences.From discussions with the catering staff it was evident that they have regular contact with people and with staff to discuss meals. People have two main options at lunch time and we saw that each person had the opportunity to have what they wanted at the evening meal; the cook told us that if people did not want what was on offer they were given the opportunity to have an alternative. From a conversation with the chefs it was clear that they and the care staff work as a team and when there is any change in peoples needs which could affect their food intake this is brought to their attention. We saw that each person has had a nutritional risk assessment carried out, which is reviewed monthly and peoples weight is checked in accordance with their care plan. We were told if staff had any concern about any persons nutrition, they would liaise with their GP and the dietitians. On the day of the our visit we watched the lunch time arrangement, we saw that people who needed support from staff were given it discreetly. Whilst we were there the meal served at lunch time was liver and onions or chicken with cabbage carrots and broccoli(fresh vegetables.)For sweet it was ground rice. People told us the food is really good I can have something different if I did not fancy what was being served. The cooks are excellent I enjoy every meal. I can talk to the cook about the food being served. One person said I am a diabetic and they look after me well. Most people who returned surveys indicated that they were happy with the food served to them. Care Homes for Older People Page 16 of 29 Evidence: We saw that a record was kept of some peoples diet and fluid in take. However, during our walk around the building in the afternoon, we saw that one person who should have had hourly fluid intake, had taken sips of fluids during the morning and there was a time lapse of two hours when a drink was last given to this person. The lack of fluid and timescale could put this person at risk of dehydration. This matter was brought to the attention of the manager. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concern and complaint would be dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: People we spoke to felt that the staff and management were approachable. People and their visitors also said that they knew how to complain and that any matters they raised were dealt appropriately. Staff who returned surveys indicated that they knew what to do if anyone came to them with concerns about the service. We have not had any complaints about the service since registration of the home. From minutes seen of residents meeting it was clear that people are encouraged to raise anything that they wanted changing or they thought could improve life at the home. People said they felt comfortable doing this, because they knew their views would be taken on board. During our visit we spoke with staff about adult protection and what it meant for the people in the home. From answers staff gave it was evident that they were clear of the whistle blowing procedure and felt confident that they and people would be protected. In the AQAA we were told all staff receive training regarding recognising and reporting the different types of abuse, one of our senior managers is a representative on a local board that looks at ways of improving systems of reporting abuse and raising awareness. This benefits our staff as regards receiving advice, information and training. Care Homes for Older People Page 18 of 29 Evidence: We were told that staff also receive training about handling aggressive behaviour and the use of restraint. In the AQAA the home also told us we are very aware that at times we need to facilitate access to advocacy and we have written information and contact telephone numbers available in the home. We were told that some staff have had training on the mental capacity act and deprivation of liberty. This will ensure that peoples right and choice are protected at all times. Care Homes for Older People Page 19 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is on going maintenance to the home which provides a safe, comfortable and pleasant place for people to live. Evidence: The home has two shared rooms which we were told are used by single occupants in most cases. We saw that peoples bedrooms were personalised and decorated to the individuals taste. Peoples rooms had items such as furniture, pictures and ornaments that they had brought with them from their own homes. People we spoke to and those who returned surveys told us that they like their rooms and they were able to bring with them some of the things that remind them of their life before they moved into the home. During our visit we found that the home was cleaned to a high standard and there were no unpleasant smells. People told us the cleanliness of the home is one to be proud of, every room is cleaned everyday. There appeared to be enough domestic hours to manage the cleaning of the home. Discussions with the staff and people living in the home confirmed this. There are a variety of sitting areas in the home, this gave people the opportunity to sit in areas which suited them. There are two designated dining rooms. We found that all communal areas were nicely decorated and furnished. The areas provide comfortable and pleasant places for people to spend time. Staff had completed infection control training and we saw no breaches of infection control. Care Homes for Older People Page 20 of 29 Evidence: The home had a fire safety inspection from West Yorkshire Fire Service. Some recommendations were made and the work had been carried out for fire detection in the loft area. In the AQAA we were told that the home always complied with any requirements following inspections by the Fire Authority and they have gained a five star rating following the last visit from the Environmental Health Inspector. The home also said that they provide people with a very high standard of accommodation; most bedrooms are en-suite singles; there is a large garden which includes a bowling green. The home have permanent garden and maintenance staff who maintains the house and gardens to a high standard. The home is furnished and decorated to a high standard, with thermostatically controlled heating and appropriate lighting throughout. There is level access throughout the home and grounds, using ramps to the gardens and a passenger lift between floors; aids and adaptations are provided when assessed as necessary. All the single en-suite rooms are equipped with a bath hoist or a shower. All bedrooms have a lockable space and people have a key to their room if desired. The home also told us that they have a stable team of domestic staff who are much appreciated by the people who live at the home. The laundry system allows for effective separation of clean and soiled linen. People have their personal washing collected from their rooms on a weekly basis and washed separately and returned to them by the laundry assistant. People said they were generally happy with the homes laundry service. During our discussions with people they were very complementary about the laundry assistant who they said makes sure that they are kept clean. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are recruited in a safe way and provided with good training so that they can do their jobs well. Evidence: People we spoke to and those who returned surveys were complementary about the staff. Their comments included: staff are very good and very patient. Sometimes they could do with more staff but things are different every day and they do not always need more. At the time of the visit, staff appeared to be busy but were able to meet the needs of the number and group of people in the home. Staff told us that sometimes they feel as if staffing level is not enough to meet the needs of the people who live in the home when the home is at full capacity. The staffing levels are:- five care staff and one senior in charge in the morning, three care staff with a senior in charge during the evening and two carers and one senior in charge at nights. The manager or deputy is also avilabe in the home during the day. On the day of the inspection we saw that care staff were being well supported by the homes other staff. Such as the activity coordinator, kitchen and domestic staff, the acting manager and administrative staff. We looked at the recruitment records for three staff, two recently came to work at the home. The records showed that staff had Care Homes for Older People Page 22 of 29 Evidence: been through a rigorous recruitment process, including completion of the required checks before they started working. This included obtaining two written references and Criminal Record Bureau (CRB), protection of vulnerable adults (POVA) first and Protection Of Children from abuse (POCA)checks. It was apparent that the registered provider is committed to having a well trained staff team. We spoke to the training officer for the organisation and looked at staff training records in their files. The home have a large amount of staff with an NVQ qualification. In the AQAA we were told that staffing rotas and weekly reports shows that the home consistently achieve staffing levels which are above average. They also said they have a comprehensive employee handbook which is in the process of being updated, and their policies and procedures contain detailed job descriptions for all staff grades. Care Homes for Older People Page 23 of 29 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 and have appropriate systems in place to seek peoples views and keep them safe. Evidence: The registered manager has recently moved to another position within the organisation; there is now an acting manager, who facilitated in this inspection process. We were told that she may be taking up the position as manager for the home. We did not see or were told of any information that indicated to us that the registered provider had used their equal opportunity procedures. This would make sure that others were given the opportunity to apply for the post. It is acknowledged that the acting manager has been with the organisation for a substantial amount of years and has experience of working with the service user group and had worked as a senior in charge coordinating the day to day care of people. People commented about the acting manager and told us she was approachable and friendly. Staff said they were able to talk to the manager if they had any concerns and they felt supported and well supervised. The home has systems in place to make sure they get the views of Care Homes for Older People Page 24 of 29 Evidence: people and others involved in care of people living in the home. In the AQAA the home told us Questionnaire audits reflect the very positive view that residents and families have of the home, and particularly of the management ethos that they perceive. The home is visited regularly by the area manager who carries out monthly audits on the running of the home; during this time people their visitors and staff are spoken to about the home. A report is made of her findings of these visits. However, as recommended in personal care, the organisation should make sure that medication is monitored regularly. We looked at information about peoples finance. In the main people, relatives or solicitors handle their affairs. In the AQAA the home told us we have a thorough system in place for the handling of residents monies. Where possible residents or their families are encouraged to manage finances. There is a company business plan and appropriate insurance cover is in place. Residents are made aware during the admission process that care planning is a collaborative process and that they will always be involved in any decisions made about their care, and are able to see their own documentation. We checked some of the homes records to make sure that this information was correct, we saw that there were regular checks of the homes fire records and hot water temperatures. The organisation has a designated health and safety officer who carries out periodical health and safety checks and in the home there is a designated care staff member who carries out weekly health and safety checks around the home. Staff have health and safety training as part of their induction and there are regular updates to makes sure staff follow all the current procedures. Care Homes for Older People Page 25 of 29 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 29 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 10 13 Arrangement must be put in 20/01/2010 place to ensure that the ordering storage and records for the use of controlled drugs meet current regulations and professional guidance. This is to make sure that essential medication is available when needed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The supporting guidance on the pressure sore risk assessment tool used should be kept in peoples care plans. This will help to make sure peoples health care needs are met There should be a system in place to monitor controlled drugs and all medication regularly. This would make sure that the homes policy and legal requirement for staff handling of medication is adhered to. People should be given fluids in the timescale agreed in their care plan and if necessary more often. This would Page 27 of 29 2 9 3 15 Care Homes for Older People 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 ensure that people do not get dehydrated. Care Homes for Older People Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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