Inspection on 09/02/10 for Derwent Lodge

This is the latest available inspection report for this service, carried out on 9th February 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Extracts from inspection reports are licensed from CQC, this page was updated on 25/04/2010.

Key inspection report Care homes for older people Name: Address: Derwent Lodge 197 New Ferry Road Wirral Merseyside CH62 1DX     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: Wendy Smith     Date: 0 9 0 2 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Derwent Lodge 197 New Ferry Road Wirral Merseyside CH62 1DX Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Glynis McKean Type of registration: Number of places registered: care home 46 Sure Care (UK) Limited Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of people who can be accommodated is: 46 The registered person may provide the following category of service only: Care Home with Nursing - Code N to people of the following gender: either, whose primary care needs on admission to the home are within the following category: Old age not falling within any other category - -Code OP Date of last inspection Brief description of the care home Derwent Lodge is a two storey purpose-built care home in a residential area of New Ferry, Wirral. It is set in its own grounds overlooking the River Mersey. The home has a car park of ample size and there is a bus stop just outside. The home provides nursing care and personal care for up to 46 people. 0 Over 65 46 Care Homes for Older People Page 4 of 27 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 quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. We (the Care Quality Commission) visited Derwent Lodge unannounced on 9 February 2010 as part of this inspection. Two inspectors carried out the visit with an expert by experience. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. During the visit we spoke with some of the people who live at the home and some members of staff, to find out their views about the home. We walked round the building to see all the communal areas and some of the bedrooms. We checked records kept at the home and spent time talking with the home manager. We also looked at any information that we had received about Derwent Lodge. Before Care Homes for Older People Page 5 of 27 the inspection the manager was asked to complete a questionnaire to give us up to date information about the service. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The expert by experience commented that: I did feel that the furniture and furnishings were well worn and in places shabby. The dining room tables and chairs were knocked about and very shabby. Areas in the home would have benefited from a good clean. A programme of redecoration and refurbishment is needed to show how all parts of the environment will be brought up to a good standard. A number of doors were wedged or propped open and a risk assessment must be carried out to ensure that people are not at risk from the spread of fire. Windows are not fitted with restrictors and a risk assessment must be carried out to ensure that people are not at risk from falling out of windows. The home is heated by storage heaters and some of the heaters are unguarded. Risk assessments in the care plans indicated that people may be at risk of burns from these hot surfaces and this needs to be addressed to make sure that people are kept safe. Some parts of the home were cold and we recommend that room temperatures are Care Homes for Older People Page 7 of 27 monitored to find out the extent of the problem so that it can be addressed. 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 27 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 27 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. Peoples needs are assessed before they move to Derwent Lodge to ensure that the home will be right for them. Evidence: Written information about the home and the services it provides is available for people to read and can be accessed in large print. The homes fees are from £421.29 to £484 per week. The manager told us that she goes out to meet and assess anyone interested in moving to live at Derwent Lodge. She usually takes one of the care staff with her. We saw a copy of a completed pre-admission assessment form in the care plan belonging to person who had recently moved to Derwent Lodge. There was also a copy of the full assessment provided by social services. The home does not provide intermediate care, however two places are contracted to Care Homes for Older People Page 10 of 27 Evidence: the Primary Care Trust for transitional care for people during an assessment period or while awaiting funding for a care package or permanent placement. People may require one of these places at short notice and information about their care needs is faxed to the home by their GP and often the Community Matron is involved in their transfer. Care Homes for Older People Page 11 of 27 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. The health and personal care needs of the people living at Derwent Lodge are met by the homes staff, with input from health professionals as needed. Evidence: Everyone living at the home has a care plan that details their health and personal care needs. The core care plans follow an activities of daily living model and are personalised to some degree to reflect the individual. We looked at care plans for five people and found that they had been completed in full but in some cases lacked detail. For example, the continence care plan for one person stated pads as needed, but there was no mention of what type of pad or in what circumstances they would be needed. Care plans instructed staff to match bed, chair, equipment etc to meet individual needs but without any detail of what this means for each person. A detailed daily report is written for each person and the care plans are reviewed monthly by a named nurse and every two months by the manager. Risk assessments form part of the care plans and these are reviewed monthly or more often if there is any change. Separate wound care records are kept for people who have a skin break Care Homes for Older People Page 12 of 27 Evidence: or have been identified as being at risk. Social assessments and care plans are kept in a separate folder and are filled in by care staff. The care plans showed that peoples health is monitored regularly and they have visits from health professionals as needed. People have a choice of GP and at the time of our visit there were nine surgeries with residents at the home. District nurses provide a service for the people living at the home who do not require 24 hour nursing care. The manager told us that residents are registered with the community dental service on admission or may choose to keep their own dentist. Other professionals who visit the home as needed are dietician, speech and language therapist, tissue viability nurse and continence adviser. An optician and a chiropodist visit regularly. Medicines are the responsibility of the registered nurses, however the manager told us that senior care staff are learning about medicines with a view to eventually being able to take responsibility for the medicines of the people receiving personal care at Derwent Lodge. The medicines storage room is on the first floor. The room was locked and was tidy and well organised. The medicines administration record (MAR) sheets were generally well completed, but two people had handwritten MAR sheets and the quantity of medicines checked in had not been recorded. Medicines carried over from one month to the next were not recorded so that there was no stock balance which could be checked for accuracy. The manager let us know that this was addressed immediately after our visit. Storage and recording of controlled drugs was satisfactory. We were able to speak with a number of the people living at the home and they were generally very satisfied with the way they are looked after. One person said If you can find a better place than this Ill go there, but I doubt you will. It is class A1. The way Im treated you couldnt do any better. Another person said that the girls are generally good but sometimes forget to give her the call bell and she has to shout for help to toilet; they treat her with respect; the food is good and she has a choice. We observed that staff had a positive and respectful attitude towards residents, however a member of staff assisting a resident with her meal was standing over the resident rather than sitting by her. We also noticed the use of paper incontinence sheets on six armchairs in the lounge. This looks institutional and detracts from the homely ambiance. Shared bedrooms have a dividing curtain to ensure privacy. Care Homes for Older People Page 13 of 27 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. People living at the home are able to choose how they spend their time and a range of social activities is provided to keep people stimulated. Evidence: The home employs two activities organisers who each work two days a week. There is an annual programme of social activities and we saw information displayed around the building so that people could be aware of what activities were planned. A monthly religious service is held in the home. On the day we visited several residents were joining in gentle exercises in the main lounge. The activities organisers keep records of what they have done and who has joined in either as a group or on a one to one basis. A minibus is available for trips out. One of the residents we spoke with told us that he is responsible for writing a monthly newsletter. People who live at the home can receive visits from friends and family at any time they choose. People can also bring in personal belongings to make their bedrooms more homely. In the annual self assessment the manager told us We serve early morning tea to all who wish, we do not wake people up before 7:30am. Between 8am and 9am breakfast can be anything from toast to a full English served in your room or the dining room. The main meal is three courses and is served at 1pm. This is followed by afternoon Care Homes for Older People Page 14 of 27 Evidence: tea, high tea and evening supper. The manager told us Meal times are flexible as is the choice of foods. We cook from basic ingredients and will follow seasonal variations of food to provide a wide and balanced diet. We buy in fresh meat and vegetables and avoid pre-prepared or frozen products if possible. Menus are on four week cycle and changed twice a year. The dining room is spacious and tables were set for lunch with cloths, napkins and condiments. All of the people who were sitting in the lounge during the morning were assisted to the dining room for lunch, but people can also choose to eat in their own room. The expert by experience who carried out the visit with us made the following observations: There was an activities coordinator working in the lounge with a resident when I arrived. They were playing draughts. She works two days each week, 9am to 4pm. This lady gathered some of the residents in a group doing some chair based exercises for the people willing to take part. I thought that she related well with the residents. She appeared to be attentive and considerate. We discussed the activities offered to the residents. They had dancing, chair based exercises, bingo, quizzes, reminiscence sessions, particularly sweet manufacturing and soap manufacturing which were pertinent to the area and some residents having worked in these areas, outings for afternoon tea. They have been out to New Brighton for fish and chips, been to a pantomime in New Brighton. They have a lady who comes along to sell clothes every three months which she said the residents all enjoy, one time is usually before Christmas. This lady brings in her shopping list to discuss prices with the residents. She said that they are always staggered at what price things are these days. She said that a Church come along each month to sing for the residents. There are paid artists who visit, singers and children dancing. There is a young boy who visits and plays the violin for the residents and he is brilliant evidently and the residents enjoy that very much. The have had several trips out for lunch and been to Port Sunlight garden centre locally. There are relatives meetings but they are not very well attended. The families enjoy coming along to join in with the activities in an afternoon. I noticed this lady relating very well with the residents. She was helping one of the residents at lunch. She reads letters for some of the residents and writes them letters if they wish. I was very impressed with this ladys sincerity and commitment to the job. There is a man who does the three day sessions and he does art and karaoke and Care Homes for Older People Page 15 of 27 Evidence: also takes them out. Two ladies were sitting in the sitting room together. The room was not very warm I felt and they both said that they were not warm enough. They did say that they could ask for a blanket if they wanted but they did not have a blanket today. I felt one ladys hands and she did feel cold. The sitting room did appear to be similar to a conservatory and I expect heat is not retained very well. Whilst I was speaking with a resident a visitor came along to visit him with her dog. The dog went around everyone which was nice to see. She rested her head on peoples knees whilst they stroked her, lovely. I had lunch with a gentleman in the dining room. There were more residents in the room than were in the sitting room. Evidently a lot of the residents stay in their rooms until lunch is ready. Lunch was soup, I did not hear what sort it was and did not hear anyone tell any of the residents what sort it was. The soup was just put down in front of people including myself. I think it was leek but also think it was packet soup. The main course was meat in gravy (casserole type meal) with fresh vegetables and mashed potatoes. I did not hear anyone say what it was for lunch or offer an alternative, the meal was just put down in front of people. The meat was not very tasty in my view. Pudding was sponge with jam and custard. I noted that the sponge was too deep and people were struggling with it. I asked for an alternative and was offered yoghurt or ice cream. Fabric serviettes were used and cold drinks offered with the meal. Tea or coffee was offered after the meal served in beakers. I did notice that the older staff members spoke with the residents and were more attentive than the younger staff. There was a friendly atmosphere in the room over lunch with residents speaking with each other and with the staff. After lunch I went into the kitchen and spoke with the chef regarding the depth of the pudding and how I felt that the residents had struggled eating it. She had made cakes which were cooling and they were thinner than the puddings. I asked whether the custard was made with milk and she said that it was. She did say that all meals were made with fresh food. I noticed in the kitchen a list of names with their likes and dislikes next to them. I noticed also that names were identified as being diabetics. I noticed also that specific cooked breakfasts were identified and on what days of the week they were offered at what time. The cook did say that the residents can have anything they want to eat and that there are always alternatives available for them. I did hear one lady in the dining room being offered toast when she did not want her lunch. Care Homes for Older People Page 16 of 27 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. People living at Derwent House are protected from abuse. Evidence: The home has a complaints procedure and this is displayed in the entrance area so that people visiting can be aware of it. Minor complaints and concerns are dealt with immediately by the manager or by the nurse in charge. They can be recorded on the communication sheet that is in each of the care plans. Since the home was registered in August 2009 one complaint that involved Derwent House has been made to the Primary Care Trust. Records showed that this has been fully investigated and responded to in writing by the manager, following the homes complaints procedure. In the annual self assessment the manager told us We have a policy of zero tolerance towards any reports of abuse and investigate thoroughly involving the external disciplines as required. All staff have attended abuse training. The staff we spoke with during our visit confirmed that they have attended safeguarding training and would know what action to take if the witnessed or suspected abuse. Care Homes for Older People Page 17 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and clean environment for people to live in however there are a number of issues regarding the environment that need to be addressed to ensure that people are warm and safe. Evidence: The home is in a residential area and has panoramic views across the River Mersey from the lounge and some of the bedrooms. There is adequate space for car parking and a patio garden that is accessible for people using wheelchairs has been developed around the dining room. A maintenance person is on site two days a week to deal with day to day repairs and maintenance. The building is 20 years old and is in need of some refurbishment to bring all areas up to a good standard. Doorways have been scuffed by wheelchairs and trolleys; a lot of dark wood makes parts of the building look drab; dining room furniture is knocked and scraped; some of the armchairs are worn and shabby; some windows are ill fitting and draughty; some rooms are in need of redecoration; some carpets need replacing. The manager told us that at present there is no schedule in place for the refurbishment of the building. We noticed that a considerable number of door wedges were in use on bedroom (including a vacant bedroom) and bathroom doors. A fire door on the first floor Care Homes for Older People Page 18 of 27 Evidence: corridor was held open where it caught on the carpet and another one was propped open with an armchair. A risk assessment and robust action plan is needed to demonstrate that fire safety is not being compromised. On the ground floor wheelchair storage was partially obstructing a fire exit. The windows are not fitted with restrictors. The sills are low and in some rooms it would be possible for a person to fall out if they leant too far out of the window. This needs to be risk assessed and appropriate action taken to ensure that people are kept safe. The building is heated by storage heaters and some areas were cold. Members of staff told us that some parts of the building are draughty. We recommend that room temperatures are monitored so that cold spots can be identified and appropriate action taken. Some of the heaters had a very high surface temperature and risk assessments in care plans identified that people may be at risk of burns from unguarded heaters. This needs to be addressed without delay. We saw that equipment such as profiling beds, pressure mattresses and hoists is provided to meet the needs of the people living at the home. The manager told us that there is no problem with funding for equipment. There are enough bathrooms and toilets for people to use. Overall the home was clean and tidy and there were no unpleasant smells. The outside refuse area needed tidying up. There appeared to be a lot of linen waiting to be washed. The bearings needed replacing on one of the washing machines and it was very noisy. The manager told us that all staff have received training about infection control and hand hygiene and all housekeeping have a minimum of NVQ level 2 training in their work place duties. Care Homes for Older People Page 19 of 27 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. Enough qualified and experienced staff are employed to ensure that peoples needs are met. Evidence: Staff rotas showed that there are two nurses on duty in a morning and afternoon, one or two nurses in an evening, and one at night. There are six care staff on duty in a morning, five in an afternoon/evening, and three at night. The manager told us that she has flexibility with the rota and puts an extra member of staff on if necessary to ensure that peoples needs are met. In addition there is a cook and a kitchen assistant each day and three housekeeping staff. Some of the staff have worked at Derwent Lodge for a long time. Some of the homes nurses have left recently and three new part-time nurses have been recruited. The manager has agreed a contract with a nurses agency to provide cover until the new staff are able to start. Thorough recruitment checks were being carried out before the new staff started working at Derwent Lodge. We saw records to show that new staff have to complete a programme of induction training during their first few weeks at the home. The manager told us that all of the care staff have achieved an NVQ level 2 qualification or equivalent, and some have level 3. We were able to speak with several Care Homes for Older People Page 20 of 27 Evidence: members of staff and they confirmed that they have received recent training about fire safety, moving and handling and safeguarding as well as other subjects. We found that the training records were difficult to follow and we were not able to confirm whether all of the staff are up to date with mandatory training. The manager said that she would look at implementing a training matrix which would show when training updates are due. Care Homes for Older People Page 21 of 27 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. Derwent Lodge has a competent and experienced manager who ensures that the home is run in the best interests of the people who live there. Evidence: The manager is a registered nurse who also has qualifications in teaching and management. She has been in post for ten years and showed great commitment to the service. Over recent months she has supported the staff during a difficult period of change. A member of staff who we spoke with said the manager is firm but fair, a second person said the manager is kind, firm but fair, and a third told us the manager is tough but not in a bad way, she likes things done properly but is approachable, the staff team get on well. One of the people who live at the home said If I had any problems I would go to Glynis. She is normally very kind and she has a lot of responsibility. I think she manages very well. The home has achieved the Investors In People quality award. There are some internal quality monitoring processes in the home, but they could be developed Care Homes for Older People Page 22 of 27 Evidence: further. Care plans are audited regularly by the manager. The activities organisers are responsible for getting feedback from residents about whether they are happy with their care. A customer satisfaction survey was not done in 2009 due to the change of ownership, but the manager told us that this will be done in 2010. Staff have had meetings with new owners of the home. Staff at the home do not act as appointee for any residents, but people can keep small amounts of personal spending money in safekeeping. We recommend that arrangements for the storage and recording of personal spending money be reviewed, and that a second person should check balances on a regular basis and sign that they are correct, for the protection of the homes administrator. We saw records to show that staff have regular supervision and appraisal meetings with the manager to monitor their progress and identify training needs. The manager told us that new staff have fire awareness training as part of their induction and thereafter a yearly refresher course. An on-line fire risk assesment has been completed. All accidents and injuries are recorded in an accident book and incidents are reported to CQC as required by the Care Homes Regulations. Dates given in the annual self assessment showed that all servicing was up to date. Care Homes for Older People Page 23 of 27 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 24 of 27 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 19 13 Ensure that people are not at risk from unrestricted windows. To prevent an accident from occuring 28/02/2010 2 19 13 Ensure that people are not at risk of burns from hot surfaces. To prevent burns to the skin. 31/03/2010 3 19 13 Ensure that people are not put at risk by fire doors being held open. To ensure people are protected from the spread of fire. 28/02/2010 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 19 Prepare a programme of redecoration and refurbishment to Page 25 of 27 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 show how all parts of the building will be brought up to a good standard within a specified timescale. 2 19 Ensure that adequate heating is provided to keep people comfortably warm. Care Homes for Older People Page 26 of 27 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 27 of 27 - 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. 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