Inspection on 02/12/09 for Heritage House Nursing Home

This is the latest available inspection report for this service, carried out on 2nd December 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.

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: Heritage House Nursing Home Huddersfield Road Millbrook Stalybridge Cheshire SK15 3JL     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: John Oliver     Date: 0 3 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: Heritage House Nursing Home Huddersfield Road Millbrook Stalybridge Cheshire SK15 3JL 01613382385 01613048198 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Modelfuture Limited Name of registered manager (if applicable) Mr Mark Birchenough Type of registration: Number of places registered: care home 46 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: The registered person may provide the following category/ies of service only: Care home with nursing - Code 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 Dementia - Code DE Physical disability - Code PD. The maximum number of service users who can be accommodated is: 46 Date of last inspection Brief description of the care home Heritage House is a converted vicarage with a purpose built extension, currently registered for 46 service users. Care Homes for Older People Page 4 of 29 Over 65 0 46 0 46 0 46 Brief description of the care home Accommodation is provided over two floors serviced by a lift. All bedrooms are single en-suite and have views of either the gardens or the moors to the side and rear of the premises. The home provides three large lounges in addition to a number of smaller sitting areas, giving people plenty of choice for socialising. The home is on a main bus route and is situated off the main Huddersfield Road close to the centre of Millbrook. There is ample parking for those who choose to travel to the home by car. The fees for accommodation and care at Heritage House range from four hundred and thirty pounds to five hundred and fifty two pounds. Items not covered by the fees include chiropody, hairdressing and outings. 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: 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 management of Heritage House was taken over by Modelfuture Limited in June 2009. This was a key inspection that included visiting the home. During this visit we looked at a selection of records, care plans and other documents. Discussions took place with the management team, staff working in the home and one relative who was visiting. A tour of the home was undertaken and people living there were asked for their comments and views about the service. We spoke to three people using the service in private and we found out what they thought about the home, the management and the staff that supported them. Before visiting the home we asked the manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helped us to determine if the management of the home viewed the service they provide the same way that we assess the service. Care Homes for Older People Page 6 of 29 Additional information used to complete the inspection report may include incidents notified to us by the manager of the home and information provided by other people and/or agencies, including any concerns or complaints. 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: Although no requirements were made as a result of this inspection there are a number of areas of maintenance that should be considered for actioning sooner rather than later. The main driveway leading up to the home was pitted with pot holes which could be dangerous to both car drivers and people approaching the home on foot. It is important that all areas of the home including external pathways and driveways are clear from obstructions and hazards to minimise the potential risk to people using and visiting the service. During our tour of the home it was noted that a number of double glazed window panes had blown making the windows appear dirty and difficult to see through. As Care Homes for Older People Page 8 of 29 some of these were in peoples bedrooms it spoilt their view of the surrounding countryside and where this is the case these window panes should be replaced first. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were assessed prior to admission so that the management of the home could decide whether they could support those needs. Evidence: The manager described the referral and initial assessment process. On receipt of a referral the manager or another member of the senior team would visit a prospective service user and carry out an assessment of their needs to determine if they can be supported by the staff and management team. Where possible people were encouraged to come and visit Heritage House and to meet the people living and working there to help them make a decision on coming to live there. Most referrals were received through the local authority who also provided information about the individuals needs. Examples of the different types of assessment provided were seen in peoples files. We also saw signed and dated placement agreements from local authorities. Care Homes for Older People Page 11 of 29 Evidence: Information about Heritage House was readily available by way of an up-to-date service user guide and statement of purpose. Copies of these were placed strategically around the home and in vacant bedrooms as part of a welcome pack. 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 general health needs were known and they were supported to access the relevant services. The medication administration system made sure that people had taken the medication they require to stay healthy. Evidence: Each person had their own individual file and care plan that was based on information gathered from the relevant assessments and through knowledge gained by staff as they get to know the person. The care plans concentrated primarily on interventions to reduce risks and general health and personal care. From talking to the manager, staff and observing how staff work with people it was shown that the knowledge that staff have in how they work with and support people was being reflected within individual care plans and support interventions. Care plans were being reviewed on a monthly basis. Records of these reviews were maintained and regular care file audits were being carried out by senior staff to ensure all required documents were in place and that care plans reflected the current needs Care Homes for Older People Page 13 of 29 Evidence: of the individual. Wherever possible the service user or their representative had signed the care plan. Reasons are recorded if the service user is unable to sign. Examples were also seen of the formal review process of purchasing authorities and the homes own review process of service delivery. In one review carried out by the management team of the home the relative attending the review stated how pleased he was with the improvements made to his mothers care. Most risk assessments seen were clearly recorded with strategies in place to manage the identified risk although on one file examined it was noted that the moving and handling risk assessment had not been fully completed or signed off. Lack of such important information not being fully completed and available could place both the person receiving a service and staff at potential risk of inappropriate practice being carried out. Peoples files contained information about their mental and general health needs and also recorded the interventions from specialist and general health providers. Watching staff interacting with people using the service demonstrated that good and positive relationships had been developed and that staff respected peoples privacy and dignity at all times. People living in Heritage House told us, I am very very happy living here, everyone is very nice and I am well looked after by the staff and I am very happy here, you couldnt wish for anything better, staff help me to wash and dress and will do anything I ask them, you cannot fault them. We also had opportunity to speak to one relative during our visit who told us, Im always made to feel very welcome. ......s privacy and dignity is always respected and staff let me know things such as when the GP has been contacted or .....s medication has been changed. On the day of our visit people looked well-groomed and had been supported to achieve a good level of personal hygiene. Records indicated that people could have baths and showers when they requested. Supporting people in these areas of their daily care inturn helped to promote their dignity. The medication administration system was assessed and found that records of deliveries and returns were being maintained. The Medication Administration Records (MARs) were sampled and found to be signed and audited to show that all the required medication had been administered. Care Homes for Older People Page 14 of 29 Evidence: We spot checked some medication that was not administered from the blister packs and found that balances were correct. A separate audit record was kept of such medication to ensure balances could be checked on a daily basis. The deputy manager told us that people could self-administer medication if they had been assessed and appropriate risk assessments were in place. We were told that no-one was self adminstering medication at the time of our visit. All staff with the responsibility for administering medication had attended safe handling of medication training. To further minimise the potential risk of errors occurring, managers carried out a monthly audit of all medication and medication practice to ensure that guidance from the organisations medication policy and procedure was strictly being adhered to. When asked about their medication, people in the home told us, I always get my tablets when I should, They (staff) bring them (tablets) to my room if Im not up and I take that many tablets I rattle! Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported to make choices and maintain control over their own daily routines and activities wherever possible. Evidence: We found that the routines at Heritage House were flexible and that people were encouraged to participate in the local community through amenities such as the local cafes, parks and shops. The home benefited from the services of a full time activities organiser. Activities included bingo, watching films and quiz nights. One to one activities such as manicures, reading a newspaper and doing puzzles were encouraged and, at the time of our visit, people were enjoying participating in decorating the home ready for the festive season. The activities organiser confirmed that she was involved with people living in the home from the moment they were admitted and gained an overview of the lifestyle preferences they previously enjoyed and transferred this information into her records. Observation of the interactions showed that people liked to sit together in the different communal areas of the home talking to each other and entertaining their visitors. Others enjoyed their own company either reading, watching television or knitting. One Care Homes for Older People Page 16 of 29 Evidence: person living in the home told us, I have everything I need here, lovely things to do (knitting) and lovely people looking after me. We saw the minutes from the last service user meeting that was chaired by the activities organiser. The minutes indicated that people were given the opportunity to voice their opinions about the service they were receiving including, food, housekeeping, staffing and activities. It is important that people living in the home are given such opportunities in order to maintain their choice and rights in the way in which they choose to live their lives. People could receive visitors at any time that was convenient to them, and people told us that they could see friends and family in private if they wished. One person told us, All my visitors are made to feel welcome. One relative was spoken to and they told us that they were free to visit at any time and made to feel very welcome by all the staff. Mealtimes were seen as an important social occasion and dining rooms were comfortably furnished and had a relaxed atmosphere. Tables were appropriately set with menus clearly indicating the choices of food available. We observed a lunchtime meal being served. At least five staff members and a number of visiting relatives were supporting people during the meal time. The support was being offered in a sensitive and dignified way with staff being sat at the side of the person they were assisting and gently encourging people to enjoy their meal. A number of people living in the home told us they enjoyed their meals and comments included, The meals are always good here, You do get a good choice offered you, Some food is better than others and You couldnt better. One relative said, ....s eats well, a choice of meals if offered and people seem to enjoy them. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The policies, procedures and staff practices were present to protect vulnerable people from abuse and protect their wellbeing. Evidence: The formal Complaint Procedure set out the stages, timescales and the procedures for people to follow if they want to make a formal complaint. The procedure was made available to people and was also available in communal areas. We asked a number of people living in Heritage House about whether they felt able to make a complaint. Each person spoken to said that they had no concerns or complaints. One person told us, If I had any worries or complaints to make I would see one of the staff or Mark (manager). One of the visiting relatives also told us, I have had to make a complaint and this was dealt with immediately and to my satisfaction. There had been four complaints made in the last six months. On examination, the records demonstrated that these had been dealt with in accordance with relevant procedures. No complaints had been received by the Care Quality Commission in that time. The registered manager of the service is also the Safeguarding Adults Manager and has completed relevant training in this area. The deputy manager is a Nurse trainer in Care Homes for Older People Page 18 of 29 Evidence: Safeguarding Adults and uses her knowledge and skills in this area to provide support to the staff team. A copy of the organisations safeguarding policy was available and accessible to all staff. The information provided staff with clear instructions of the action they must take if they suspect any type of abuse has taken place. A copy of the latest Tameside Multi Agency policy was also available. Staff spoken to at the time of our visit were very clear about the procedure to follow and action to take should an allegation of abuse be made. One member of staff told us,We have a duty to protect the people in our care. At the first sign of any abuse I would report this to my manager. When asked what they would expect him to do they said, Report it to the relevant safeguarding contact team. We looked at the training records which indicated that 80 of the staff team had completed Protection of Vulnerable Adults (POVA) training and that further training for all staff in this area was arranged for early in the new year. 13 Staff had also completed the National Vocational Qualification (NVQ) training level 2, and protection of vulnerable adults is an important element of this course. There had been two referrals to the POVA list in the last six months. All relevant paperwork had been completed by the manager and was seen on file. The procedures and recording systems for supporting people with their personal finances and spending was in place. This will be looked at further in the Management and Administration section of the report. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises were clean and offered enough space and flexibility to meet peoples needs. Evidence: On approaching Heritage House the driveway was pitted with pot holes which could be dangerous to both car drivers and people approaching the home on foot. It is important that all areas of the home including external pathways and driveways are clear from obstructions and potential hazards to minimise the potential risks to people using and visiting the service. All areas of the home were found to be clean, tidy and free from any unpleasant odours. Communal areas were furnished to a good standard and were homely and very comfortable. Some new furniture had been purchased including, coffee tables, bedside tables and a couple of new armchairs for one of the landing areas. Decoration was to a good standard although some areas of the home were showing signs of wear and tear and we were informed by the manager that things such as redecorating the home was part of the ongoing refurbishment and maintenance plan. We looked at a number of bedrooms and found that most had been personalised to varying degrees reflecting the character of the person whose room it was. Where Care Homes for Older People Page 20 of 29 Evidence: nursing care was being provided profile beds were in place to promote the comfort and well being of the person. Other aids and adaptations were seen to be in place such as hoists, bed pulleys and adapted toilets and bathrooms. We noted that in room 43 the carpet was worn near the doorway and beginning to fray. This could become a tripping hazard to both people using the service and staff and should be replaced sooner rather than later. The manager told us that this was in the process of being done. As we toured the home we noted that a lot of the double glazed window panes had blown causing them to look dirty and making them difficult to see through. It was especially noticeable in room 10 where the person enjoys sitting in their room looking at the views of the hills and wildlife. Consideration should be given to replacing all failed double glazing units. A number of house-keepers were on duty at the time of our visit and it was seen that they respected the privacy and dignity of people still in their rooms when they wished to clean them. They knocked on doors and waited for a response before entering and it was good to hear them chatting with the people whilst carrying out their duties. People spoken to said they appreciated the work the domestics did and the time they spend chatting to us. Laundry facilities appeared appropriate to meet the needs of people using the service and plans were in place for all staff to receive updated Infection Control training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were being supported by sufficient numbers of appropriately qualified and experienced staff. Evidence: Staffing rotas seen indicated that sufficient numbers of staff were deployed in the home to meet the current needs of people using the service. At the time of our visit there were 13 people using residential services and 17 using nursing services. Staff spoken to said that there were usually enough staff on duty as did people using the service and there was no indication that the service was understaffed. We found that staff working at Heritage House had received training to prepare and support them for the work they did. Training records indicated various staff had received training in moving and handling, fire safety, protection of vulnerable adults, food hygiene, medication administration, first aid and health and safety. We were told that 13 care staff had achieved a National Vocational Qualification at level 2, 6 care staff at level 3 and 6 domestic staff at level 2. Staff spoken to told us, The new management team are very keen on making sure we get all the training we should, I have done basic food hygiene, medication administration, protection of vulnerable adults and I will be doing Mental Capacity Act training in December and If you need any particular training you can ask and it will Care Homes for Older People Page 22 of 29 Evidence: usually be arranged. It is important that all staff receive training that is appropriate to the jobs they do in order to maintain and further develop their skills and knowledge. One visitor to the home told us, Mark (manager) came in at a difficult time but he has a good deputy and I have seen an improvement in staff development. The general ambiance and atmosphere of the home is good. People living in the home told us, Staff always come when I need them. Night staff come in and check Im OK, they will bring me a drink if I want one, Staff are always around when you need anything, sometimes you wait a little longer but not often and Some staff are better than others but on the whole everyone does their best for us. Samples of staff files were seen and it was found they all contained the required documentation and checks including reference to the Criminal Record Bureau certificate. We saw evidence that recently employed staff were in the process or had completed the company induction pack which included Skills for Care. Once completed, the manager or deputy manager will sign off the induction record. We did see one induction record that had been completed but had not been signed off. 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 management, policies and procedures for the operation of the home were in place and worked in the best interests of people. Evidence: The registered manager has extensive experience of managing care homes and care homes with nursing. He is supported by a deputy manager who is also a registered nurse and the clinical lead nurse in the home. The registered manager is also supported by senior managers within the organisation who are also qualified nurses and able to advise him on clinical issues if he needs to question the advice of the clinical lead nurse. Both people living and working in Heritage House were pleased with the management of the home and service and comments included, We now have a really good management team who offer us plenty of support and guidance including regular supervision, Since the new manager and deputy have been in post there have been definite improvements, (both are) very approachable and the atmosphere is so much Care Homes for Older People Page 24 of 29 Evidence: better, staff get on better, Mark (manager) and ......(deputy) are always out and about and talk to us whenever they see us, they know us all by name (residents) and Since the new manager has been here I know I have a care plan that tells staff what to do for me. We saw that people living in the home meet on a regular basis. This was an opportunity for people to talk about any concerns and raise and issues. It is important that everyone living in Heritage House has an opportunity to maintain their independence and voice their opinions on how they wish to lead their lives. Regular staff/team meetings were held and included all staff working in the home. These meetings were seen as an opportunity to discuss things such as good practice issues, policies and procedures, new legislation and updated information from the organisation. All staff received regular one to one supervision and this enabled them to discuss their personal development, training needs and any concerns they may have. We were also told that supervision was used to make sure staff were continually aware of their responsibilities regarding the safeguarding of people living in Heritage House. The way in which peoples money was managed was done through a robust system that provided a clear audit trail of expenditure and receipt. At the time of our visit the service was also being assessed for the Investors In People Award (IIP). This award looks at how staff are valued within the service and how well their personal development is promoted through regular and appropriate training and supervision. We found that the health and safety of both people using the service and staff was being promoted and a random check of servicing records including gas, electric and equipment used in the home demonstrated that regular servicing and maintenance was being carried out. We saw that a number of hoists were being used throughout the home, both manual and electric. All had been serviced and people needing the use of a hoist had their own slings to minimise the risk of inappropriate equipment being used and reduce the risk of cross infections. Within the Annual Quality Assurance Assessment (AQAA) we were informed of areas within the service that had improved and also areas that it was felt additional Care Homes for Older People Page 25 of 29 Evidence: improvements could be made or achieved. It is important that the management team of the service recognise good practice and understand that continual development of the service is important if people using the service are to receive a high quality service at all times. Where the management team know they have made improvements, it is essential that they continue to maintain and progress with the further development of the service and staff team. This is important to people using the service in order that they receive the support they need, and that it is provided in a manner that continues to be safe and life enhancing. Care Homes for Older People Page 26 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 27 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 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 All risk assessments should be fully completed and signed off to reduce the potential risk to both people using the service and staff of inappropriate practice being carried out. The carpet in room 43 should be replaced sooner rather than later to minimise the potential risk of slips, trips and falls from where the carpet is beginning to fray. Where the double glazing has failed and window panes have become blown these should be replaced in order for people to continue enjoying the views and to enhance the appearance of the home. The pot holes in the driveway leading to Heritage House should be repaired to minimise the potential risks to both people driving and walking up to the home. 2 19 3 19 4 19 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. 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