Inspection on 29/01/10 for Hillcrest Care Home

This is the latest available inspection report for this service, carried out on 29th January 2010.

CQC found this care home to be providing an Excellent 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.

Other inspections for this house

Hillcrest Care Home 09/11/05

Hillcrest Care Home 17/06/05

Hillcrest Care Home 31/01/05

Hillcrest Care Home 06/05/04

Hillcrest Care Home 23/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/04/2010.

Key inspection report Care homes for older people Name: Address: Hillcrest Care Home Kenilworth Drive Kirk Hallam Ilkeston Derbyshire DE7 4FJ     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: Janet Morrow     Date: 0 8 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 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) © 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 29 Information about the care home Name of care home: Address: Hillcrest Care Home Kenilworth Drive Kirk Hallam Ilkeston Derbyshire DE7 4FJ 01629531811 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: sue.hollingworth@derbyshire.gov.uk www.derbyshire.gov.uk Derbyshire County Council care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of people who can be accommodated is 24 The registered person may provide the following category of service only Care home only Code PC,to people of the following gender either, whose primary needs on admission to the home are within the following categories Old age, not falling within any other category Code OP Maximum number of places 24 Dementia, not falling within any other category Code DE Maximum number of places 24 Date of last inspection Brief description of the care home This is a Local Authority Care Home providing personal care only for 29 older people of either gender. The service has 20 single rooms on two floors, and two double bedrooms. There is a shaft lift providing access to the upper floor. The service is situated in the middle of a housing estate in Kirk Hallam. The local shops, pub and post office are within walking distances. The premises have gardens mainly to the rear of the building which include two central courtyards with seating areas. Fees are up to Care Homes for Older People Page 4 of 29 Over 65 0 24 24 0 Brief description of the care home £375.06 for a shared room and £404.06 for a single room per week for permanent service users, but a range of prices for short term care service users. Extra charges are made for hairdressing, chiropody, magazines, newspapers and contributions towards 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: 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 inspection visit was unannounced and took place over two days for a total of 9.5 hours. Case tracking methodology was used, which means that the records of three people using the service were examined and relevant people spoken with to assess what impact the service had on those peoples quality of life and well-being. An expert by experience assisted with the inspection process. 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. The expert by experience was present for four hours and spoke with service users, relative and members of staff. His findings are incorporated into the report. Care Homes for Older People Page 6 of 29 We spoke with seven of twenty-three people using the service, three relatives, four members of staff, two visiting professionals and the manager and deputy manager during the visit. One visiting professional was spoken with by telephone following the inspection visit. Care records, maintenance records, a sample of policies and procedures and staff records were examined. A partial tour of the building was undertaken. Twenty-five surveys were received prior to the inspection visit; fifteen from staff and ten from people using the service. Written information in the form of an Annual Quality Assurance Assessment (AQAA) was provided by the service prior to the inspection visit and informed the inspection process. This information is referred to as the AQAA throughout the report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Personal service plans had improved to integrate the needs related to dementia across all identified care needs. Employment information retained in the service now included written references. The service was continuing to develop its expertise in caring for people with dementia and was in the process of applying for a specialist dementia registration with the Care Quality Commission. Specialist training had been provided for staff and all had been provided with safeguarding vulnerable adults training. More staff hours have been provided on week days and two relief managers had been appointed. Decorating of lounges, corridors, bedrooms and dining rooms had taken place. New flooring had been laid in the dining room. Staff recruitment procedures had been changed to allow prospective staff to visit the Care Homes for Older People Page 8 of 29 service so their interactions with service users could be observed prior to their interview. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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. The service was able to meet peoples needs, based on the detailed assessment information provided. Evidence: The AQAA stated that Each service user has an individual pre-admission assessment to ascertain whether we can meet their need. The manager told us that visits to prospective service users were made prior to their admission and that they, or their advocates, were encouraged to visit and day care was also offered before making a decision. Relatives spoken with also confirmed this. We examined three peoples care files and saw that there was assessment information from external professionals as well as information gathered by the service. This established that the service was able to meet peoples individual needs. Care Homes for Older People Page 11 of 29 Evidence: Risk assessments were in place on the files for risk of falls, nutrition, pressure sores and moving and handling. Those people using the service confirmed that their care needs were met. A visiting professional spoken with also confirmed that the needs of the people they were involved with were met and described the care as very good. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and care needs were met and their rights to respect, dignity and privacy were promoted. Evidence: The Aqaa stated that With agreement we work with the service user, relative and carers in partnership in order to provide the best support for the individual and We have staff trained in carrying out exercises to service users and promoting good wellbeing and reducing the risks of falling. We examined three peoples care files. Two had a care plan (personal service plan) in place that contained information on how to address needs. Personal service plans were clearly written and well presented and were used as a working tool. The plans covered a range of needs, linked to physical health needs such as personal care, mobility and eating and drinking and took into account the persons mental health needs throughout. Each area of need clearly stated how best to engage with the person concerned to ensure the care was carried out on an individual basis. For example, one plan stated that any unusual behaviour should be investigated carefully Care Homes for Older People Page 13 of 29 Evidence: to ensure that physical symptoms such as pain were not missed and assumed to be as a result of dementia. There were also plans for night care that took into account that people may be awake and up during the night. The third record examined was for someone who was admitted for respite care. The service stated that they used the assessment information provided on admission on which to base the provision of care for people using the service for short periods and that a formal plan was not devised. There was sufficient information in the assessment documentation to identify where support was required and the manager stated that there was additional information recorded on the daily notes. The plans had been reviewed regularly; one persons had been reviewed in June and September 2009 and the other had been reviewed in February 2010. Access to health professionals such as opticians and General Practitioners was recorded in the files examined and there was monthly recording of weight on both care plans seen. Nutritional needs were monitored and action taken if people appeared to be losing weight or not eating well. One visitor told us that they were pleased with the care and said their relative had put weight on since using the service. They also added that the persons dementia had not deteriorated, but that they were observing a slight improvement. The service was striving to provide the best possible service for people with dementia that addressed their needs on an individual basis. This meant the service had looked at environmental issues such as signage and colour schemes around the building, recruitment and training of staff, involvement of family and a range of activities. They had also had a dementia care mapping exercise conducted by external people in April 2009. This was a technique were people were observed during a specified time period and interactions with staff monitored. The findings from this confirmed that staff were dealing with people in a sensitive manner and doing their best to understand peoples individual communication methods. Discussion with the manager also confirmed that the service wanted to provide the best care and support possible and she stated that the service was passionate about what we do. Observation during this inspection visit also verified the effort staff made to try and understand and deal with people in a professional and caring manner. Very positive comments were made by relatives and visiting professionals about the standard of care, empathy and understanding shown by staff. For example, one relative said nothing is too much trouble, they seem to take things in their stride and I would pay the staff in gold bars, they are wonderful; another said the service was very Care Homes for Older People Page 14 of 29 Evidence: accommodating and another said staff listen carefully and that they were so pleased with the care. Several visitors spoken with described the atmosphere in the service as calm and felt this had a beneficial effect on their relative. People using the service also praised the care and one person told us that if people struggled with anything then staff found something different for them. One person said I enjoy sitting around and the staff and residents are excellent. Nine of the ten surveys received from people using the service responded that they always received the medical attention required and one responded that they usually did. One survey commented that staff were very helpful and attentive. A visiting professional commented that the service had transformed the person they were dealing with and described the results as stunning. Another professional spoken with described the care as excellent. The quality of the care was also reflected in staff comments; they were clear about what they needed to do and were motivated in their roles. They felt job satisfaction was good and one described their work as very rewarding. They also told us that they tried to be as flexible as possible to meet individual needs and that observing body language and unusual behaviours was key to interpreting peoples needs. Observation during the inspection visit confirmed that staff were skilled in this and a recent internal audit also noted that staff were accommodating to the service users needs - as opposed to being led by routine. Staff surveys received also showed that staff were motivated; one commented that they provided excellent care for the residents and support to families, another said the peoples individuality, needs and dignity were in mind at all times and another that the service did well in taking care of residents with dementia. A general check on medication administration record (MAR) charts showed that all charts were signed properly. Two people were signing handwritten MAR charts and quantities of medicines received were recorded. Three peoples charts were then examined in more detail and all were completed accurately for administration with the chart corresponding with the blister pack. There were controlled drugs in use and the record was examined; the amount held corresponded accurately with the controlled drugs record. Storage of medicines was satisfactory and a random sample of medication examined showed that these were within their expiry dates. The medication refrigerator Care Homes for Older People Page 15 of 29 Evidence: temperatures were recorded daily to ensure safe storage of medicines. The medication policy covered essential areas related to drug administration, including what to do if there was an error, and there was also a copy of the Royal Pharmaceutical Society Guidelines on administering medicines in care settings available. Care Homes for Older People Page 16 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. Well managed activities, meals and community contacts enhanced peoples quality of life. Evidence: The AQAA stated that We hold service user meetings, Erewash forum, relatives group and the amenities group where ideas on improvements are discussed and taken on board. Within these groups service users are able to make decisions on what they would like to see on the menus and activities programmes. The service was endeavouring to provide appropriate activities for people with dementia and had established a table with a range of games and tactile items for people to pick up and use when they wished. This facility was well used during the inspection visit and people were observed looking at items on the table and touching them or using them. Those people who liked to walk were able to do so safely around the building and in the enclosed garden area and staff accompanied people in the local area. Regular activities included craft, quizzes, monthly outings, in house entertainment, bingo, shopping trips, chair based exercises, theme and food tasting evenings and Care Homes for Older People Page 17 of 29 Evidence: religious services. People enjoyed seasonal celebrations, birthdays and outings. A service users meeting held in January 2010 commented that everyone had enjoyed the Christmas celebrations. Family and friends were also invited to special evenings and events and feedback on surveys from relatives regarding a social evening commented that it was well organised. Photographs were on display in the corridors of social events and outings that had taken place. Observation showed that activities were planned and executed in a professional manner. Five of the ten surveys received from people using the service responded that there were always activities arranged and five responded that there usually were. The service worked hard to maintain and encourage family involvement and all relatives spoken with commented that the service was welcoming and friendly. Residents meetings were held regularly and there continued to be an Erewash Forum of Local Authority residential services in the area with an independent chair to which each service sends two service user representatives. The minutes of the January 2010 meeting were seen and confirmed that people could make suggestions and raise issues that concerned them. The manager was aware of who to contact for an advocacy service and was aware of the Mental Capacity Act 2005 and its implications for decision making with people who have impaired abilities and had undertaken training in this area. She stated that no one using the service currently had an advocate. There was information in the service about the Act and the associated Deprivation of Liberty Safeguards. The serving of the lunch-time meal was observed and showed that the food was plentiful and nutritious with a choice offered. Those people spoken with during the lunch-time period said that they enjoyed their food. Menus were examined and showed that there was good variety of nutritious and wholesome food. Food stocks were good and there was fresh fruit available. Staff spoken with were knowledgeable about individual food likes and dislikes and were able to cater for these. Specialist diets, such as diabetic, were catered for. Nine of the ten surveys received from people using the service responded that they always liked the meals and one responded that they usually did. Care Homes for Older People Page 18 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. Adherence to clear systems and procedures ensured that peoples concerns were listened to objectively and that they were safeguarded. Evidence: The AQAA stated that We have a clear and accessible complaints procedure illustrating time scales and that there had been one complaint received in the last twelve months. We saw the complaints telephone number on display and the complaints record was examined, which showed that there was a clear format for recording issues and what action had been taken to resolve them. People spoken with said they knew who to speak to if they had any worries or concerns. There had been no complaints received at the office of the Care Quality Commission since the previous inspection visit in September 2007. All ten surveys received from people using the service responded that they knew who to speak to if they had any concerns. The service adhered to the Derbyshire Local Authority safeguarding vulnerable adults procedures and had information about keeping safe in various locations about the premises. Staff spoken with were aware of their responsibility to report any suspicions of abuse and confirmed that they had received training in safeguarding procedures. Training records confirmed that safeguarding vulnerable adults training had been Care Homes for Older People Page 19 of 29 Evidence: provided in 2009. All fifteen staff surveys received confirmed that they knew what to do if someone had concerns about the service. Care Homes for Older People Page 20 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 building was well maintained, which ensured people had safe and comfortable accommodation to enjoy. Evidence: The AQAA stated the premises were well maintained and the service offers a homely place in which to live and that planned improvements were to have further bedrooms redecorated, new carpets to the upstairs and stair case, a new roof over the middle corridor. Efforts had been made to adapt the building to meet the needs of people with dementia. The coloured doors and signage assisted people to find their rooms easily. Seating in the lounge had been arranged purposefully to enable people to engage in activities, doze off or watch television. The kitchen was neat and tidy and well laid out. The individual rooms seen were personalised with furniture, ornaments and pictures. The laundry was neat and tidy and all equipment was in working order. People spoken with, and their relatives, confirmed that their laundry was done well. The kitchen was also clean and tidy and had achieved a four star rating in January 2010 from the Local Care Homes for Older People Page 21 of 29 Evidence: Authority for hygiene standards. Staff spoken with were aware of how to control the spread of infection and confirmed that there was always a plentiful supply of protective equipment, such as gloves and aprons. A recent infectious outbreak had been dealt with properly and advice sought from the relevant agencies. Eight of the ten surveys received from people using the service responded that the premises were always fresh and clean and a visiting professional spoken with said the building was always clean and there was no smell. Care Homes for Older People Page 22 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. Well trained and motivated staff ensured people were cared for safely. Evidence: The AQAA stated the service had improved its recruitment process. It stated we have invited applicants into the service and asked them to interact with the service users before their interview. We have been able to observe them, their body language and the way they have interacted with service users as well as staff. Three staff files were examined and generally showed evidence of good recruitment processes. Most of the documentation required by Schedule 2 of the Care Homes Regulations 2001 was in place, including a Criminal Record Bureau check, evidence of identity and qualification certificates. However, there was insufficient information on one file to give a full employment history. The rota for the week beginning 8th February 2010 was examined and showed that there were three staff on duty between 7am and 10pm. However, this was reduced to two people at the weekends. Six staff surveys responded that there were usually enough staff to meet peoples needs and seven responded that there sometimes were. Six staff surveys commented that more staff at weekends would be an improvement; one commented that with more staff the residents would receive more one to one time and another said the home struggles at the weekend because there is always limited staff. Staffing was discussed with the manager and she confirmed Care Homes for Older People Page 23 of 29 Evidence: that there were only two staff on duty at the weekends but that managers would assist with care tasks where necessary. There were no issues reported that were related to lack of staff, although one relative commented they could always do with more staff, couldnt they? Seven of the ten surveys received from people using the service responded that there were always enough staff when needed, two responded that there usually were and one that there sometimes were. The AQAA stated that nineteen of twenty-one care staff had an NVQ 2. The service was therefore exceeding the target of having 50 of staff with an NVQ2 and is commended for its commitment to qualification training. Training information provided by the service and certificates seen on staff files showed that mandatory health and safety training took place as well as training in areas related to care. Staff spoken with confirmed that mandatory health and safety training had occurred in the last twelve months and that courses in medication, tissue viability, the Mental Capacity Act and dementia awareness had also been provided. Training records seen confirmed this. One member of staff described the training as pretty good. Fourteen of the fifteen staff surveys received confirmed that relevant training was provided for their role and one responded that it wasnt provided in relation to their role. One commented that training for staff is uppermost in the managers mind. Care Homes for Older People Page 24 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 service was well managed in peoples best interests. Evidence: The AQAA stated We have a clear and accountable management structure appropriate to the size of the home and that an open and honest approach to all aspects of running the home is encouraged. An open and transparent approach by the management team allows all users, relatives and staff feel part of an ever developing service with good outcomes for all. The manager was experienced and suitably qualified to run the home. She delegated responsibility for particular aspects of management to each of the three deputy managers. All managers had responsibility for supervising staff, who confirmed that they received good supervision and support. The management structure ensured that there was always a manager on duty and that staff had access to advice and support. One member of staff said that everything runs smoothly. Care Homes for Older People Page 25 of 29 Evidence: There were a variety of quality assurance approaches taken, e.g. questionnaires, residents meetings, Erewash Forum, relatives surveys. Some comments from relatives were received regarding a social function and all were favourable: for example, very sociable and courteous staff, lovely food and very well organised. An internal audit had been undertaken in January 2010 and made favourable comments about the way the service operated and noted that contact with service users was made a priority and the staff group are very flexible. Three peoples financial records were examined and showed that there were computerised systems in place for safeguarding peoples money. There were receipts available for individual purchases and secure storage facilities for cash and valuables. Staff training records and the AQAA supplied by the service indicated that training had been undertaken in mandatory health and safety subjects such as first aid, moving and handling, infection control, food hygiene and fire safety in 2009. Staff spoken with confirmed that this training took place. The AQAA also stated that regular maintenance of equipment took place and a random examination of records showed that this included the portable electrical appliances in November 2009, the electrical wiring in 2006 and hoists in December 2009. The fire alarms were being tested on the second day of the inspection visit. 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 2 7 27 There should be a care plan for all people using the service, irrespective of length of stay. The service should re-consider its staffing arrangements at weekends to ensure there are a consistent number of staff on duty to meet needs. Staff recruitment records should always have a full employment history that explains any gaps. 3 29 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!