Please wait

Inspection on 15/04/09 for Manor Farm House Residential Home

Also see our care home review for Manor Farm House Residential Home for more information

This is the latest available inspection report for this service, carried out on 15th April 2009.

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

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

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

What the care home does well

The home employs caring and attentive staff who are much appreciated by the residents. `Look after us very well.` `Good and caring`. `The girls are good. Take notice of everything. Nice to talk to.` The home asks new residents for their views on how the home managed their admission. This is good practice and part of the quality assurance policy to continually improve the home. The home has put staff through a comprehensive dementia care training programme which enables staff to provide the most appropriate care for those with that condition. Residents and the home are well supported by the doctors and nurses of the local practice and by the hospital consultant responsible for dementia patients to ensure that they get timely and appropriate medical support. The home provides a varied traditional menu of well-cooked food, which on the day of the visit was pleasing and looked appetising. `The food is nice`.

What has improved since the last inspection?

There were no requirements or recommendations made at the last key inspection. The home has continued a programme of redecoration and refurbishment of resident rooms. Several large trees have had to be felled because of disease. This has given some ground floor rooms extra light. An extra staff member is now on duty during the day to give specific support to individual residents. Although a recent development, it should give some residents more opportunities to do activities of their choice, and be given time just to chat.

What the care home could do better:

The home does seek the views of its residents by a post-admission questionnaire, and by involving residents in their care plan reviews. However, the home should find a way of gathering information from residents, relatives and visiting social and NHS professionals to confirm what they do well, and highlight any aspects of care which need improvement. The AQAA did say they planned to do this. The AQAA also said that the home planned to continue to improve the decor of rooms, and to replace the majority of flower beds and shrubs, and plant new trees.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Manor Farm House Residential Home Church Road Kessingland Lowestoft Suffolk NR33 7SJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Goodship     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Manor Farm House Residential Home Church Road Kessingland Lowestoft Suffolk NR33 7SJ 01502740161 01502740756 hector.jackson@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Hector Jackson care home 25 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 25 0 Manor Farm House is a residential care home registered under the provisions of the Care Standards Act 2000 to accommodate 25 older persons. It is privately owned by Mr and Mrs Jackson. Located in the village of Kessingland, Manor Farm House is close to main amenities although transport would be required to access them. Manor Farm House was first registered in 1983 and consists of a two storey main building with a bungalow extension that is linked to the main building. The Home provides 17 single bedrooms and four double bedrooms that are all provided with a wash hand basin. There is a choice of areas for service users to sit, either in the large lounge in the extension, a smaller seating area, or the conservatory. The dining room is situated at the front of the home and provides views of the open countryside. There is a stair-lift fitted to assist service users to access the first floor. At the time of this inspection the fees ranged from £362.00 to £502.00 per week. Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home on 15th April 2009 for an unannounced key inspection. The previous key inspection had taken place on 23rd May 2007. We had issued an Annual Service Review in April 2008. This visit focussed on the outcomes for residents assessed against the Care Home Regulations and the National Minimum Standards. The manager was present throughout our visit, and was able to show us all the files and documents required, and to take us on a tour of the home, introducing us to residents, and to two visitors. We spoke in detail to the visitors, and to two residents in the lounge, and to two staff members. Prior to our visit, we had issued a questionnaire survey to a sample of stakeholders. Care Homes for Older People Page 6 of 28 We received ten surveys back from service users, ten from staff and five from NHS professionals. We have quoted from these surveys in parts of this report. The manager was also required to complete an Annual Quality Assurance Assessment telling how the home matched up to the national minimum standards. The information and data in this have also been used in the preparation of this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect that their needs will be assessed to ensure that the home can meet those needs and that they and their representatives will have sufficient information to make an informed choice about where to live. Evidence: We examined the Statement of Purpose and the Service User Guide. They told prospective residents and their families about the home, its staffing, and how the home worked on a day by day basis. It also contained information on how to make a complaint. All the people who responded to our survey said that they received enough information to help them decide if the home was the right place for them before they moved in. They all confirmed that they had received a contract detailing the fees to be charged, and the terms and conditions of their residence. The manager explained that the initial fee information to a new resident could not always include details of how the payment of fees was to be arranged until the funding local authority had confirmed to Care Homes for Older People Page 11 of 28 Evidence: the home their financial commitment for a resident. We were told that new residents were asked to complete a post-admission questionnaire which covered all aspects of admission including understanding the paperwork, and the manner in which they were welcomed into the home. We saw a completed questionnaire in the file of the newest resident. All items had been rated as satisfactory. The AQAA told us that prospective residents were offered opportunities to visit the home, and they had a six week settling in period before a meeting was held with the the resident, their family and their social worker to check that the person was happy with Manor Farm. The manager told us that they completed a pre-admission assessment on each prospective resident, whether they were living at home or were in hospital. We saw the assessment for a recent admission. The file also held the community care assessment and discharge assessment from the hospital. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect their needs to be assessed and reflected in their care plan. They and their family will be involved in reviewing their care to ensure their needs are being met. Evidence: We examined three care plans. The format was comprehensive, with initial assessments of care needs and monthly reviews by a senior carer of all activities of daily living, including personal care, sleeping, dressing, mobility and communication. They also included a list of each persons medication, with a description of the purpose of each drug. The care plan for a resident admitted with communication problems after a stroke described how they wished to convey their wishes, usually by writing things down. One of the plans showed that staff had been concerned at their fluid intake. Instructions for staff included encouraging them to take fluids, and ensuring that fluids were easily available. One person had found it difficult to swallow their tablet medication. The home had arranged for some of them to be changed to a liquid formulation for their comfort. Care Homes for Older People Page 13 of 28 Evidence: One of the residents we tracked suffered from a form of dementia. The records fully documented the changing behaviour shown and the effect on their physical health. Medical visits had been regular and medication had been changed several times to tackle the mental and physical problems. The care plans included records of multidisciplinary meetings with the family. A family member expressed their concern to us that they believed this resident was being over-prescribed by the doctors, and the home was not keeping the family informed of changes. We could find no evidence of lack of involvement of the family in this persons care. The level of prescribed medication was a matter for the medical staff, and this was due to be discussed with the family shortly. Care plans included records of visits by health professionals to the home including the chiropodist. The manager reported that the home had good links with the local psychogeriatrician who responded quickly to calls from the home. She said that the local GP practice was also quick to visit if asked. All the residents who responded to our survey said that they received the medical support they needed. All the NHS professionals who responded to our survey said that peoples health care needs were properly monitored, reviewed and met by the home. They also said that the home sought advice appropriately and acted on it. All plans included moving and handling risk assessments. These were confirmed, by observation and by discussing with carers, to be up-to-date and understood by the staff. The manager was a qualified trainer and assessor. We saw that the next refresher course for her was in May 2009. Other risk assessments covered falls, and use of a walking stick. We saw in the record that these assessments were regularly reviewed and, when necessary, changed. Carers knew residents well and were able to tell us about each resident and their varying abilities. They explained how they supported residents to look after themselves as much as they were able and how they supported those who needed assistance with, for example, eating their meals. This support was observed at lunchtime. Plenty of fluids were seen to be available within reach for residents in different parts of the home. In discussion with staff, it was clear that they were aware of the importance of fluid intake for older people. We observed the lunchtime drug round. Most recipients were in the dining room but a few were in their rooms. The correct procedure was followed. The trolley was used in the dining room and was used securely. Medicines were observed to be taken before Care Homes for Older People Page 14 of 28 Evidence: the senior carer signed the sheet. The MAR sheets were examined and there were no gaps in signatures. The stock levels tallied with the quantity of drugs delivered from the supplier and administered. All bottles had been dated on opening and were within the allowed timescale. The pharmacy supplier visited quarterly to do an audit of the medication procedures. The care plan proforma included a section on Expressed wishes on death. Not all were completed as, according to the manager, some residents or their relatives found it difficult to address this sensitive area. We saw a card from a relative that said: It was a comfort to know that X was being so well looked after. Another card said: I know I dont have to worry about X while they are with you. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be offered appropriate activities, and to be able to maintain contact with family and friends, and choose what they would like to eat. Evidence: Although we did not receive any surveys from relatives this time, relatives have told us in the past how well the home kept them in touch with anything of importance about their relative. The AQAA told us that there was no restrictions on visiting. We spoke to two visitors who told us they visited several times during the week. One visitor regularly took the resident out for the day. The manager told us that many residents had lived locally and still kept in touch with friends. Eight of the ten residents who responded to our survey said that there were always or usually activities arranged that they could take part in if they wished. Some residents could also go out for a walk with support. One said they would like to be taken outside for walks more, and another said they would like someone to talk to more and read the paper to them. The manager told us that the home had added an extra carer to the staffing levels each day from 10am to 4pm specifically to give individual residents more time for things they wished to do. We spoke to the person on duty that day Care Homes for Older People Page 16 of 28 Evidence: covering this shift. They told us of the range of activities they had been able to do with some residents on a one to one basis. These included making up memory books with them, helping them write a letter or just chatting to them. Residents who participated in an activity had this recorded in their daily record. Other activities were listed on the notice board, including cards, dominoes, exercises to music, and skittles. Staff commented that reminiscence quizzes had proved popular. These had been rented from a local source. These had provided a particularly interesting activity for those with early onset dementia. There was a four-week rolling menu, which was varied, and it was seen that there were sufficient fresh vegetables and fruit available in the dry store. One resident said: There is always plenty of choices and the food is excellent and plenty of it. The lunch was plated up in the kitchen, and taken to each resident by two carers. There were two more carers in the dining room supporting residents. The atmosphere was calm, with friendly chatting between staff and residents. The room was in a sunny position overlooking the garden. All the residents said in our survey that they always or usually liked the meals. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that their concerns will be listened to and acted upon, and that they are protected from abuse by the homes policies and staff training. Evidence: The home had a complaints procedure that was given to residents, or their relatives when admitted, and was displayed on a notice board in the home. The procedure met the requirements of the regulations, giving the timescale for responding to a complaint, and the address for taking complaints to the Commission. Although the AQAA told us that there had not been any formal complaints over the past year, the record shown us by the manager listed eleven concerns raised by relatives. All bar one had been about the mixing up of clothes between residents after laundering. The manager had now given one staff member responsibility for sorting clothing from the laundry. This had reduced the problems. Three of the residents in our survey said that they did not know how to make a formal complaint, but all ten of the respondents agreed that there was someone they could speak to informally if they were not happy. All staff received training on the protection of vulnerable adults from the manager. This was usually on the agenda of staff meetings and was recorded in the minutes. We saw the minutes of the staff meeting in April. It included discussion of vulnerable adults, and confidentiality. Staff we interviewed were able to describe what action they would take if they witnessed any alleged abuse. Care Homes for Older People Page 18 of 28 Evidence: Staff were recruited after the correct identification and criminal record checks to protect residents. We saw the records of these checks in staff files. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a homely, comfortable, clean and safe environment. Evidence: The AQAA told us about improvements to the environment in the last twelve months. During a tour of the building, we saw new bedroom furniture and new carpets. Large trees had been felled in the grounds on professional advice. As well as giving the home the opportunity to replan flower beds and plant new trees, some of the rooms on the ground floor had gained more light. The manager told us that the driveway was to be resurfaced the next day. The home had advised us earlier in the year when cracks had appeared in two rooms. While these were being repaired, the home had arranged to move residents in and below those rooms to temporary rooms elsewhere in the home. This had been agreed with us. The residents could access the enclosed garden and there was a small conservatory off the main sitting room. A resident and a visitor were sitting there during the afternoon. The laundry was in a separate unit outside the back door. It had an impermeable floor and was clean and tidy. The sluice was provided in a separate room away from residents, WCs and bathing facilities. Care Homes for Older People Page 20 of 28 Evidence: Overall residents rooms were seen to be clean, well decorated and full of their personal possessions. The AQAA told us that two staff had been given responsibility for maintaining the infection control procedures in the home. This included checking that foul material was correctly bagged, that red bags were used for foul laundry items, that cupboards with hazardous items were locked and that staff wore correct protective equipment. We saw that staff had access to aprons and gloves and were using them. There was a hand-cleansing gel dispenser opposite the front door which visitors were asked to use to protect the home from cross-infection. There was a stair lift to the first floor. All residents were supported by staff when using this. Although there was a small sitting room on the first floor, no one was using it, and the manager said it was only used occasionally by visitors when talking to residents.The absence of a shaft lift meant that only residents who were safe to use the stair lift could take a room on the first floor. All the residents who responded to our survey said that the home was always fresh and clean. Since the kitchen had been refurbished, the cook had taken responsibity for its cleaning instead of the night staff. The kitchen had been inspected by an Environmental Health Officer of the local authority in February 2009. We saw the report which concluded that the standards were good. A few recommendations were made which had all been actioned. Care staff were rostered for cleaning duties separately from caring duties. All cleaning was recorded and signed for. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be supported by staff who are safely recruited, well trained to meet their needs, and in safe numbers. Evidence: We examined the personnel files for three staff. All of them showed that proper recruitment procedures had been followed. In particular, none had started until the first level of criminal record check had been obtained. Other identification checks had also been made. The files contained training records showing that new staff did an internal induction and also the Common Induction Standards course. Staff were able to confirm the recruitment procedure, and the training that they had undertaken. The home had no vacancies at the time of inspection. It did not use agency staff as it was able to rely on the permanent staff to cover any gaps through holidays and sickness. At the time of the visit there were 6 care staff and the senior carer on duty. There were 4 staff on the afternoon and evening shift with a senior carer, and two staff at night. One of the carers was on duty from 10am to 4pm was specisfically responsible for client care activities, giving individual attention to residents who needed more support. We noted that staff were able to go about their work and respond to residents Care Homes for Older People Page 22 of 28 Evidence: needs in a calm and unhurried manner. Residents were seen to be receiving individual attention as was required. Staff behaved in a courteous manner. At lunch, residents who required support were mainly seated at one table so that staff assisting them were always at hand. One resident said: The girls are good. Always busy doing something. They take notice of everything and are nice to talk to. Residents told us that staff were always or usually available when they needed them. All the staff in our survey felt that there was always or usually enough staff on duty to meet the needs of the residents. Training records for different grades of staff confirmed that training was on-going and up-to-date. The AQAA told us that fifteen staff had completed the NVQ Level 2 and six were currently studying for it. Staff who were spoken to confirmed that they had undertaken training, either as part of their NVQ, in-house refreshers or external courses, in moving and handling, food hygiene, infection control, health and safety, adult protection, dementia care and safe administration of medication. The latter was undertaken by senior carers, who were the only care staff responsible for the administration of medication. The manager and senior carer were accredited trainers in moving and handling, and the manager was also a trainer in adult protection. Staff told us in their surveys that they were given training that was relevant to their role and helped them understand and meet the individual needs of people. The surveys also told us that around half the respondents to the survey felt that there could be better communication between staff about changes to residents needs and about changes around the home. One suggested there should be handover sheets for the new shift showing key changes. However all of them thought that the home put the residents first, and that the care given was to a high standard. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a well run home where their best interests and safety are protected. Evidence: The manager had worked at the home for many years. She had completed the Registered Managers Award. She was an accredited trainer in moving and handling, and had done a four month dementia care course. In the AQAA, the manager had stated her intention of delegating more tasks to the senior carers. She had now appointed one of them to be the Supervisor, with responsibility for appraisals (supervisions), rosters and medication. Records of the regular supervision of staff were seen in the files and confirmed by staff. Annual appraisals were also undertaken. Care Homes for Older People Page 24 of 28 Evidence: Apart from the post-admission questionnaire, the home did not seek the views of residents and other stakeholders on the care given in a regular and systematic way. However the manager felt that the regular review of the care plans reflected residents views and expressed wishes. We saw from the files that reviews were held regularly with the resident and sometimes their family. She also hoped that the staff on client care duties on an individual basis would identify the wishes of residents whose views might not otherwise be picked up. Thank you cards and letters were received and were prominently displayed. A more systematic way of gathering the views of all stakeholders would highlight where improvements were necessary as well as confirming what the home was doing well. The records of the monthly testing of hot water temperatures were seen. Room checks were done monthly by the manager or a senior carer to audit cleanliness, check door closers, and to ensure that all equipment in the room was working, and that the resident was in a safe environment. Maintenance contracts for the fire alarms and other fire protection equipment, and for the hoists were seen and were up to date. The fire alarms and the fire extinguishers were also checked weekly. No doors were seen to be wedged open. The fire risk assessment had been reviewed in October 2008. The entrances to the home were protected by keypad entry systems, except the one to the internal secure garden. The manager was not an appointee for handling the financial affairs of any resident. These were the responsibility of their relatives or legal representative. The home kept a cash float for each resident which was topped up by families as necessary. Cashbook records and receipts were available for each person. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 33 The home should find a way of collecting the views of residents and other stakeholders to confirm what the home does well and highlight areas for improvement. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!