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Inspection on 30/01/09 for Maranatha Rest Home

Also see our care home review for Maranatha Rest Home for more information

This is the latest available inspection report for this service, carried out on 30th January 2009.

CSCI 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

Maranatha is a small friendly home. Because it is small people feel that their individual needs are understood and catered for. Staff know residents well. There is a stable core group of staff working at the home and this provides consistency and stability for the people living there. During the site visit staff were kind and caring in their approach. People are able to welcome their friends and families at any time.

What has improved since the last inspection?

Since the previous inspection the home has new owners and a new manager. The home is better organised, and information needed for the inspection was more readily available than on previous occasions. The new manager, assisted by a consultant, is making good progress in reviewing all aspects off the home, making improvements where necessary. A good assessment tool for identifying the needs of new residents has been developed. This will help people moving into the home in the future to be assured that the home will be suitable for them. Care planning has developed, and now provides better and consistent information for staff. Care planning has become more person centred. People or their relatives are encouraged to see and agree care plans. New menus have been developed that will offer people more choice and variety of food. Recruitment procedures have improved so that people are safeguarded by good practice being maintained. When staff start work at the home they are given training so that they understand the principles of good care and safe working. Refurbishment of the home is continuing with an improved environment and facilities gradually being provided. Staff training records are now better organised so that it is possible to identify what training has taken place. Since the previous inspection staff have undertaken many different training courses to improve and update their skills. This helps to ensure that people are cared for by competent staff. Following changes in ownership and management work is ongoing to develop a strong and effective team.

What the care home could do better:

People`s social and occupational needs could be better assessed and catered for so that they have more opportunities for stimulation and activity. Activities provided should be relevant to people`s individual needs.Although people are encouraged to make choices in many aspects of their lives, development is needed to ensure that this is also the case in relation to food and menus. Further efforts are needed to try and ensure people can have a say about how the home is run. Quality assurance processes need to be developed to offer everyone involved with the service an opportunity to freely express their views. As the home is registered to provide dementia care the premises should be assessed for any potential hazards so that people are cared for as safely as possible.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Maranatha Rest Home 211 York Road Southend On Sea Essex SS1 2RU     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: Vicky Dutton     Date: 3 0 0 6 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 27 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 27 Information about the care home Name of care home: Address: Maranatha Rest Home 211 York Road Southend On Sea Essex SS1 2RU 01702467675 01702600884 Syed@smh.demon.co.uk 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) : AMA Generic Ltd care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 15 0 The maximum number of service users who can be accommodated is 15 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE Date of last inspection Brief description of the care home Maranatha Rest Home is an established private home providing personal care and accommodation for up to fifteen older people. Within this number the home is registered to care for up to five people who have a diagnosis of dementia. Maranatha is a detached property comprising of eleven single and two double bedrooms. There is a choice of two communal lounge areas, a dining area and a conservatory. Bedrooms are provided on the ground and first floor, with the first floor being accessed via a passenger lift. There is a small garden for people to use and on street parking for visitors. The home is situated close to Southend town centre and to the seafront. Care Homes for Older People Page 4 of 27 Brief description of the care home Maranatha has both a Statement of Purpose and Service Users Guide available. The previous inspection report was available to residents or other interested parties in the homes entrance area. It was confirmed that the current fees at the home are £427.00 to £450.00 per week. There are additional charges for chiropody, hairdressing, taxis when required and newspapers/magazines. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key site visit. The previous site visit to the home took place on 3rd July 2008. At this visit we (CQC) considered how well the home meets the needs of the people living there, how staff and management work to provide good outcomes for people, and how people are helped to have a lifestyle that is acceptable to them. The level of compliance with requirements made at the previous inspection was assessed. The site visit took place over a period of seven hours. A partial tour of the premises was undertaken. Care records, staff records, medication records and other documentation was selected. Various elements of these were looked at to see how well these aspects of care and running the home are managed. Time was spent talking to, Care Homes for Older People Page 6 of 27 observing and interacting with people living at the home, and talking to staff. We also spoke to three visitors during the site visit. The homes Annual Quality Assurance Assessment (AQAA) was sent in to us. This is a self assessment document that services are legally required to complete and send to us. The AQAA was received by the due date, was fully completed, and outlined how management feel they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives, involved professionals and staff. We received responses from three people living at Maranatha. One relative, one visiting professional and two staff. The views expressed at the site visit and in survey responses have been incorporated into this report. We were assisted at the site visit by the manager, deputy manager and other members of the staff team. One of the new owners and the consultant currently assisting the home also assisted through offering information. Feedback on findings was provided throughout the inspection. The opportunity for discussion or clarification was given. We would like to thank the staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: Peoples social and occupational needs could be better assessed and catered for so that they have more opportunities for stimulation and activity. Activities provided should be relevant to peoples individual needs. Care Homes for Older People Page 8 of 27 Although people are encouraged to make choices in many aspects of their lives, development is needed to ensure that this is also the case in relation to food and menus. Further efforts are needed to try and ensure people can have a say about how the home is run. Quality assurance processes need to be developed to offer everyone involved with the service an opportunity to freely express their views. As the home is registered to provide dementia care the premises should be assessed for any potential hazards so that people are cared for as safely as possible. 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know through assessments and information sharing that the home will be suitable to meet their needs. Evidence: We saw that there was an up to date Statement of Purpose and Service Users Guide in place that would provide people with good information about the home. When we looked at details of the eleven residents currently living in the home we saw that everyone has lived at Maranatha for some time, and no one had moved in since the previous inspection. The manager showed us the pre-admission assessment form that they would use to assess peoples suitability for moving into the home. It was detailed and would help to assure people that that the home would be able to meet their needs. The AQAA said, We invite prospective residents to visit the home and stay for a meal so that they may feel the homely atmosphere, sample the home cooked Care Homes for Older People Page 11 of 27 Evidence: food, talk to staff and residents and generally get a feel for the place. This is the first key inspection since the home has been under new management. As there have been no new admissions we could not assess the effectiveness of the homes admission processes. We did however see that systems are in place, and have therefore rated this outcome as good. This will be more fully assessed at the next key inspection. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good personal and healthcare support to meet their individual needs. Evidence: People spoken with, and responses on a small number of surveys, showed that people are happy with the care they receive. On surveys people said that they always received the care and support that they needed. At the site visit people appeared relaxed and well cared for. Residents who were able to comment said that staff looked after them very well. A visitor said, The care is very good, cant be faulted. Nothing is ever to much trouble. As previously mentioned, since the last inspection Maranatha has new owners, and a new manager has been in post since January this year. Since then the care planning system has been completely overhauled to provide a cohesive and comprehensive approach to assessing and meeting peoples needs. The manager and three members of staff have undertaken training in care planning this year. We viewed three care files and found that care plans had been discussed and agreed with residents or their families. Care files contained relevant assessments and risk assessments, general information and care action plans. Where people are cared for in Care Homes for Older People Page 13 of 27 Evidence: their rooms care files are kept there so that staff have ready access. These files also included detailed nutritional and fluid intake records that were well maintained, and ongoing care records. Care plans provided staff with good information to help them support people in ways that they need and prefer. When we spoke with the manager and staff they had a good awareness and understanding of individual residents needs. The manager regards care planning systems as a work in progress and some possible improvements were discussed. Care plans tend to concentrate on peoples physical and behavioural needs. One persons care file had no care plan in place to reflect their social/activity needs. Daily records are kept in the form of recording the outcomes of the care plans. Staff are not then using this this flexibly to record other important issues such as any accidents/incidents occurring, visitors or outings. Statements such as safety maintained and all care given were frequently made that did not give a feel for how the person had spent their day, what they had enjoyed and so on. Other records relating to peoples care such as activities, and ongoing care such as bathing and weight are kept separately to their individual care files. This may not provide a joined up approach. We saw that care plans are kept under regular review to ensure that peoples changing needs are recognised. People felt that their healthcare needs are met. Information seen in care files showed that people access a range of different professionals such as continence advisors, district nurses, opticians and dentists to meet their individual needs. People are supported to attend hospital appointments to support their ongoing care, and relevant referrals are made when new issues arise. A visiting professional said on a survey that staff always sought advice and acted on it to meet peoples social and healthcare needs and improve their well being. They also said that staff are, Always very helpful and offer help and support where needed. Care files included assessments relating to nutrition, tissue viability, falls, fractures and pain. Nutritional records are maintained, and peoples weight is monitored as far as possible. Various staff have recently undertaken training in: nutritional awareness, sensory impairment, diabetes, pressure care, respiratory failure, catheter care, prevention of falls and bone health. This shows a commitment to ensuring that staff are skilled and can ensure peoples well being at all times. We looked at medication systems and records to see how well this aspect of peoples care is managed. In general peoples medication is managed well, with good records maintained. Some best practice issues were highlighted to address. This included ensuring that when medicines are prescribed to be taken on an as and when required basis (PRN), that a clear protocol is in place. Training records showed us that most staff have undertaken recent training in the administration of medicines. To support staff practice it was advised that the guidelines produced by the Royal Pharmaceutical Society on managing medicines in care homes be made available. Care Homes for Older People Page 14 of 27 Evidence: During the day staff were respectful and supportive to residents. A visiting professional felt that one of the things staff did well was to ensure peoples privacy and dignity. The deputy manager said that they had recently undertaken training in Decency and Dignity in Care, a workbook based programme which had been very good. Although not specifically assessed we saw in care records that end of life issues had been discussed. One person had an appropriate care plan in place so that their specific wishes would be carried out. On the AQAA the manager said that over the next twelve months they hoped to provide training in palliative care and bereavement. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have some opportunities for a fulfilling lifestyle, but may find that activities available do not meet their individual needs. Evidence: The AQAA completed by the manager said under What we could do better, Increase staffs understanding of activities suitable for client base. Increased high dependency levels mean that group exercise sessions and activities are not always feasible. Training booking information viewed showed that that three staff, the manager and deputy manager are all due to attend two day training courses during July on dementia and activities. This will hopefully encourage a more proactive and individualised approach to providing activity and occupation for people. From observations and records viewed during the site visit, this is an area that does require development. During the day people just sat and dozed or looked at newspapers. Some one to one interactions and activity with staff took place in the morning. The television was on all day but at a level that could not probably be heard by residents. One person went out for a walk with the provider as this is something they enjoy. The hairdresser was visiting and some people enjoyed having their hair done. Activity records viewed recorded, watching television for most people for the majority of Care Homes for Older People Page 16 of 27 Evidence: entries, with occasional variations of visits to the hairdresser, nails done, listened to radio, skittles and cards. As previously identified care plans could be better at assessing and identifying peoples individual social and occupational needs. The manager said that one resident has a regular visit from a church and that peoples spiritual needs would be catered for on an individual basis as identified at the assessment stage when they moved into the home. Visiting at the home is open and people can enjoy having visitors at any time. One person said, My family visit all the time which I enjoy. I can entertain them here in my room. A visitors room is available, but this is down steps, and when viewed was quite cluttered with activity and other equipment. A tour of the premises showed that people are able to bring in personal possessions to help them feel at home. Information on advocacy services was available so that people know where they can go for independent support and advice if they wish. Care plans showed that people would be encouraged to make choices in their daily lives such as what to wear. A three weekly rotating and seasonal menu has recently been introduced. Although this identifies that choices are available for each main meal, at the moment systems are not in place whereby staff actively encourage people to make individual choices about what they eat. Nutrition records viewed showed that one main meal was recorded and that everyone always had this choice. The manager said that a white board and individual menus were going to be produced to make people aware of the choices avaialble. Improvements are also planned to the dining environment with improved flooring, addittional seating and new tablecloths and place mats. People seemed generally happy with the food provided and made comments such as, Very nice home cooked food, and, That was tasty. On surveys people said that they always or usually enjoyed the meals. There was plenty of fresh fruit available, and staff encouraged drinks throughout the day. People in bed were not forgotten and during the afternoon staff took fruit down to a resident in their room. Another resident said that they were hungry and a staff member offered to get them a sandwich. A visiting professional said that staff, Provide encouragement at mealtimes for all those who need prompting. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for safely through practice in the home. Evidence: The home has a complaints procedure in place that is on display for people. We saw that this requires some updating to make our, (CQCs), role in complaints management clear. People should also be advised that they can take their concerns to the Local Authority. We have been made aware of one complaint made against the home, this is currently being looked at by Social Services under their safeguarding procedures. When we looked at complaints records we saw that all issues relating to this, and previous concerns raised by the same complainant to the previous manager, had been well recorded. We saw that up to date local guidelines on safeguarding adults were readily available. Training records showed that all staff have undertaken recent safeguarding training. Staff spoken with understood the issues, and their responsibility to report any concerns. Given the recent complaint made, the need to be proactive in having discussions with the safeguarding team should any concerns be raised was highlighted. Care plans viewed showed that variations in peoples behaviour were understood and planned for. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely environment where there is an improving picture of furnishings and facilities. Evidence: Maranatha is a small home that is close to local amenities, with the town of Southend not far away. Local transport links are good. The home has a pleasant conservatory and a small garden with table and chairs for residents to use if they wish. Since the previous inspection the new provider has slowly been making improvements in the home. Two bedrooms have been refurbished. A new boiler has improved the water supply. New equipment such as an electric hoist and fire fighting equipment has been purchased. A large new television has been provided for residents in the main lounge. People generally seem happy with the accommodation provided. However much remains to be done to improve the overall standard of furnishings and decor in peoples bedrooms. The provider indicated that they have a plan in place to gradually bring the home up to a good standard. Although people currently accommodated do not tend to wander independently, management do need to keep in mind that the home is registered for dementia care. Potential hazards should be assessed and reduced as far as possible. At this visit the laundry was not secured. Although there were generally staff in the kitchen this area Care Homes for Older People Page 19 of 27 Evidence: was open. Also open was access to the side of the building with potential hazards and access to the street. The home appeared generally clean and was odour free. Training records showed us that staff have undertaken training in infection control to enable them to work safely and follow correct procedures. An adequate laundry area is available. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by caring and well trained staff. Evidence: During the day we saw that the provider, manager and staff all interacted well with residents, and there was a good rapport between them. There was a friendly and relaxed atmosphere in the home. People said that staff were good. One person said, I only have to buzz and they are there. A visitor said that one of the things they liked about the home was that it was small, So the staff are always very attentive and really know all the residents as individuals. There is a stable group of core staff at the home and this provides consistency for residents. The AQAA said that only one member of staff had left in the last 12 months, and that in the previous three months no agency staff had been used. At the moment rotas confirmed that staffing levels are being maintained at three staff during the day and one awake and one sleeping in member of staff at night. The managers hours are generally supernumerary. This seemed adequate on the day with eleven people being accommodated. In discussion with the manager they are aware of the need to keep staffing levels under review and adapt them as necessary. The Statement of Purpose said that, We also accept up to five elderly people for day care. Although we were aware of the odd day care provision being made, no formal discussion or agreement has been made with us for the provision of up to five places a day. This may be something left over from the previous Care Homes for Older People Page 21 of 27 Evidence: management of the home. The new management team need to consider if they wish to continue this policy. If so we, (CQC) need to be assured that proper consultation with residents has taken place, and that other issues have been addressed. From information on the AQAA, and confirmed at the site visit, out of nine senior/care staff four have attained a National Vocational Qualification (NVQ) at level 2/3. A further two staff are undertaking an NVQ. Other staff have nursing qualifications from their countries of origin. One is hoping to start their NVQ at level four. This and other training shows a commitment to having a well trained and skilled workforce caring for residents. One new member of staff had started work at the home since the new management arrangements. We looked at their file to see if recruitment checks that safeguard residents had been undertaken. We saw that appropriate checks such as Criminal Records Bureau, references, and proof of identification had been carried out before the person started work. Staff spoken with said that they had completed their common induction standards. This was confirmed through training records. We saw that induction standards are completed through an external training agency. On the new member of staffs file there was nothing to show that they had received a basic induction into the home, such as fire procedures, routines and other arrangements, policies and procedures. This should happen so that management know that staff are aware of internal policies and local practice. As identified in other areas of this report, since the previous inspection staff have undertaken a good level of training. In particular training in dementia care has taken place. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home where management are working to implement changes and improvements to benefit them. Evidence: Since the previous inspection the ownership of the home has changed and a new manager is in post. Although discussion with the manager and some feedback on staff surveys suggests that this has not been an easy time, it is to staffs credit that the change has not seemed to impact on peoples care. A visitor said, To be honest I had not really noticed the change of management. In fact things have got better with the refurbishment and other things. The new manager is experienced and has NVQs in care at levels two and three. Both the manager and deputy manager have just started their Leadership and Management course which is at NVQ level four. At the moment the manager is being supported by a consultant to bring the the home through a period of change, and review all aspects relevant to running the home. This arrangement is open ended. This inspection identified a number of improvements to Care Homes for Older People Page 23 of 27 Evidence: the home. Requirements made at the previous inspection have been addressed. The AQAA and discussions with the manager showed that they have a good idea about what further improvements and changes they need or wish to make. Formal meetings for people living at the home or their relatives have not up to now been held. The manager said that they have tried to get people involved in expressing views about the home through relatives coffee mornings and so on, but that interest is not currently there. The new provider has not as yet carried out any quality assurance exercises to give people the opportunity to express their views about the service. The manager said that the AQAA had been useful in reviewing the service. It was satisfactorily completed, and showed that management know what further improvements need to be made. The AQAA identified that many of the homes policies and procedures date from 2003 and have not been reviewed. The manager is aware that this task needs to be carried out so that staff are working to up to date information. The new owners are frequently in the home. Visits as required by regulation are carried out on a monthly basis. We saw that these are thorough in their approach. The provider said that they also carry out spot checks during the evenings and nights. The manager confirmed that no monies or personal property is held on behalf of residents. The AQAA completed showed that systems and services in the home are serviced and maintained. Since the last inspection replacement water valves to ensure consistency of temperatures have been fitted. Window restrictors have also been fitted to ensure residents safety. We saw from fire records that the system is regularly checked and tested. However the last fire drill recorded was 29/12/08. Under comments it said, Further fire drill to sharpen response. No further fire drills had been recorded. We noticed during the day that a number of doors are held back with wedges. The provider and manager said that plans are in hand to address this. Records indicated that all staff had fire training last year, so they should know how to respond in the event of an emergency. We saw that staff training in core areas such as moving and handling was up to date. The AQAA did however recognise that, Staff need to attend update health and safety courses as places become available. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Care Homes for Older People Page 26 of 27 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). 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