Inspection on 01/12/09 for Morton Cottage Residential Care Home

This is the latest available inspection report for this service, carried out on 1st December 2009.

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

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

Other inspections for this house

Morton Cottage Residential Care... 17/07/08

Morton Cottage Residential Care... 30/01/08

Morton Cottage Residential Care... 06/09/07

Morton Cottage Residential Care... 19/07/06

Morton Cottage Residential Care... 04/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Morton Cottage Residential Care Home 210 Wigton Road Carlisle Cumbria CA2 6JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jenny Donnelly     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Morton Cottage Residential Care Home 210 Wigton Road Carlisle Cumbria CA2 6JZ 01228515757 01228521876 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Morton Cottage Residential Care Home Ltd care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category 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 (maximum number of places: 6) The maximum number of service users who can be accommodated is: 32 Date of last inspection Brief description of the care home Morton Cottage is owned and operated by Mrs April Dixon with Mrs Amanda Longford as the registered manager. The home is registered to provide accommodation for up to 32 older people. The property is a large detached house on the outskirts of Carlisle. Accommodation for the residents is on two floors with a passenger lift accessing the first floor. There are 24 rooms for single occupation and four that can be shared by two people. All the bedrooms have en-suite toilet and washbasin facilities and there are communal toilet and bathing facilities throughout the home. There are two lounges, Care Homes for Older People Page 4 of 27 Over 65 0 32 6 0 1 5 0 1 2 0 0 9 Brief description of the care home one lounge/dining room and a separate dining room on the ground floor. A guide to the services and facilities provided by the home is available on request from the manager. The scale of charges range from £398.00 to £462.00 per week (December 2009). 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 the main or key inspection for the year. The lead inspector Jenny Donnelly asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. We also sent surveys to some of the people who live in the home and to the staff. The findings of these surveys are included in this report. We (the Care Quality Commission) made an unannounced visit to the care home on 1st December between the hours of 09.30 and 4 pm. During this visit we toured the building, spent time in the lounges, and dining room where we watched lunch being served. We spoke with people living in the care home and their visitors. We also spoke with the manager and the staff on duty. We looked at files and documents that backed up what we were told and what we saw. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? Following the last inspection the manager produced an improvement plan to address the shortfalls we had found at that time. During this visit we saw that these improvements had been made. Risk assessments and nutritional assessments for people had been improved; they were now more detailed and had been kept up to date. This helped staff to know how to support people safely. Care Homes for Older People Page 7 of 27 The management of medicines had improved. All staff who handle medicines had attended a training update, and the manager had introduced regular medicines audits. This has resulted in a reduction in the number of small mistakes that were being made. A training plan is now in place and the records of training attended by staff have been improved. We saw that training had been provided by qualified trainers in a number of subjects and further training was planned for the New Year. There was a new induction training package for new staff, and all existing staff were also being asked to complete this. There have been improvements to the decor throughout the building, with many bedrooms and the communal rooms having been refurbished. There were plans to refurbish the remaining lounge. Some efforts had been made to improve the activities and entertainment on offer and the manager was continuing to consult with people on this. 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 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service had been provided with information about the home and had their care needs assessed before they moved in. This helps ensure the home will be able to meet peoples needs, and assists them to settle in quickly. Evidence: The manager had produced an information brochure for people, telling them about the services and facilities offered at Morton Cottage. This provided a good level of detail, and the manager told us she had plans to update it and provide more photographs. People interested in the care home were welcome to visit, to look around and meet with residents and staff. This enables people to ask questions and helps them gauge whether Morton Cottage is the right care home for them, or their relatives. We looked at the admission arrangements for new people and saw the needs assessments for the last two people admitted. We saw that the manager had completed a very detailed assessment of their cultural, social, personal and health Care Homes for Older People Page 10 of 27 Evidence: care needs. The assessment included information about peoples specific wishes and expectations. For example, one persons assessment showed they wanted to eat in the dining room and mix with other residents in the lounge. We also saw that the manager had gathered information from other professionals involved in the persons care such as their social worker or hospital staff. This process helps people to know if the home will be able to meet their needs, and allows the manager to arrange for any specialist training or equipment before the person moves in. Staff told us they tried to spend time with new people, to introduce them to others, and help them settle in. There was information on file setting out the terms and conditions of peoples stay, and this detailed the fees and stated who was responsible for payment. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were receiving good quality health and personal care, delivered in a way that was acceptable to them and promoted their general health and well being. Evidence: Following the last inspection, we asked the manager to improve peoples risk assessments, carry out nutritional assessments and tighten up on the management of medicines. The manager had forwarded us a copy of her action plan for doing this, and we were pleased to find that successful improvements had been made in all these areas. Each person had an individual plan of care which guided staff in what level of support they needed. We looked at three of these in detail. The plans followed a set pattern, which made them easy for staff to refer to and to find the information they wanted. We saw that risk assessments had been completed for things such as the use of bed rails, moving and handling needs, nutritional needs and skin care. These assessments were very detailed and gave staff clear instructions on how to assist people. For Care Homes for Older People Page 12 of 27 Evidence: example there was clear guidance about a persons swallowing problem, and this specified the recommended consistency of food and drink needed and how to best position the person. There was evidence in these assessments that peoples wishes had been listened to and included in the assessment. We saw these risk assessments had been kept under review and updated as changes occurred. In addition to the risk assessments, care plans were in place describing what daily help people needed from staff. These covered all general daily activities such as washing, dressing and eating, as well as specific plans relating to peoples health and psychological needs. As with the risk assessments, the care plans were very detailed, and included information about peoples expressed wishes and choices. Health care records showed that people had good access to outside health professionals. There were records of visits by doctors, community nurses, opticians, chiropodists and speech and language therapists. We saw that the treatment and advice given by these professionals was recorded in the care plans, and that staff acted in accordance with this. We saw from the way staff interacted with people throughout the day, and in the way they wrote the care records, that staff treated people with dignity and respect. We also observed that people appeared well cared for, and were nicely dressed in clean clothes. People we spoke with and surveyed, told us; My mother is looked after very well, if there are any incidents the staff phone me and we are always in contact, the family can relax knowing mother is happy. Care staff are always there when I need assistance, they are very friendly, the quality of care is at a high standard. Staff told us; We care for the needs of different service users 24 hours a day, 7 days a week, making it feel like their home. We treat people with respect and dignity, giving them independence and choice. We looked at the management of medicines and found this was organised and safe. There were written policies and procedures to guide staff on ordering, storing, administering and disposing of unwanted medicines. There was guidance on what to Care Homes for Older People Page 13 of 27 Evidence: do if a mistake was made, and how staff could support people to manage their own medicines if they wished. We saw the storage of medicines was secure and the records we looked at were well kept. We checked the stock of medicines for a number of people and found the records and actual stock balanced as it should. We saw that intermittent medicines, such as weekly or monthly items were being well managed. The arrangements for as required medicines were good, and staff knew what these medicines were for and when to give them. Medicines with a short shelf life, such as eye drops, had been marked with the opening date, so staff knew when they needed to be replaced. There was a homely remedy policy, which enabled staff to give people simple remedies for mild pain or coughs and colds, without having to wait and see their doctor. We asked the manager to look at alternative ways of recording the administration of homely remedies, so each person had an individual, not a shared, record. Staff who administer medicines had recently attended a training update, and since the last inspection the manager had been completing a monthly medicine audit. We could see from this audit that the number of small mistakes staff had been making, such as not completing records properly, had reduced significantly. Care Homes for Older People Page 14 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 using this service were able to make some choices in their day to day life, and told us they were happy with the meals provided. People would like a better range of activities to give greater social stimulation and interest, and the manager was working to address this. Evidence: We arrived in the home at 9.30 am and saw that several people were enjoying their breakfast while others had finished and had moved into the lounge areas. During our walk around the building later in the morning, we noted a number of people were still in bed, or had returned to bed for a lie down after breakfast. The manager said some people liked to be up early and others preferred to stay in bed late and staff accommodated this. Throughout the day we saw that people were free to choose where to sit, either in one of the three lounge areas, or staying in their bedroom. We saw some people moved between the quiet lounge and television room as they wished. Bedroom doors had locks fitted and some people held their own key and liked to lock their door when they left the room. We saw that people had been able to bring their own possessions and furniture into the home as space allowed. Care Homes for Older People Page 15 of 27 Evidence: A member of staff held a bingo session during the afternoon in one of the lounges; three or four people joined in and small prizes were awarded. Staff told us they also did nail care and had chats with people, as and when they could. The manager told us she was trying to increase the range of activities available and hoped to provide more outings. She was considering recruiting an activity organiser to do this, and we thought this would be beneficial to people. We could see there had been some discussions at residents meetings about the kind of things people would like to do. Currently activities comprised of whatever care staff did on an informal basis, a monthly visit from local museum staff who brought props for reminiscence sessions, a monthly singer, weekly communion and twice weekly hairdresser. The manager said there had been two meals out this year, and there would be school children visiting during the run up to Christmas. Visitors said they were made welcome in the home and staff said, When families visit we take them to their relative and offer them tea or coffee. One residents survey told us that, Activities and entertainment could be better. A staff survey also suggested, A bit more activity within the home, more hands on games, reading and entertainment would be good. There is a singer which people really enjoy. We saw lunch being served in both dining rooms and noted that one person was able to eat in the lounge as they chose and another ate their meal in their bedroom. The home had a two week menu in operation which is kept under regular review and is discussed at residents meetings. Breakfast was a selection of fruit, cereal, porridge and toast. Lunch was the main meal of the day and comprised of a choice of two main courses, two desserts and fruit. Tea time was a lighter meal offering sandwiches and a hot dish such as eggs or sardines on toast, cake and fruit. We saw that people were well supported by staff at meal time and were discreetly assisted as necessary. Staff were seen to offer people extra helpings, and were serving hot and cold drinks throughout. Tables were nicely set with cloths and the meal time was calm and unhurried. We saw that everyone ate well and people told us they enjoyed the food. We saw that special diets, such as soft and diabetic diets were catered for. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew how to raise concerns and were confident that they would be listened to. Staff were aware of the policies and procedures on managing complaints and safeguarding people from harm. Evidence: Following the last inspection, we asked the manager to ensure all staff had up to date training on what constituted abuse and how to report any concerns or allegations. Since then all staff have undertaken training with a qualified training provider on this subject. The home also had copies of the latest Cumbria Council multi-agency guidelines on safeguarding people from harm, which guides staff in how to raise concerns and make referrals. We know the manager understands this process as she recently told us about a referral she made to the safeguarding team for advice. The home has a complaints procedure that tells people how to raise concerns or complaints, and our surveys indicated that people knew about this. A visitor we spoke with said he had raised a complaint a long time ago, and the manager had dealt with this effectively. The manager told us there have been no complaints made since the last inspection, and none have been directly to us. Staff said they would respond straight away to any concern or complaint made to them and would let the manager or the owner know immediately. We did not see or hear anything of concern on the day and people indicated they were Care Homes for Older People Page 17 of 27 Evidence: happy and content living in the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Morton Cottage provided a warm, comfortable and safe environment for people to live in. There were adaptations to help people with mobility problems and the standard of decor was being continually improved. Evidence: Morton Cottage is well maintained and kept in a good state of decorative repair. We spoke with the maintenance man who has regular weekly and monthly checks and services to complete in addition to running repairs and decoration as instructed by the manager. Since the last inspection a number of bedrooms had been decorated and these continue to be done on a rolling programme. The home had an environmental health inspection in May 2009 and was recommended to carry some minor works, which we saw had been completed. Communal rooms comprise of a spacious dining room, a quiet lounge and a television lounge, and a larger dining lounge. The manager told us the large dining lounge was to be refurbished the following week. New patio doors, new floor covering, wall decoration, and new tables and chairs were being provided. The other dining room and lounges had been decorated and provided people with pleasant comfortable rooms to use. There was a secure garden at the back of the home and a large driveway and grounds at the front, which was secured from the road by high gates. Care Homes for Older People Page 19 of 27 Evidence: There were three bathrooms, comprising of one assisted bath with a shower attachment, one bath with a seat, and one ordinary bath that was not used. The manager told us she hoped to make this unused bathroom into a wet room shower in the future, which would give people more choice. There were three toilets near the lounges and dining room, two of these were very spacious disabled access toilets that allowed plenty of room for hoists and staff to work in. The third toilet had a narrow doorway giving very poor access. The manager was considering refurbishing this toilet, but due to the poor access we discussed removing the toilet and using the space for a much needed equipment store. The home had 24 single and 4 twin bedrooms. All bedrooms had an en suite toilet and a wash hand basin. Two of the twin rooms were currently being let as large singles, and those people sharing had agreed to do so. Bedrooms varied in size and shape and we saw that some people had brought their own items of furniture from home. One bedroom was out of use awaiting ceiling repairs. All bedrooms had door locks fitted and people could keep the key and lock their room if they wished. We saw that a few people chose to do this and one lock had been lowered so a person in a wheelchair could reach it. The home was suitably equipped for people with mobility problems. There was a passenger lift to the first floor, handrails were fitted, there were grab rails in bathrooms and toilets, and there were three mobile hoists in addition to the fixed bath seats. We found the home was clean and fresh and remained so throughout the day. There was a small laundry that dealt with all personal clothing, bedding and table linen. We saw that peoples clothes had been nicely laundered and were well presented. People are asked to name label their clothing, but there was some unnamed laundry which the manager had put out for people to look at to see if it was theirs. The manager told us she was planning to provide a sluicing facility in one of the outbuildings, as staff currently have to sluice items in the yard, which is not ideal. There were plenty of places for staff to wash their hands and soap dispensers and paper towels were provided for this. The environmental health officer awarded the kitchen 4 stars for their food safety. A survey told us; The home is clean and warm. 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 cared for by a caring team of staff who receive sufficient training and support to help them do their jobs well. Evidence: During our visit the home appeared to be sufficiently staffed, so that people did not have to wait for attention, and the day was running smoothly. The owner and manager were present, along with four care staff, two domestics, a cook and the maintenance man. We were told that the staff hours had been altered slightly to provide extra staff in the early morning, to support those people who liked to get up early. Following the last inspection we asked the manager to focus on staff training, produce a training plan and keep better records about the training completed. We looked at records of staff training and spoke with some of the staff who backed up what the records told us. Care staff were supported to undertake a National Vocational Qualification in care at level 2 or above, and over 50 had achieved this. We saw that other training including safe moving and handling, medicines administration, health and safety, infection control and safeguarding vulnerable adults had taken place this year. Training was provided by an external company, who had also delivered an induction training course for new staff. The manager had made arrangements for all staff to complete this induction in the New Year, along with plans for training on Care Homes for Older People Page 21 of 27 Evidence: dementia and nutrition. There was a training plan in place showing what training was booked to take place and what had been completed by each staff member. We looked at recruitment procedures and checked the records for two new and one long term staff member. These showed that thorough recruitment checks had been completed with written references and criminal records bureau disclosures being applied for. These checks help to make sure that staff are suitable to work with vulnerable people. People told us; The staff are very caring, and, The home employs friendly staff. Staff said; I receive a lot of support and training to enable me to do my job, and, We do a lot of training courses and I am doing my NVQ level 2 in health and social care, which I am receiving a lot of help with. 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. The home is well managed, and people who use the service are consulted about any changes. There are systems in place to help protect the health, safety and welfare of residents and staff. Evidence: The owner of Morton Cottage, Mrs April Dixon, works in a hands on capacity and is based in the home throughout the week and tells us she often calls in at weekends. The registered manager, Mrs Amanda Longford, currently works three days a week. Between them the home is robustly managed. Further to our last inspection, they sent us an action plan setting out how they would make the improvements we had asked for. We have checked on this and found they have made improvements in the way the service is run. The owner and manager keep a check on the quality of their service in a number of ways. We saw that surveys had been completed by visiting professionals, such as doctors and opticians, by people who live in the home and their relatives, and by staff. Care Homes for Older People Page 23 of 27 Evidence: The results of these surveys are collated and any suggestions for improvements are included in the homes action plan. We also saw the notes of residents and staff meetings where people had been able to share their views and make suggestions about the way the home is run. The manager monitors the quality of care planning by overseeing this herself and completes regular checks on the way medicines are managed in the home. Care staff are formally supervised every couple of months and we saw some records which confirmed this. The manager held some money on behalf of service users if they wished, and we looked at the arrangements for this. The money was securely stored in individually named packets, and records showed the amount of money received plus any spending, which was backed up by receipts. We checked the records and money of two people and they were correct. The home has recently registered with the information commissioner for data protection. The manager told us there was no one living in the home subject to a Deprivation of Liberty Safeguard at this time. We looked at the health and safety records and saw that up to date checks and services had been completed on the fire equipment, water temperatures, the call bell system, gas and electrical systems and the passenger lift and hoists. Staff received three monthly fire instruction and there were periodic fire drills. Risk assessments for peoples moving and handling needs, and challenging behaviour were detailed, and guided staff in how to support people safely. 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 1 9 We recommend that any homely remedy medicines given are recorded on individual rather than shared record sheets. We recommend that the manager continues the work she has started in improving the provision of, and access to, social activities. 2 12 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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