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Inspection on 20/04/10 for Rider House Nursing Home

Also see our care home review for Rider House Nursing Home for more information

This is the latest available inspection report for this service, carried out on 20th April 2010.

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

People living in this home can be confident the manager will visit them before they move in. They will do this so that a full assessment of people`s needs can be completed. The people who use the service are treated as individuals and the staff ensure they make day to day life as pleasurable as they can. The staff team are well established and know people well. The overall management of people`s medication in the home is good. There are systems in place for the safe storage, record keeping, safe administration and disposal of medication. There is safe and thorough recruitment of staff, this means the service provides safeguards for people who live at the home. All of the people involved in this inspection were positive about the manager and the staff and their caring attitudes to the people who use the service. We received positive comments about staff being caring and friendly. People who live at Rider House told us: "The staff are really good, they work hard and treat us well." The people who live at the home are supported by staff so they can stay in touch with their families and friends. Communication with all parties is good. A visitor told us: "I am more than happy my partner always appears relaxed and content." There are good links with other health care professionals, such as doctors and specialist nurses to make sure that the people who live at the home stay healthy. We receive data to verify the home seeks advise where necessary. There are activities to take part in. People told us there are `usually` things going on. The staff are happy and enjoy their work, they told us: "It`s so much better, we all work as a team and help each other out, we are really busy but it`s manageable."

What has improved since the last inspection?

The home has continued to improve since the last random inspection where we were able to evidence that the requirements we had made at the last key inspection had been complied with. For a full account of this please refer to the random inspection report dated 9th November 2009. The morale has improved and staff work in a way that supports everybody as an individual. Systems and structures that were put in place are now embedded, this means the manager has clear audit trails and clarity of information. People living at the home are more than satisfied with Rider House and as a result they receive good care and good outcomes.

What the care home could do better:

Medication administration charts should be completed when prescribed creams are applied; this will ensure there is a clear audit trail and evidence that a consistent approach is taken. Turning charts should be completed whilst dealing with skin integrity issues, again this offers evidence of good management and provides clear instructions for the staff. The manager should check the wardrobes as some were not fixed to the walls, this is a potential health and safety hazard.

Key inspection report Care homes for older people Name: Address: Rider House Nursing Home Stapenhill Road Burton On Trent Staffordshire DE15 9AE     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: Rachel Davis     Date: 2 0 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Rider House Nursing Home Stapenhill Road Burton On Trent Staffordshire DE15 9AE 01283512973 01283511749 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rider House Limited Name of registered manager (if applicable) Roslyn Ann Fox-Roberts Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 38 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Physical Disability (PD) 38 Date of last inspection Brief description of the care home Rider House is a 38-bedded care home (with nursing care) and is situated on the Stapenhill Road, approximately one mile from the centre of Burton upon Trent. Rider House is part of the Elder Homes Group, the registered manager is Roslyn FoxRoberts. The home is registered with us to meet the needs of adults with a physical disability and those with a terminal illness. The home also has two intermediate care beds, which are facilitated by the Primary Care Trust (PCT) and the Social Care and Health Directorate. This means people can reside at Rider House on a short-term basis Care Homes for Older People Page 4 of 28 Over 65 0 38 1 8 0 5 2 0 0 9 Brief description of the care home with an intensive internal and external support programme with a view to them returning to their own home within a reasonable period of time. Information about the fees for this service are included within the Service User Guide, they vary from £485 £525 per week. This was correct at the time of the inspection but people may wish to enquire directly to obtain up to date information. The environment is fit for purpose and in the process of modernisation and refurbishment. 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 20th April 2010 and used the National Minimum Standards for Older Persons as the basis for the inspection. The people who live there and the staff did not know we were coming. The previous key inspection was held on 18th May 2009, we made six requirements during that inspection. There has also been one random inspection visit 9th November 2009. At this inspection we checked to ensure the six requirements had been dealt with. Before this visit took place we sent out an Annual Quality Assurance Assessment (AQAA), this is a self assessment document that all services must complete. The AQAA gives us important information about the way the home is meeting National Minimum Standards in care and the improvements planned to create better outcomes for the people who live there. The AQAA was returned within the required timescale. We Care Homes for Older People Page 6 of 28 looked at any notifications they have sent to us about events that affect the well being of the people who live there. Questionnaires were returned to us from people who use the service and staff members. Four were returned from staff and two from people who live at Rider House. We case tracked two people who live in the home. Case tracking includes meeting people and talking about the care they receive or watching staff supporting them, looking at their care records and medicines and the way that they are helped to make choices and decisions. This assists us to understand the experiences of people who live in the home. Time was spent talking to the staff team on duty during our visit and observing the way they interact with the people they care for. We spoke to seven people about their experiences of living in the home and three visitors. We looked around the building to make sure it was clean, warm and comfortable. We looked at approximately four bedrooms, the lounge areas, the dining room, kitchen and bathing facilities and toilets on both floors. We briefly inspected the storage system and medication procedures, checked financial procedures and we looked at the records of staff training and recruitment. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 28 Medication administration charts should be completed when prescribed creams are applied; this will ensure there is a clear audit trail and evidence that a consistent approach is taken. Turning charts should be completed whilst dealing with skin integrity issues, again this offers evidence of good management and provides clear instructions for the staff. The manager should check the wardrobes as some were not fixed to the walls, this is a potential health and safety hazard. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. The admissions procedure ensures that people who may use the service have their needs assessed. This means people have assurances that Rider House can meet their needs. Evidence: The Statement Of Purpose and Service User Guide are given to people who use the service when they move in. These documents are also available at the main entrance and contain all the information necessary. The home is considering introducing audio and/or pictorial versions. Terms and conditions of residence are provided to everyone, this means people are clear of what to expect. The AQAA tells us: We ask prospective clients and or their families to come and look around the home, without an appointment. Everyone tries to make them feel Care Homes for Older People Page 11 of 28 Evidence: welcome. They are invited for tea and to spend some time with us. We complete a comprehensive preadmission assessment to ensure that we are able to meet the clients needs. We always ask any involved social worker for a care plan prior to admission. The preadmission assessment is discussed with staff and any views taken on board. We have two Intermediate Care beds in dedicated rooms. We work closely with all the intermediate care team to enable the clients to regain their independence and return home. Evidence seen during the inspection confirmed this is an accurate account, one person told us, someone came to see me in hospital before I came to live here, and my family were also involved. We looked at the plan of care for someone who had moved into Rider House since the last inspection. The home had gathered information on their needs and covered details on maintaining their safety, health, social and psychological care and the support that people that use services needed. Information was obtained about their life histories so staff had information about their lives before they moved into the home. There are two intermediate care beds at Rider House which are identified in the Service user Guide; these are used on a short term basis (usually for six weeks). These are used to support people in returning to their own home, they are funded through the local authority and the Primary Care Trust (PCT.) Appropriate external professional support is provided to enable people to return home, for example physiotherapists and/or or occupational therapists. 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. Individual plans of care ensure that peoples health and personal care needs are met. Evidence: People who use the service and their visitors were keen to share their views; they reported they were very happy with the quality of care provided their comments include: The staff are very friendly. Kind and helpful. I am happy here They are very good, they look after me. I like the flexibility regarding visiting I can come anytime. Everything is good, 100 Questionnaires returned verified the staff listened, respected peoples dignity, were available, polite and courteous. People have access to health care services both within the home and in the local community. Some people choose to attend local dentists, opticians and other community services. People unable to access local services are supported by visits to Care Homes for Older People Page 13 of 28 Evidence: the home. There are good working relationship with all health and social care professionals. A member of staff told us, We have a good reputation; as a result we are full and have a waiting list. We saw various records on peoples care notes where social and medical intervention had occurred. There is information in the plan of care of health care treatment and intervention, and a record of general health care. The staff are able to think in a person centred way and were able to give us a verbal update when requested. A number of life histories have now been completed which further supports the staff and shows the home considers peoples needs in an individualized way. We saw that information regarding tissue viability and how to manage this was difficult to audit as there was no specific evidence of when turns were undertaken, onto which side, and whether fluids were being well managed to aid hydration. We can verify that the situation had been well managed practically and indeed the pressure sore had healed. We recommend the home ensures their records verify that action taken is fully recorded to evidence continuity of care and good clear management of the care provided. We briefly observed the nurse administering medication at lunchtime and saw she was following appropriate procedures in handling and recording what she gave to people. The nurse kept the medication secure at all times. There have been improvements in medication management and systems and structures are in place to confirm safe practice. The home complies with the administration, safekeeping and disposal of drugs. We evidenced that prescribed creams in peoples rooms were not signed off on the medication administration records nor recorded in daily notes. A system needs to be in place to ensure creams are being administered as directed but overall medication systems follow good practice guidelines. We did not inspect the controlled drugs on this occasion, we have been satisfied with the management of these on previous inspections. We were able to observe staff talking with people who use the service, they were Care Homes for Older People Page 14 of 28 Evidence: respectful and polite. We noted the staff knocking on doors and people told us the staff were kind and friendly. Where people remained in bed they look relaxed and comfortable. People had access to their nurse call systems. This means they can call for assistance easily and as and when required. Screening was also available in the one shared bedroom. 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. The routines of daily living and activities available are flexible and varied so they suit the expectations, preferences and capacities of the people who live at the home. Evidence: The AQAA tells us: We have open visiting and encourage visitors to the home. The Pat dog continues to come in regularly. We continue to have monthly bingo with the community invited. We have outside entertainers. We ensure that any quizzes are in large print to enable those with sight problems to join in. We have regular multi-cultural services for those who wish to attend. We offer a varied, nutritious menu and follow the directions of dietitians as required. Service users are able to request anything special they would like to eat. We ensure that the Speech and Language Therapist is involved with people with swallowing problems. Specific diets are adhered to. Our inspection confirmed the above to be an accurate account. We looked at the activity provision in the home. People who completed our surveys told us, There are activities to do. The activities coordinator provides approximately 15 hours of activities per week. The staff on duty told us they also try hard to keep people active, Care Homes for Older People Page 16 of 28 Evidence: they also confirmed that activities do take place and external entertainment is also provided. Written records were also seen to corroborate this. We asked a number people living at Rider House if they were ever bored or would prefer more stimulation, everyone was happy with the present arrangements. Visitors spoken with felt people were stimulated and appeared content. They spoke well of the home and confirmed communication was good and they had no concerns for the welfare of their loved ones. One person said if they had any comment to make on improvements it would be the home was sometimes short staffed, this was fed back to the manager during our inspection. People confirmed they could go out with family and friends and no restrictions were made, one visitor recorded in the comments book by the office: This is my first visit to Rider House what a lovely place. It is so clean and fresh with great views and lovely food, all the staff are so friendly and caring. Religious needs are observed and met where possible, a monthly religious service is held for everyone in the home who wish to attend. 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. Complaints and concerns are acted upon to show they are taken seriously. Evidence: People can access the complaints procedure because it is displayed in the reception, it is also available within the Service User Guide. The complaints book identified four complaints/grumbles since the last inspection, these had been dealt with suitably and concluded. It was evident that any grumbles or concerns had been raised and recorded also. This supports the service with identifying how changes are made to improve the services for the people who live there. There is also a comments book where people can offer their views anonymously if they so choose. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse to vulnerable people and provides a framework of consistency to protect those individuals who are at risk. During our inspection we check to ensure vulnerable people are suitably protected. There have been no safeguarding referrals made since the last inspection. We could see from records staff receive training in this field including an awareness of The Mental Capacity Act Deprivation of Liberty Safeguards. This means the staff are aware of their responsibilities and ensure there are no other less restrictive ways of Care Homes for Older People Page 18 of 28 Evidence: keeping people safe and well if their liberty is compromised. Decisions must always be in the persons best interests and assessments and questions must be satisfactorily answered. The home have initiated policies and procedures as required to ensure this occurs. 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. People live in a safe, comfortable and well-maintained environment, which is equipped to meet their needs. Evidence: There have been continued improvements and people live in a clean, warm, safe and homely environment. We look at peoples bedrooms as part of our case tracking process. Whilst we were doing this we saw they had been personalised and were warm and comfortable. People told us they liked their rooms and they felt at home and happy. We saw that some wardrobes were not fixed to the wall, this needs to be undertaken to ensure safety. Infection control appears to be well managed, toilet areas, bath equipment and wash basins were clean. There are adequate hand washing facilities for staff with liquid soap and paper towels, the staff confirmed gloves and aprons are readily available. Domestic staff told us they had suitable and sufficient cleaning products, the home smelt fresh and clean. We did see some bath products were stored in the shower rooms cupboard and it was not locked. All products should be stored in peoples room to avoid any communal usage and protect their welfare, ie possibility of ingestion. Care Homes for Older People Page 20 of 28 Evidence: A couple of wooden commodes were seen and these should be decommissioned as they do not meet infection control standards. The manager stated 12 new commodes are on order. The carpet in one room was creased and presented a tripping hazard , we highlighted this to the manager. Rider House has a hoist on order and two new profile beds, it was confirmed there are no restrictions placed on equipment orders if it is necessary. Staff said they had plenty of bedlinen and towels and were not short of any equipment. A new boiler is being installed soon. The homes refurbishing programme continues. 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. There is a good recruitment process in place to ensure that staff are suitable to work in the home. The staff are suitably trained and supported. Evidence: During the time we spent at Rider House we spoke to a number of staff and observed or heard them supporting people. We found there were very positive and engaging interactions between those people living at the home and the staff members. People told us they like the staff and they undertake the tasks well, they also said the staff are caring and do not rush them. Improvements have continued at Rider House which has had a positive effect on the team, here are their comments made in either questionnaires or directly. I love my work we treat people like are own family. We work so well as a team now, we are much happier. We give a good standard of care, there is also a good standard of training and its regular. Give exceptional care to residents. There is excellent team work. Morale is so much better. We listen to residents and support families. Staff are very caring, residents are treated as individuals, the home provides a happy and caring environment. Nurses and carers all work together we are a team. Things are so much better. Care Homes for Older People Page 22 of 28 Evidence: Duty rotas were not checked on this visit but we saw enough staff on duty to meet the needs of people who use the service and we can confirm the home has a consistent and cohesive staff group. Four members of staff completed and returned our survey; they told us that checks such as criminal record bureau and references were carried out before they started to work at the home. All four people told us that they are given training that is relevant to their role and they know what to do if they had any concerns about the home. We looked at the files for two members of staff including the last person to be recruited. The new file contained two written references, identification, a Criminal Record Bureau disclosure and an Independent Safeguarding Authority (ISA) first check. This means staff have been suitably vetted prior to working with vulnerable adults. The home needs to ensure there is evidence of appropriate supervision between an ISA check and the receipt of the CRB certificate. The manager was aware this should have been completed and will follow it up. It was confirmed that new staff only work alongside other staff, although there was no record of this. The manager completed a risk assessment to support this on the day of the inspection. The AQAA says: We have a good skill mix of staff; all staff are encouraged to undertake NVQ to at least level 2. We have an excellent retention rate, with several staff having been here since we opened 16 years ago. Any recruitment is based on equal opportunities and protection. The staff and management confirmed training was good and easily accessible. 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. The home is run in the best interests of the people who live there. Evidence: The manager was available during this key inspection, she has the required qualifications and experience necessary to run the home. The Annual Quality Assurance Assessment was completed by the manager and it was returned to us within the required timescale. The annual quality assurance assessment (AQAA) is a legal document that all services have to complete on a yearly basis. The information was sufficiently detailed to demonstrate the service was based on robust and continual self assessment. All sections of the AQAA were completed and information has been expanded upon to give us a clearer picture. The content of this years AQAA is much improved. We are satisfied the home is offering good outcomes to the people who live there; the home is run in their best interests. We spoke with staff who considered morale is much better; there is a feeling of team spirit and unity. Care Homes for Older People Page 24 of 28 Evidence: The registered manager and the Elder Care Homes Group have formulated and distributed quality assurance questionnaires to people who use the service, staff, relatives and stakeholders. This means there is information available to assess how the service is meeting needs or viewed by other people. When completed this needs to be evaluated and a written copy produced and made available to the people who live at Rider House. This will again evidence how improvements and changes are made. Staff we spoke with told us the manager is approachable and provides support to the staff team. Relatives we spoke with also said that they feel they can go to the management team with any problem and will be listened to. Staff meetings and resident meetings also take place. The home has appropriate arrangements in place for the safekeeping of peoples money. We checked the records and found receipts available for transactions, balances were also checked and accurate. As expected no member of staff is an agent for peoples money and where possible all monies coming into the home are receipted. Supervision of staff is undertaken but some timescales have slipped, the registered manager is aware of this and needs to prioritize supervision sessions. 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 8 Records used to monitor the care provided, (in this instance turning charts)should be completed in sufficient detail to ensure the home can evidence care is provided in a consistent and safe way. Ensure medication administration records are completed on all occasions. This means there is a clear audit trail to confirm medication management. Evidence of a choice of menu should be recorded for the people using the service. This demonstrates people are offered an alternative meal. The carpet in one room should be looked at to remove the tripping hazard it presents. All wardrobes should be secured to promote the safety of the people living there. The home needs to ensure that all products hazardous to health are locked away at all times. This is to ensure the safety of the people who live there. Ensure that staff receive regular supervision so that people know the staff are appropriately managed. Page 27 of 28 2 9 3 15 4 5 6 19 19 26 7 36 Care Homes for Older People Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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