Inspection on 16/06/09 for Riverlea House

This is the latest available inspection report for this service, carried out on 16th June 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

Riverlea House 27/06/06

Riverlea House 03/08/05

Riverlea House 20/04/05

Riverlea House 19/01/05

Riverlea House 02/09/04

Riverlea House 06/02/04

Riverlea House 13/11/03

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Key inspection report Care homes for older people Name: Address: Riverlea House 105b/107 Lower Road River Dover Kent CT17 0QY     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: Christine Grafton     Date: 1 6 0 6 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 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) 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 28 Information about the care home Name of care home: Address: Riverlea House 105b/107 Lower Road River Dover Kent CT17 0QY 01304823935 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: riverlea@btconnect.com Choicecare 2000 Ltd care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 44. The registered person may provide the following category/ies of service only: Care home only ? (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 (OP) Date of last inspection Brief description of the care home Riverlea is a large detached building situated in the village of River, on the outskirts of the town of Dover. The home is close to village shops and public houses, and public transport is easily accessible. The home offers accommodation on two floors, and there is a passenger lift giving access to the first floor. There are 43 bedrooms, including one double and 10 with ensuite facilities. On the ground floor there are four communal lounges, a dining room and dining area. The grounds of the home are small, with two patio areas, and two lawned areas that back onto the river. There is a small parking area at the front of the property and to the rear of the property. There is some on road Care Homes for Older People Page 4 of 28 Over 65 44 0 Brief description of the care home parking available close by. The fees for support from the home are set during the assessment period and are very individual to the needs of the service user, depending on the level of support required. A rough guide to the level of fees charged is around £313.62 to £432.00 per week. Any additional charges are detailed in the service users guide, a copy of which is kept in every bedroom. The most recent CQC report is available on request from the home. 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: This report takes account of information received since the last inspection of 20th June 2007, including a visit to the home. We visited the home without telling anyone we were coming so that we could see what it is like for people living there on a usual day. We arrived at 09.45 hours and stayed for the day, leaving at 16.00 hours. We spoke to the manager, staff and residents. The manager showed us around the communal areas of the home and we saw a sample of bedrooms. We observed what was going on, the home routines, staff practices, and what activities were taking place. We looked at some of the homes records. We also used the homes annual quality assurance assessment known as an AQAA for short. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the previous year, what they aim to do and lets Care Homes for Older People Page 6 of 28 us know when they have completed important environmental safety checks. Information from the last inspection is also referred to. We have used the term residents to describe the people who live in the home. At the time of our visit there were 31 residents living at the home. The manager has been in post for eighteen months, is not yet registered with us, but indicated that this is now in hand. She is referred to throughout the report as the manager. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? They have maintained the good standards that we saw at our last inspection and carried on to develop practices to benefit residents. They have taken action to address the two requirements we made at our last inspection. They have made the outside storage area for clinical waste more safe and have made changes in the two laundry areas to better control the spread of infection within the home. They have developed the care plans to make sure that they have all the information that staff need, which has resulted in them providing good care to the residents. They have continued with their redecoration and refurbishment programme, which has made the environment more homely and safe for residents. They have really changed things a lot in this respect so that whereas the environment was judged as adequate at the last inspection, it is now good. They have continued with their staff training programme to help staff develop their knowledge and skills. Residents can therefore have confidence that staff know how to Care Homes for Older People Page 8 of 28 do things in the right way. They have dealt with any issues raised by residents and staff and any other people with a vested interest in residents welfare and made sure that any conclusions reached are passed onto the person who raised the issue. The manager has strengthened the homes quality monitoring methods and identified areas for future development. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. People considering moving into the home have an assessment that tells staff about them and the support they need. This makes sure that their needs can be met upon moving in. It is not the general policy of the home to admit residents for specialist intermediate care, so standard 6 was judged as not applicable at this inspection visit. Evidence: Residents are provided with written information about the home, which is kept in their own rooms, so that is readily available for them to refer to. This includes the homes statement of purpose and service users guide, copies of the menus and the complaints procedure. This information is discussed with all prospective residents to provide a picture of what the home has to offer and when they are admitted staff go through it all again with them. Care Homes for Older People Page 11 of 28 Evidence: We discussed the admission procedure with the manager and looked at the documentation for one new resident. New people admitted to the home have a full assessment of their needs beforehand. On most occasions, the manager goes out to asses the prospective resident in their own home or hospital, tells them about Riverlea and what to expect, and carries out the assessment. Information is gathered from care managers and other professionals and all this is considered to make sure that the home can meet the persons needs when they move in. Following admission a care plan is drawn up with the resident and is regularly reviewed and updated as things change. The home does admit people for respite care, but does not provide dedicated accommodation, or specialist facilities, to deliver short term intensive rehabilitation and does not admit people for intermediate care. We spoke to two people staying for respite care. They told us that staff had been very supportive when they first moved in and were helping them to recover their independence, so that they would soon be returning home. Some residents come in regularly for periods of respite care and one resident told us, I came here last year and was so pleased with everything that I am pleased to be back. They went on to say that when the time comes when they will have to consider permanent residential care that this is the place they want to come and live in because it is so friendly and there is a nice atmosphere. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having a plan of care that has the information needed to make sure that their health and personal care needs are met. They can be assured that their medication will be dealt with safely, that staff understand their needs and they will be treated with respect. Evidence: We looked at three residents care plans and saw that these are individual to the person and well organized, with an index, making them easy to follow through. They contain detailed information about the persons needs, with guidance for staff on how to provide their individual care. They cover a wide range of things, including, personal care, healthcare, nutritional needs, communication, mobility, risk of falls, continence, pressure sore prevention, mental health, personal safety and risk. Care plans are reviewed each month by the key worker. Residents are assisted to keep well and we saw details in the care plans of contacts with doctors, community nurses, or other health professionals. There are records of Care Homes for Older People Page 13 of 28 Evidence: any follow up actions and recovery. Care plans contain details about any medical conditions, such as diabetes. Where any risks are identified, action plans are in place to make sure that residents are kept safe. We saw examples of specific guidance about keeping people safe regarding three different medical conditions, with signs of ill being to look out for and descriptions of what to do in cases of relapse. We spoke to a care staff member about one case and they described what they do to keep the resident safe. This matched what we had read in the care plan. The staff member stated that they use the care plans all the time and went on to say how much better they are now, following work completed by the manager, so that care plans contain more information for staff to refer to. When asked what the home does well the staff member stated, the care, we provide good care. This was confirmed by the residents we spoke to. We looked at the way medications are managed and found that things are in order. Medication is securely stored and kept at a safe temperature. We looked at a sample of records completed each time a medicine is dispensed and saw that apart from one issue discussed, they had been properly recorded. The manager audits the medicines each month and in this way any discrepancies are usually picked up quickly and dealt with. The manager and staff member that we spoke to confirmed that staff who give out the medications have undergone training. This was confirmed when we looked at the staff training matrix. Care plans are written in a way that promotes dignity. We saw specific guidance for staff about maintaining privacy and dignity when assisting with personal care. We observed staff assisting residents in a way that shows respect for dignity. We spoke to six residents about the home and care they receive. They told us that the staff are friendly and helpful and that there is a nice atmosphere in the home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having opportunities to take part in activities that suit their needs and from being able to keep in contact with families and friends. Residents benefit from receiving a nourishing and balanced diet, with choices available to them in pleasing surroundings. Evidence: An activities timetable is displayed on notice boards throughout the home that includes quizzes, bingo, sing alongs, crafts, manicures and hairdressing. During the morning of our visit an exercise lady was at the home and we saw a group of residents taking part in this activity. Afterwards they told us how much they had enjoyed it and also of their enjoyment in participating in the other activities provided. There is a volunteer who comes in to do the bingo and other activities who is currently going through the recruitment process to be employed as the activities coordinator. Residents also spoke about having musical entertainment monthly which they enjoy. They are currently making plans for the summer fair. Residents have been asked what they would like and requested strawberries and cream. We were told that this has been arranged and entertainment has been booked. Care Homes for Older People Page 15 of 28 Evidence: Religious and spiritual needs are identified in the care plans. A monthly service is held in the home for residents to attend if they wish. Visitors are welcomed and residents are encouraged to keep in contact with their relatives and friends by telephone and letter writing. Some residents go out into the community alone and others go out with relatives. We saw some residents enjoying the small garden facilities. Discussion with residents and staff, plus daily records in the care plans, confirmed that daily routines are flexible and residents can choose their times of rising and retiring to bed. Past occupations and interests are recorded and the key worker system makes sure that staff really get to know residents and tailor the care they provide to individual needs. Staff are encouraged to spend regular one to one time with the residents that they are the key worker for. This helps to make sure that choices are known and if anything comes to light that staff cannot resolve, they contact outside agencies to act in the residents interests. Residents each have their own copy of the four week menu plan in their bedrooms. Two choices are offered at dinner and tea times and there is a wide choice to choose from at breakfast times. We saw that the menus provide a nutritious diet. The residents that we spoke to said that the food is usually good and they confirmed they always have a choice. There are several different dining areas to choose from and dining tables were attractively laid for dinner with tablecloths, runners and condiments. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that any complaints will be listened to and sorted out. They can be assured that staff practices in the home will safeguard them from harm. Evidence: Each resident has their own copy of the complaints procedure in the service users guide, which is kept in their room. A copy is also displayed in the entrance hall. Any complaints are recorded and investigated. We saw records of these showing that issues raised are taken seriously, responded to and outcomes shown. The manager works some shifts and is readily available to residents on a day to day basis during the week. She is also on call at other times and can be contacted by senior staff if there is anything of concern that needs to be discussed. Residents and staff told us that the manager has an open door policy and they can talk to her at any time. The manager stated that this means that any problems are usually sorted out as they occur, before they build up into anything more serious. The manager is an adult protection trainer and trains staff in house. The staff training matrix indicates that twenty six staff have completed this training, including ancillary staff. The AQAA indicates they have received two complaints during the past twelve months and we saw that these had been resolved. They have made one safeguarding adults referral, which we were notified about and was dealt with properly by the home. Care Homes for Older People Page 17 of 28 Evidence: The manager stated that twelve staff have recently completed training on the Mental Capacity Act and training on the deprivation of liberties safeguards has been booked for fifteen staff to attend later this month. The home follows safe recruitment procedures that include protection of vulnerable adults (POVA) register and criminal records bureau (CRB) checks for any new staff employed. This helps to make sure that residents are properly protected. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a comfortable and homely environment. The programme of ongoing redecoration and maintenance makes sure that the home is safe and suitable for residents living there. Residents are protected by the practices followed to maintain hygiene and prevent the spread of infection in the home. Evidence: The AQAA indicates that since the last inspection the redecorating and refurbishment programme has continued and improved the environment for residents. We saw that this is right. We looked at the communal areas of the home and a sample of bedrooms. All areas seen were clean, comfortable and well maintained. Hall and stairways, plus a number of bedrooms, have been redecorated, with some new carpets fitted. New furniture has been provided including, new beds, bedroom furniture, dining room chairs and some new lounge armchairs. Curtains and bedding have also been renewed. We saw a number of bedrooms that have been made to look very personal with the residents own furniture and mementoes. Residents told us that they like their bedrooms and they find the seating in the lounges comfortable. All radiators have now been guarded to reduce the risk of burns. Care Homes for Older People Page 19 of 28 Evidence: The last inspection identified that the laundry facilities and the clinical waste disposal storage area needed attention to ensure safe infection control and we made two requirements, which have been met. We saw that a separate locked storage area has been constructed away from the main building for the safe storage of clinical waste. The laundry flooring has been replaced and hot water cylinder boxed in. The manager informed us that there are plans to change the washing and drying areas over, so they will have two commercial washing machines and a double tumble drier. They will need to add a wash hand basin when this is done. There is a laundry assistant on duty during the week and two cleaners cover the whole week. We spoke to the laundry assistant who described how soiled items are dealt with. We saw that there are plentiful supplies of liquid soap, paper towels and protective clothing for staff. We observed staff following safe hygiene procedures and saw that clinical waste is being dealt with safely. This means that residents and staff are protected from the spread of infection within the home. There is currently no sluicing facility for the cleaning of commode pans. However, there is a bathroom used for this purpose that is not used by residents and is kept locked. They have plans to create a proper sluice room within the next three months. In the meantime, the manager is going to carry out a risk assessment to look at staff safety as they have to bend over the bath to clean the commode pans. There are plans to refurbish two bathrooms, all toilets, create a wet room and new hairdressing room within the next thee months. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that there will be enough staff on duty with the right skills to meet their needs and that recruitment practices are adequate to protect them. Evidence: We looked at the number of staff on duty and saw that there is an average of four carers on duty throughout the day, with additional ancillary staff for cooking and cleaning. Rotas are planned to make sure there will be enough care staff and ancillary workers on duty during the day and night. We spoke to some of the residents about the numbers of staff on duty. Most said they thought there were usually enough, but one commented that sometimes staff are very busy. We discussed this separately with the manager and a staff member. They both felt that there are enough staff on duty throughout the day and at night when there are three waking staff on duty. We observed staff assisting residents and saw that when residents asked for assistance they were helped in a cheerful, competent way. Staff are encouraged and supported to achieve their National Vocational Qualification (NVQ) in care level 2 or above. Information in the AQAA indicates that twelve out of twenty permanent care staff have achieved this and the manager informed us that five more staff are currently working towards it. The training matrix also shows that staff have completed a wide range of training courses to enable them to keep people Care Homes for Older People Page 21 of 28 Evidence: safe. A staff member spoke about their training and said how good it has been. They described how it has helped them to provide good care for the benefit of residents. We looked at two staff files and saw that all the necessary security checks had been completed before they started work at the home. These include two written references, verbal references, criminal records bureau (CRB) and protection of vulnerable adults (POVA) register checks. This helps to make sure that they are trustworthy to be around residents. All new staff undergo induction training with mandatory training included in the early stages of employment and regular updating as necessary. We saw that staff training is ongoing and a range of courses have been booked for the next few months. Care Homes for Older People Page 22 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 managed in a way that safeguards residents best interests, promoting and protecting their health, safety and welfare. Evidence: Since the last inspection, there has been a change of manager. The new manager has been in post for eighteen months now. She is currently undertaking her NVQ level 4 with the new management component and indicated that she would be submitting her application for registration soon. The manager has a positive attitude about the home saying, I love it here. She manages a budget and has seen through the improvements to the environment, so that whereas it was adequate at the last inspection, it is now good. She has developed the care plans to provide staff with more information and carries out monthly audits, for example, medications and a falls analysis. She prepares a monthly summary audit of deaths, any pressure sores, incidents of major weight loss and any instances of aggression. This is monitored by head office. Care Homes for Older People Page 23 of 28 Evidence: Staff, residents and relatives are able to speak with the manager about any matters. We spoke to six residents and two staff members, who all confirmed that the manager has an open approach and always listens to them. One resident said, Mandy our manager is very nice, one of the best weve had. Two staff members confirmed this, saying that since the current manager has been in post the home has improved. One said, There have been changes, nice changes, it has improved, the decor, more staff, lots of training. Mandy is a good manager, very supportive. The AQAA was completed on time and gave us an indication of how the home is doing. This helped us in the planning of our visit and we have tested out some of the things that they say they do well in the AQAA and found them to be correct. We discussed how future AQAAs could provide information in a more relevant way, so that it is associated with the various outcome groups and to support some of the statements made with a wider range of evidence. That said, we have seen that the manager has developed a range of quality monitoring methods and that outcomes for residents have been good. The manager said she has recently sent out some quality assurance surveys to relatives, visitors and health professionals. We saw copies of some residents surveys completed in 2007, shortly after the manager took over her role at the home. We also saw records of recent staff meetings and residents meetings. The manager stated that action has been taken to address issues raised. We discussed that this now needs to be recorded to show an analysis of the survey results and any action plans drawn up following the residents and staff meetings, showing the outcomes. This would then enable them to quantify from a user perspective where things have improved and show that they have acted upon suggestions made. The area manager does monthly visits and writes a report on the conduct of the home. The manager told us that the home holds small amounts of personal money for some residents and that records are kept of any transactions, with a running balance. We saw that the area manager does an audit of residents monies during their monthly quality monitoring visits. Care Homes for Older People Page 24 of 28 Evidence: The AQAA indicates that the homes equipment is maintained and services are up to date and we did not observe any safety hazards during our visit. The staff training matrix indicates that staff receive training on safety things such as fire safety, first aid, food hygiene and moving and handling. A staff member confirmed they had done all these courses plus more. The two requirements we made at our last inspection have been met. These were to ensure the appropriate storage of waste disposal and the control of infection and that the laundry rooms fully comply with the requirements in all areas to ensure the control of infection. 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 Care Homes for Older People Page 27 of 28 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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