Inspection on 21/01/10 for The Chase Care Centre

This is the latest available inspection report for this service, carried out on 21st January 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Chase Care Centre 07/06/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 25/04/2010.

Key inspection report Care homes for older people Name: Address: The Chase Care Centre 4 Printers Avenue Watford Hertfordshire WD18 7QR     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: Julia Bradshaw     Date: 2 1 0 1 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: The Chase Care Centre 4 Printers Avenue Watford Hertfordshire WD18 7QR 01923232307 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: manager.chase@lifestylecare.co.uk Life Style Care (2005) Plc care home 110 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home The Chase Care Centre can provide accommodation to 110 service users. A 20-bed living unit on the ground floor is dedicated to younger adults who have a physical disability or head injury. A 10-bed living unit on the ground floor is for service users who are physically disabled under the age of 65 requiring nursing care, and can be accessed separately. The first floor accommodates 40 older people who require nursing care who have dementia; the floor is divided into two separate living units accommodating 19 and 21 service users. The second floor accommodates 40 older people who require nursing care. A 21-bed living unit for older people who have dementia and a 19-bed living unit for older people who have a physical frailty. Each unit has a separate communal lounge, kitchendiners where there are facilities for service users and visitors to prepare refreshments. Each unit has assigned rooms specifically for activities, with the provision of a quiet room. There is also a snoozlem Care Homes for Older People Page 4 of 28 110 0 110 Over 65 0 110 0 Brief description of the care home and gym. The home has plenty of storage space and the laundry and kitchen are sited away from service users bedrooms. Staff accommodation and a training room are situated on the second floor and is not accessible to service users. The home has a large enclosed garden; this enables service users to utilize the grounds safely. Closed circuit television is in situ and is discreetly positioned over the main entrances to the home. The home is located close to Watford town centre and is fully accessible by public transport services. 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: The focus of the inspections undertaken by the Care Quality Commission is based upon outcomes for the people using the service. We looked at six care plans and tracked the individual care for those people. As part of the planning we look at information we received including the Annual Quality Assurance Assessment (AQQA) This is a self assessment document required by law in which the provider tells us how well they think they are meeting outcomes for individuals. We also looked at any concerns and also feedback from relatives, staff and the people using this service. The last key inspection was carried out on the 11th July 2007 and this was the second key inspection carried out since the service opened. There was also a Random Inspection carried out on the 3/07/08 and an Annual Service Review was conducted on the 11/07/08. Although the first key inspection was carried out within six months of its registration with the Commission it was not fully occupied at this time. We observed staff at work and how they interacted with the people living at within the home. There was also a tour of the building in which the the inspectors had the chance to talk to the Care Homes for Older People Page 6 of 28 staff and manager of the service. There is an up to date copy of both the Statement of Purpose and Service User Guide held within the main reception of the home. A copy of the most recent inspection report is also available upon request from the managers office. The range of fees for this service are from £561- £1400 per week. Due to the size of this service it was decided that three inspectors were required to carry out this inspection in order to ensure that it could be assessed effectively. 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: The manager must ensure that when staff providing care to service users, they must ensure that they respect peoples dignity and privacy at all times. There were several examples observed by the inspectors where peoples dignity and privacy was compromised. The nursing care plans within the home must have an up to date running record of fluid intakes and outputs which ensures that people are being provided with adequate levels of fluid. The manager should review the current arrangements for covering the reception area of the service outside of the normal working hours, as on occasions visitors have stated that they have had to to wait for sometime to gain access into the home. We also experienced this as we waited ten minutes to gain access and then only because we entered the service with a member of staff coming on duty, who had a key to the building. Care Homes for Older People Page 8 of 28 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. Information about the service is kept up to date and provided for all prospective users. Everyone wishing to enter the service has a basic assessment of needs completed. This ensures that all parties can be sure the service can meet individual needs. Evidence: The manager stated that both the statement of purpose, which set out the aims and objectives of the service and the service user guide, which provides basic information about the service and the specialist care the service offers, had been updated since the last inspection took place. Both these documents were displayed within the main reception of the home. The service user guide provides details of what the prospective residents can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. When requested the service can provide a copy of the statement of purpose and guide in a format which will meet the capacity of the resident. Care Homes for Older People Page 11 of 28 Evidence: The documentation of six residents was seen and the pre-admission assessment took into consideration the psychosocial, physical, religious and social needs. Most information requested from The Chase CARE Centre is provided upon request (although some is only given when the perspective resident or their family arrive for a viewing of the home). The Chase Care Centre operates an open house policy which allows individuals or small groups of people to visit the service, upon request. Admissions are not made to the service until a full needs assessment has been undertaken. The registered manager or senior staff members complete the assessment prior to admission to the service. The assessment format is detailed in style and seeks to establish the primary care needs of the individual prior to admission. The assessment explores ten areas of physical health care needs, including personal care tasks. Each defined area is then further explored . For example the section on personal care is further defined and states one carer to assist with personal care. It was evident that the service strives to seek the information and assessment through care management arrangements, prior to admission. A total of six care plans were case tracked. There was a section for the assessor to explore the religious needs of the individual. During the inspection time was spent talking to the people using the service. Several positive comments were received from both relatives and residents including The staff are all kind here. I am always well cared for and the staff cannot do enough for me. It was established that the administrative paper work relating to the admission and assessment of the people using the service provides adequate detail and the main outcomes for the individuals are met and that the service has the capacity to support people who use the service and respond to diverse needs. Generally staff supporting people were seen to interact with respect and dignity for the individual at all times. All privately funded people who use the service are provided with a statement of terms and conditions or a contract. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. People who are funded receive a social service contract. Contracts are reviewed when there is a change in the needs of the person using the service. 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. People using the service can be assured that their personal care and health care needs are met and that their care plans provide adequate information in order for staff to ensure the care is tailored to individual preferences and needs. Evidence: A total of six care plans were case tracked fully, it was established that people who use the service receive personal and health care support using a person centered approach. Personal health care needs including specialist health, nursing and dietary requirements are recorded in each persons care plan. The care plan provides a detailed guide for staff to know how to support the person. The care plan is generated from the Prue admission assessment and includes, risk assessments for the management of falls, bed rails, manual handling and self medication. The care planning format explores and outlines the individual needs and preferences of a person. The care plan is written from the perspective of the individual and documents the persons own preferences and wishes. For example the persons choice of clothes, personal hygiene preferences and style of hair. The manager must ensure that all fluid charts are evaluated at the end of each 24 hour period to ensure that the input and Care Homes for Older People Page 13 of 28 Evidence: output measures are reconciled thus ensuring that the individual is receiving adequate amounts of fluids. One care plan we checked did not have a daily total recorded from the 14/1/010 to 20/1/10. Another chart we saw did not have a total intake recorded on the 16/1/10. Another fluid chart did not have a total recorded for the 15/1/10. One care plan did not contain any information within the lifestyle section or a photograph. During this inspection is was noted that a member of the domestic staff came into the dining room whilst people were still eating their breakfast and started to clean the carpet. This practice is considered to be both disrespectful to the service users and could present as a health and safety risk. It was observed that personal support is responsive and tailor made to meet the individual choices, needs and preferences. Generally staff were observed to respect the privacy and dignity of all people. However on one occasion we observed that staff did not consider a residents dignity whilst hoisting them within a communal area. The use of a modesty blanket would have ensured that the residents dignity was protected and maintained. Also we observed the morning drinks being served from the unit trolley but there was no choice of drinks being offered, just tea, the milk was being poured straight from the large plastic container and the sugar being used was dirty. Staff were seen to be wiping peoples mouths with rough paper hand towels. These are examples where staff should endeavor to improve their understanding of respecting the service users and ensuring peoples dignity is maintained at all times. The atmosphere and approach of the service is friendly and welcoming. The service listens and responds to individual choices and decisions with regard to who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs as appropriate. Residents have access to health care and remedial services. The health care needs of residents unable to leave the service are managed by visits from local health care services. Evidence was seen within the care plans of specialist health care support services visiting the service and in addition to the care plan there were detailed notes made by the specialist visiting the service for example General Practitioners. A number of comments were received from people that use the service. One person commented that, The staff are always approachable and my bedrooms is always clean and tidy. Residents care plans are tailored to the individual and reviewed on a regular basis. This ensures staff are always working towards providing the best possible outcomes for those using our service. All health care needs are recorded and reviewed. Reviews are either conducted by the home or visiting professionals (recorded accordingly). During the inspection it was directly observed that care plans were reviewed on a regular basis. It was observed that one of the documents in place reviews and assesses the persons level of independence. The service has an efficient Care Homes for Older People Page 14 of 28 Evidence: medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. A total of three peoples medication was case tracked in order to ensure compliance. Room temperatures were being recorded where the medication is stored. Ordering and returns documentation was up to date and accurate. The people using the service are given the support they need to manage their medication, where appropriate. The service has a good record of compliance with the receipt, administration, safekeeping, and disposal of controlled drugs. Staff have completed and passed an appropriate medication course. An assessment has been carried out to ensure each member of staff is competent to handle, record and administer medication properly. The manager works hard to ensure that all medication practices are strictly implemented and adhered to. This includes random spot checks on medication records. 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. People who use the service are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: There was range evidence seen throughout the service that people had been involved and encouraged to take part in creating some art and craft displays to reflect peoples interests and to celebrate a variety of events throughout the calendar year. Peoples personal interests are assessed as part of their overall assessment of need. The service has a total 99.5 hours per week for activities throughout the home, which includes one full time worker and the remaining hours are divided up into several parttime workers. The AQAA states that We have themed activities rooms - a computer room, a reminiscence room and an arts and crafts room. Residents are positively encouraged to leave their units and mix with other client groups for structured activities. Residents regularly go to Watford shopping or to the pub with the activities co-ordinators and care staff. We have a hairdressing salon and a visiting hairdresser for two / three days a week. We have two Church Services a month within the home. The service does not have any on site transport and requires people to take taxis or public transport where appropriate. The AQQA also states that We need to improve Care Homes for Older People Page 16 of 28 Evidence: the activities for those residents who are nursed in bed and are sourcing equipment that will enable us to achieve this.We were able to sample the lunchtime meal and it was found to be both flavoursome and nutritionally balanced. Several people spoken to said that they together food was There is always plenty of choice. The kitchens were also inspected and found to be well organised, clean and adequately staffed. 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. People who use the service can be confident that the current system for managing complaints is effective thus ensuring people are protected. Evidence: The service has a detailed complaints procedure in place. This includes a section outlining the individual complaint and an action plan to resolve the issues raised. The policy and procedure in place ensures people using this service are protected from abuse. The AQQA stated that All staff receive training in the protection of vulnerable adults as part of their induction process and have further training to assist in recognising signs of abuse and who to raise concerns to. There is also a Whistle blowing policy in place and staff are also informed at staff meetings about abuse and what to do if this is suspected. Although this service does generate a large amount of regulation 37 notices referred to The Care Quality Commission the manager appears to be reporting these concerns effectively and appropriately. Five staff spoken to during this inspection stated that they were aware of the policy relating to vulnerable adults and knew how to report their concerns, if necessary. 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. The service provides a well maintained, safe and comfortable environment in which people can live and meets peoples needs and expectations. Evidence: The service provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs, where necessary. The service is pleasantly decorated throughout and both the bedrooms and communal rooms provide a personal homely feel. Several people were happy to show us their rooms, all of which appeared comfortable and had been personalised in order to make them more homely. Improvements to the environment which include, repairs to the ceilings where there had been a leak and some water damage had occurred. The service has an effective system in place to ensure all health and safety standards are maintained. Fire records on the day of this inspection confirmed that regular checks are being carried out. These included, both the fire alarm check and emergency lighting check carried out on the 13/01/10, the latest fire drill was carried out on the 14/10/09. The latest annual fire inspection was carried out on the 21/09/10. The most recent gas safety check was carried out on the 18/03/09. The lifts were last serviced on the 6/11/09. A bed rail audit was last carried out in January 2010. These regular checks confirm that the service strives to maintain peoples health and safety effectively. The manager has increased the domestic and maintenance hours in order to enhance and Care Homes for Older People Page 19 of 28 Evidence: improve both the health and safety and cleanliness of the home. Although the service has an infection control policy in place there must be also be an infection control audit carried out regularly in order to ensure standards are being maintained to a satisfactory standard. This was fedback to both the manager and area manager at the end of this inspection. The area manager agreed to action this point and confirmed that there currently was no infection control audit taking place within the service. Information given to the manager included the document Essential Steps Audit published by the Department of Health. 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. The service has effective management systems in place to support staff by providing the necessary supervision and training to ensure an effective staff team are able to support people living within the service to lead safe and fulfilling lives. Evidence: There are adequate qualified and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service. The AQAA states that a full time supernumerary Deputy Manager is also in post. There are three Unit Managers in post who take charge of the building in the absence of the Manager and Deputy Manager. The service recognises the importance of training and delivers a programme that meets any statutory requirements and the National Minimum Standards. The AQAA states We have reduced the agency usage and recruited some very good staff. We have put an effective induction programme in place and now have an ongoing training programme to underpin skills and knowledge within the home. The staff training records were checked and confirmed that all staff have received their mandatory training. In addition staff have received moving and handling training, fire awareness training, dementia training, food hygiene training, medication training, safeguarding adults training and infection control training. Staff spoken to confirmed they receive regular supervision and several staff stated that they found it productive and supported. A variety of staff meetings are held on a regular basis and include Care Homes for Older People Page 21 of 28 Evidence: senior staff meetings, night care meetings. The most recent staff meeting minutes were dated the 3/12/09 and the 6/01/10. All staff are clear regarding their role and what is expected of them. People using the service report that staff working with them know what they are meant to do and that they meet their individual needs in a way that they are satisfied with. The Manager has the required qualifications and experience to run the home. Feedback received on the day of the inspection from staff and the people who use the service that they find the management team approachable. The staff induction is comprehensive and is linked to skills for Care. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff files were audited and were seen to contain all the required documentation, with the exception of one file which did not contain an address for the second referee. The manager must ensure that all staff files contain all the required information, in order to ensure the service users are protected. Rotas were seen and displayed adequate staffing numbers on duty to meet the needs of the people using the service. Specific attention was given to the busier periods of the day. The manager workers a variety of hours that cover both the day and the evening to ensure they have a regular overview of the service being provided. The service benefits from having a full compliment of staff at the time this inspection was carried out. Staff confirmed that they receive supervision at least six times per year and they also attend staff meetings on a two monthly basis. 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. People using the service can feel assured that the manager is suitably qualified and competent to run the service and provide trained competent staff in a safe and well managed environment. Evidence: The Registered Manager has been in post since April 2009 and has worked hard in further developing and improving standards within the service. The Registered Manager has the required qualifications and experience and is competent to run the service. The Manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. The manager was directly observed throughout the inspection to lead by example and manage the service efficiently. The Manager leads and supports a stable staff team who have been recruited and trained satisfactory levels. The manager promotes equal opportunities, has good people skills and understands the importance of person centered care and effective outcomes for people who use the service. There are a variety of quality monitoring systems within the service which include, medication auditing, Care Homes for Older People Page 23 of 28 Evidence: environmental audits, care planning audits and regulation 26 visits are carried out effectively and on a regular basis. The inspector was able to see the most recent Home Managers Monthly Audit carried out in December 2009. This audit is carried out bi-monthly and covers every aspect of the service. The service also carries out an annual Satisfaction Survey for relatives and staff and the most recent audit carried out was displayed within the main reception of th service and scored an overall average of 76 satisfaction with the current service provided. The service has sound policies and procedures, which are internally reviewed and updated, in line with current thinking and practice. The manager ensures staff follow the policies and procedures of the home. The staff team are positive in translating policy into practice and showed good knowledge of care principles, health and safety and safeguarding issues. The manager must ensure that there is an effective Infection Control Audit in place to protect and maintain effective standards of infection control throughout the service. The dignity and privacy of service users should be continuously monitored and maintained at all times to ensure that people are supported to lead dignified lives. Several practices observed during this inspection compromise peoples privacy and dignity. The manager should review the current arrangements for visitors to access the home, outside of the normal working hours as the inspectors arrived at the home at 08.15 and could not gain access or alert anyones attention to let them into the building for a period of over ten minutes. Care Homes for Older People Page 24 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 25 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 1 8 13 Individual nursing care plans 26/02/2010 must contain a regular monitoring system with regard to the daily fluid intake and output to ensure people are receiving adequate amounts o fluids, within any 24 hour period. to protect and maintain peoples welfare. 2 10 12 Staff must ensure that peoples dignity and privacy is protected and maintained at all times. To ensure people are receiving the best possible care from the service and that their dignity is not compromised 26/02/2010 Care Homes for Older People Page 26 of 28 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!