Inspection on 25/09/09 for The Grange

This is the latest available inspection report for this service, carried out on 25th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grange 23/10/06

The Grange 19/12/05

The Grange 14/06/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Grange 69 Southend Road Wickford Essex SS11 8DX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Thompson     Date: 0 1 1 0 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The Grange 69 Southend Road Wickford Essex SS11 8DX 01268766466 01268767130 thegrange@runwoodhomes.co.uk www.runwoodhomecare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Runwood Homes Plc care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home The Grange is registered to provide care and accommodation for forty three older people including those who have dementia. There are forty two rooms, all of which are currently used as singles. All bedrooms have private en suite facilities. There is a choice of seven sitting and dining areas, Care Homes for Older People Page 4 of 28 Over 65 0 43 43 0 Brief description of the care home including a sensory room and a room which is designated for smokers. There are four bathrooms and two shower rooms. The home is set on two main levels and each of these has a lower level. A passenger shaft lift provides access to all four levels. Outdoor space comprises an enclosed rear garden which is part slopping. There is seating on the slopping grassed area and on a separate paved patio area at the back of the garden. The patio area also has a large gazebo with tables and seating. Vehicular access to the front of the building is restricted to emergency vehicles only, and a barrier is in place. Staff and visitor parking is provided at the rear of the home. The Grange is situated on a busy road near Wickford town centre with its shops and amenities. It is on a regular bus route and there are regular trains from Wickford station, which is close by. At the site visit it was confirmed that the current range of fees for the home are £454.57 to £560.00. Additional charges are made for chiropody, newspapers, toiletries and some transport costs. CQC inspection reports can be obtained from the home, or via the CQC internet website, www.cqc.org.uk. 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 unannounced key inspection commenced on Friday 25th September 2009 with a second announced visit on 1st October to complete the process. The content of this report reflects the inspectors findings on the days of the inspection along with information provided by the service and feedback by service users, staff and other parties. The manager was at the home on both of our visits and assisted us in a professional and helpful manner. Our most recent inspection prior to this visit was on 10th September 2007. The manager completed and returned their Annual Quality Assurance Assessment (AQAA) to us in time for the inspection. This is a self assessment required by law which gives homes the opportunity of recording what they think they do well, what they Care Homes for Older People Page 6 of 28 could do better, what has improved in the previous twelve months as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. Discussions were entered into with the management of the home, service users, visitors and staff on duty. CQC survey questionnaires were also provided to service users, staff and stakeholders. We received fourteen completed surveys and reference to feedback from these has been made within this report. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. What the care home does well: What has improved since the last inspection? 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 set out on page 4. Care Homes for Older People Page 8 of 28 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 can be confident that the admission processes ensures that the home can meet their needs. Evidence: The manager said that two staff will visit prospective new service users to undertake an assessment of their needs. This will usually be the manager and the deputy manager, but may sometimes include a Care Team Manager (CTM). Evidence of this process was seen in two files for people admitted since the last inspection. Assessment headings looked at included, background information, personal hygiene, communication, behaviours, medication, mobility, social contacts, elimination, sight, medical, safety, falls, religious, oral, hearing, pressure care, eating and drinking needs and special considerations. Files seen contained the information needed for staff to provide the right initial support when the service user first moves in. Copies of assessments carried out had been signed by the assessor. Care Homes for Older People Page 11 of 28 Evidence: The manager showed us an information brochure pack that is sent to all people who express an interest about moving into The Grange. The information pack includes the homes Statement of Purpose, Service Users Guide, a sample activity programme and an invitation to visit the home for coffee and a look around. Discussion with service users and relatives confirmed this. Comments included, we looked around the home before deciding that this was the best one for our relative, we looked at many other homes before deciding on The Grange, I could visit before I moved in. 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. The information in care plans ensures that peoples needs could be met in a way they would wish. Evidence: Three care plans were inspected. Included was a profile of the person with background information, personal details, and next of kin contacts. Assessments of identified needs were recorded with instructions of the care required to meet these needs. Areas of assessment were based on those identified upon admission and added to afterwards. Care plans seen included assessments on memory, communication, orientation, mobility, activities, independence, bathing, continence, personal care, temperament and social relations needs and considerations. Care files also had risk assessments which showed the actions needed by staff to reduce risk, and a mental status and dependency assessment. There were records of reviews and of daily staff observations. Records of service users weight had also been kept along with records of GPs visits and treatment and on any Care Homes for Older People Page 13 of 28 Evidence: other medical consultations. Service users night time needs were included in night care plans. Care plans and risk assessments had been reviewed every month, or sooner if needed. Care notes recorded any changing needs. Care plans seen had been signed as agreed by the service user and appropriate relative. The manager said that the home gets good support from District Nursing services on pressure care needs and with the supply of appropriate aids and treatment. Continence issues are supported by the community continence team with the manager currently acting as link to this service. This is to ensure there is regular communication and updates on service users continence needs. Hearing needs are provided for by GP referral to a local hospital. Dental services are available to service users from a dentist who comes into the home or by visiting a community based dentist outside. The manager said that there are also some service users in the home who continue to see their own dentist. GP services are provided by three local practices and some people had kept their own GP. A chiropodist and an optician visit regularly, records of visits with written outcome notes were seen. The homes medication policies and procedures were seen and included instructions and guidance on ordering, receipt, storage, administration, self medicating and returns of unused stocks. There was also guidance and a risk assessment in place for those people who look after their own medication. Staff told us that they been trained on medication practice and there were certificates seen on staff files to evidence this. Only CTMs, the deputy manager or the manager deal with medication. Practice competency assessments were seen to have been carried out regularly by the manager to ensure staff remain competent for this role. Medication administration records were inspected no shortfalls were noted. Discussions with individual service users and comments made in surveys returned to us confirmed that they thought they were well cared for and were treated with respect by staff. Staff on duty were seen to be attentive and helpful in their dealings with service users. Comments made to us included, The Grange provides fabulous staff, staff are very caring, nothing is too much trouble for the staff, staff are always cheerful, the home has a family atmosphere, the staff are ever so friendly, the staff are lovely. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in The Grange can expect to have a lifestyle that matches their expectations through opportunities for activity, and enjoyable food. Evidence: Service users meetings are held every month and relatives meetings are held twice yearly. Minutes were seen of the areas covered, these included food, activities and staffing. The home encourages contact between service users and their families and many service users receive regular visitors. The Grange has a full time activities coordinator who was enthusiastic and committed to providing a wide and stimulating range of activities and interests for service users to enjoy. All service users had an assessment of their social needs which is reviewed every three months and there were also risk assessments in place for all activities and for outings outside the home. Regular activities offered included weekly visiting entertainers and several outings are organised each year. Outings included trips to the seaside, local bowls club, shopping trips, lunches and community attractions in the area. Transport is arranged for outings, this is funded by staff fund raising activities and from donations to the home. Care Homes for Older People Page 15 of 28 Evidence: Records had been kept of all activities offered to people and these included, swimming sessions, visiting entertainers, karaoke, reminiscence, music, bingo, singalongs, quizs, indoor games, hand massage and Sonas (a therapeutic approach focusing on the senses and on exercise). Regular community visitors to the home include two volunteers who play piano to service users, a sensory group, a talking news service and a weekly hairdresser who uses the homes large hairdressing room to provide this service. Three local schools sometimes visit to sing to service users and some service users had made visits to the schools to attend events there. A church service is held in the home monthly and some service users receive their own church visitors. People are made aware of planned activities through a monthly newsletter compiled by the activities coordinator and taken around to every room. People spoken with said they were satisfied with activities offered and some confirmed they only took part if they choose to. Actual comments made included there is always plenty to do here, the activities are varied and well planned by a very competent activities coordinator, the organisation of activities is well done, the activities are good. When asked, service users told us that their family and friends could visit at anytime and that staff always made them welcome. Comments in surveys and from relatives spoken with confirmed that they visit regularly and at any time, and that the atmosphere in the home is always friendly. Inspection of private rooms evidenced that service users had been permitted to bring their own personal items with them on admission, and some people told us they brought their own items in with them. Information for service users and their relatives on how to access independent advocacy support was seen displayed in the entrance hallway of the home. The manager said that this service had been used by some for advice relating to individual service users. Nutrition records and menus were looked at, these evidence choice and variety. The cook confirmed that the main daily meal is lunch with two menued choices but with further options provided if service users did not like the menued meal. Teas are usually a hot dish or sandwiches. The manager said supper meals are always Care Homes for Older People Page 16 of 28 Evidence: available. Food stocks were good and service users spoken with at the inspection were mostly satisfied with the food. Actual comments made included, the food is good and I get enough to eat, the food is quiet good here, the food here is very good, I have no complaints. There were however a small number of comments that the meat is sometimes tough. These comments were relayed to staff and it should be noted that the new manager had already introduced a monthly round of surveying service users for their views on the food provided to try to meet peoples expectations. Detailed records had been kept of peoples nutritional intake so that any changes in eating habits can be looked into without delay. 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. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. Evidence: The complaints procedure was displayed in the home and was included in the Service Users Guide. These contained guidance on how to make a complaint and who to complain to. Also included were timescales for responses from staff and a standard template for staff to record any complaints and concerns. Information in the AQAA states that ten complaints had been received in the twelve months leading up to this inspection and that action had been taken on all. We looked at records of complaints and these evidenced that complaints had been investigated and that these had been dealt with appropriately. Since our last inspection the service had received a number of written compliments. The manager had displayed these in the staff room to ensure staff are aware of positive feedback about the service. Service users spoken with said they knew who to speak to if they had any concerns, and they seemed confident that any concerns would be looked into properly. Comments from relatives also indicated that they were confident that complaints or concerns would be dealt with appropriately. Care Homes for Older People Page 18 of 28 Evidence: The homes policy on adult protection was inspected. There was written guidance for staff on recognising and reporting abuse, and the actions to be taken by staff if abuse is suspected, The guidance included types of abuse and a whistleblowing policy reminding staff of their responsibilities to report suspected poor practice. Staff spoken with displayed awareness of this subject and procedure and confirmed that they had received training on adult protection procedures. Records of this training were seen. The homes induction training also covered adult protection and safeguarding vulnerable people. The manager had been trained on deprivation of liberty and on the Mental Capacity Act. Training on these subjects had been booked to be provided to other staff in October 2009. 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. Service users live in a comfortable, clean and homely environment. Evidence: The Grange provides a comfortable and mostly well maintained environment. The site visit included a tour of the premises when it was noted that the home was very clean and there was no evidence of any unpleasant odours. The bedrooms, lounges, dining rooms and all communal areas were well furnished and decorated. We looked at the kitchen where we noted that some cupboard doors were chipped or damaged. The manager advised us that the registered provider had plans in hand to refurbish the kitchen, but a start date for this work had not yet been set. During the site visit we also noted, in our opinion, that the stairs used by people to access the lower sections of each main level of the home may present a potential fall hazard to people with dementia. We discussed this issue with the manager who undertook to consider ways of making the top of these stairways more noticeable to people when they approach them. Bathrooms had aids and adaptations to meet the needs of the people using the service, and there were sufficient toilets sited close to communal rooms. The manager said that all bathrooms and shower rooms had wcs and all bedrooms had en suite wc. Bedrooms seen were bright, clean, comfortable and made homely with peoples Care Homes for Older People Page 20 of 28 Evidence: personal possessions. During discussion with service users all who expressed a view confirmed that their rooms were comfortable and kept clean. Comments made included yes my room is always kept clean, my room is cleaned regularly by staff, the home is kept clean. The communal space in the home included seven lounges/dining rooms, including a sensory lounge and a smokers lounge. Communal rooms were bright and the furniture looked comfortable. The manager said that since our last inspection all communal rooms had been redecorated. The garden areas were well maintained. Some of the garden was slopping and therefore may not be easy to access by some service users, however there was a patio at the rear which was flatter where there was a gazebo and seating. The laundry areas were looked at and the equipment in place was considered suitable for the size of the home. There was also sufficient space for staff to work in. 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. People are cared for by a properly recruited and trained staff team. Evidence: The homes staffing rota was looked at and showed daytime staffing levels as six carers and one CTM on morning shifts, and five carers and one CTM on afternoon shifts. The managers hours are supernumery (extra) as are the deputy managers hours on two days each week. On the remaining days the deputy manager is part of the care team and performs the duties of a CTM. Night staffing is two waking carers and one CTM. In addition to the care staff the home had staff to cover the following roles, cook, kitchen assistant, administrator, housekeeping, laundry, domestic, activities coordinator and a maintenance person. Staff spoken with confirmed that regular team meetings take place to ensure that all are kept informed of relevant issues and are able to take part in planning and decision making in the home. Minutes of past meetings were seen. Discussion had included health and safety, training, abuse awareness, philosophy of care in the home and staffing. Three staff recruitment files were inspected. Evidence was seen to confirm that application forms had been completed, interviews held, written references obtained, written terms and conditions issued, and criminal records checks undertaken. Copies Care Homes for Older People Page 22 of 28 Evidence: of proof of ID, photographs and job descriptions were also on files. Staff are supported in undertaking NVQ training, and information provided with the AQAA states that thirty one out of thirty five permanent care staff have achieved or were undertaking their NVQ 2 or 3 awards. This figure includes all CTMs who have their NVQ awards and well exceeds the 50 recommended number of staff with this award. Staff records seen showed that new staff undergo initial orientation induction training covering health and safety subjects, service user care and abuse awareness. After this staff move on to full induction based on the Skills for Care Common Induction Standards for social care staff. Staff said that they received induction training, they also said that the manager is supportive and will respond quickly to any queries or concerns they may have regarding service users well being. All staff have individual training records and there is a training matrix which identifies training undertaken for the whole team, as well as when updates are due. Training records seen and discussion with staff confirmed that staff had been provided training on, dementia awareness, activities, food hygiene, manual handling, first aid, NVQ, health and safety, infection control, challenging behaviour, fire safety, abuse awareness (safeguarding), falls prevention, medication and the mental capacity act. Comments in staff surveys returned to us also confirmed that they had received regular training. 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. People live in a well run home that is managed in their best interests. Evidence: Since our last inspection the registered manager had retired and the previous deputy manager had been promoted to manager. The new manager said they had twelve years experience of working in the care sector with three of these as deputy manager at The Grange. The manager holds the NVQ 3, has enrolled onto the Leadership and Management award level 4, and has applied for registration with the Commission. The quality assurance (QA) process used at The Grange involves a planned annual audit of the service by the providers. The last audit was seen and this was dated January 2009. A report is compiled on the findings, this was also seen by us and included an action plan of what the manager needs to do in response to improvements identified. Items on the action plan had been signed off once completed. The QA process was seen to include gathering the views of service users and their relatives. This included a monthly survey asking them their opinions on food, admission Care Homes for Older People Page 24 of 28 Evidence: information, staff attitudes and social activities provided. The manager confirmed that personal allowance monies are held for safe keeping for some service users. Records had been kept of the balances held and of receipts for expenditure. A random sample of these were checked and found to satisfactory. Staff had received regular 1 to 1 supervision support and annual appraisal. The manager provides this to CTMs who in turn support other staff. Records of this process were seen and included discussion on key worker role, service user issues, training, health and safety, responsibilities and development needs. We asked staff if they felt properly supported by the manager and all who responded agreed that they were. Actual comments made in surveys returned to us included there is good support from the manager and all senior staff, the new manager has worked hard to complete all the needs of the home, the new manager is always available to discuss peoples needs. Random samples of records required to be kept were looked at. These included, the Statement of Purpose and Service Users Guide, assessments, care plans, staff rotas, staff recruitment, visitors book, fire drills, nutrition, medication, background info and next of kin details and fire procedures. All of these seen were satisfactory. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling, fire safety, food hygiene, first aid and health and safety. There were also premises and fire risk assessments in place to try to minimise risks in these areas. The fire service visited the home in August 2009 and identified an issue relating to required improvement to fire doors. The manager confirmed that the registered provider was taking the appropriate action to rectify this issue. Certificates and service records were seen to confirm that the homes hoists, passenger lift, emergency lighting, fire equipment and alarms, electrical installation supply, gas boilers and portable electrical appliances had all been tested/serviced. Hot water temperature is regulated and manual checks are also carried out regularly. These were seen. 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 1 19 13 The registered provider needs, where possible, to make stairways in the home safer for people to use. This is to reduce, where possible, potential hazards to peoples safety. 31/12/2009 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 19 Damaged cupboard doors in the kitchen should be replaced or repaired. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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