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Inspection on 04/08/09 for The Old Vicarage (Allithwaite)

Also see our care home review for The Old Vicarage (Allithwaite) for more information

This is the latest available inspection report for this service, carried out on 4th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Old Vicarage is a friendly care home with `family` feel, where people said they were made very welcome. There was good written information provided about the service and the admission process for new people was welcoming and reassuring and helped people settle quickly. Each person had an individual plan of care, which they were consulted on, and this included any personal wishes and choices. People spoke highly of the care they received, saying they were very well looked after. People in the home looked well cared for and content, and had good access to general health care services. The staff worked with the local district nurses to access specialist equipment as needed and to provide comfortable end of life care. The management of medicines was safe. People felt they had choices in their day to day life and enjoyed the level of social activities provided. There was a good range of activities and entertainment both in the home and outside, with events taking place throughout the year. The home maintained good links within the local community and enjoyed many visitors. The provision of food was also highly praised. People said they were able to influence the menu and were very happy with the quality and choice of meals served. Birthdays, anniversary`s and other special occasions were celebrated, and people appreciated and enjoyed this. People said the manager and staff were very approachable and felt they could safely raise any concerns or complaints with them. There was a low incidence of complaints, and those made had been handled sensitively. The staff team were committed and caring and had good access to continuous training and development. The building was well kept and had benefited from a lot of decoration. The home was warm, comfortable and clean throughout with good standards of hygiene maintained. People were happy with their accommodation and had the aids and equipment they needed.

What has improved since the last inspection?

Since the last inspection a lot of decoration and replacement of carpets, curtains and furniture had taken place. In response to peoples` suggestions, new smaller dining tables and matching chairs had been ordered, and the gardens had been improved. There was also a new washing machine, and new towels and wash cloths had been purchased for everyone. Staff training had increased with 70% of care staff now having a National Vocational Qualification in care and seven staff had completed training in palliative care. The manager had continued to listen to, and act on peoples` views to improve the service.

What the care home could do better:

It was recommended that the manager produce written guidance for staff on the use of `as required` medicines. This is help staff to understand what these medicines are used for and to know when it is appropriate to administer them.

Key inspection report Care homes for older people Name: Address: The Old Vicarage (Allithwaite) The Old Vicarage (Allithwaite) Allithwaite Grange-over-Sands Cumbria LA11 7QN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jenny Donnelly     Date: 0 4 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Old Vicarage (Allithwaite) The Old Vicarage (Allithwaite) Allithwaite Grange-over-Sands Cumbria LA11 7QN 01539533703 01539536954 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Barbara Siddiqi care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home The Old Vicarage is owned by Mrs Barbara Siddiqi. Mr Kamal Siddiqi acts as the business/general manager, and Alison Adair is the registered manager. The home is situated in the quiet village of Allithwite, which is within two miles of Grange over Sands. There is a bus route near by and the nearest shop is half a mile away. The Old Vicarage is registered to provide accommodation for up to nineteen older people, nine of whom may have varying forms of dementia. The building is an older property that has been adapted and extended for its present use as a care home. There are thirteen Care Homes for Older People Page 4 of 27 Over 65 0 19 19 0 Brief description of the care home single rooms and three doubles, although all the rooms are currently used for single occupation. Accommodation is provided over two floors with the upper being served by a passenger lift. The toilets and bathrooms are equipped to assist people with a disability. There is a lounge, dining room and conservatory providing communal space for the residents. The weekly fees range from £540.00 to £680.00 according to care needs and the type of bedroom occupied. There are extra charges for newspapers, magazines, hairdressing, chiropody and personal toiletries. This home does not provide intermediate care. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the main or key inspection for the year. The lead inspector Jenny Donnelly asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was fully completed and returned to us by the date we asked. Jenny Donnelly made an unannounced visit to the care home on 4th August between the hours of 09.30 and 15.30. During this visit we (the Care Quality Commission) toured the building, spent time in the lounges, and dining room where we joined people for lunch. We spoke with people living in the care home and their visitors. We also spoke with the registered manager, general manager and the staff on duty. We looked at files and documents that backed up what we were told and what we saw. The last key inspection took place in August 2007, and in August 2008 we completed Care Homes for Older People Page 6 of 27 an Annual Service Review. An annual service review is where we look at all the information we have gathered about a service over the previous year, including the managers Annual Quality Assurance Audit and surveys that we sent to people who live in the home. From this we make a judgement about whether the home is continuing to provide a good service to people, or whether we need to inspect sooner than planned. We received positive feedback about The Old Vicarage, and did not alter our inspection plan. Copies of all these reports are available on request from us, or from the care home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: It was recommended that the manager produce written guidance for staff on the use of Care Homes for Older People Page 8 of 27 as required medicines. This is help staff to understand what these medicines are used for and to know when it is appropriate to administer them. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was good information available about the care home, and the assessment process helped people know if the home would meet their needs. New people were made welcome and helped to settle in. Evidence: The service has developed a helpful information pack, and a welcome pack for new people. This includes general information about the care home and the services and facilities on offer. It also includes a copy of the homes latest inspection reports, a copy of the complaints procedure, sample menus and a sample activity programme. People moving into the home had a four week trial period to see if they settled in and to make sure the home was suitable for them. New people were only offered a place in the home after an assessment of their needs had been carried out. We saw copies of these assessments and found they included all the basic details about peoples health, personal and social care needs. We saw that Care Homes for Older People Page 11 of 27 Evidence: the manager also gathered information from other professionals involved with the person, such as their social worker or previous carers. These assessments were used to draw up a plan for care for the person. People were issued with a statement of terms and conditions for their stay, these were either by private arrangement or managed through a funding body such as the council. We saw copies of these agreements were kept on file. Visitors told us they had been made very welcome when they first came to look around the home, saying the manager had been helpful in giving them information. One person we spoke with said she had settled in very quickly as the staff were so friendly. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received good quality health and personal care that took into account their wishes, and was delivered in way that was acceptable to them. Evidence: Each person had an individual plan of care set out in a book specially designed for this purpose. We looked at three of these books in detail and found they contained all the necessary information. Care plans clearly described what level of care and support each person needed and took into account their personal wishes and choices. Care plans and risk assessments had been reviewed and updated monthly. People, or their relatives, had been regularly asked to read and sign their agreement to the care plan. We saw some people had written comments saying how pleased they were with the care being provided. We talked with people living in the home and with some visitors who all told us they were pleased with the standard of care, saying they were well looked after. People said their individual choices and wishes were respected, and that staff accommodated their requests. We saw that those people who were unwell and stayed in bed, received Care Homes for Older People Page 13 of 27 Evidence: plenty of attention throughout the day. Everyone appeared well cared for, suitably dressed in clean clothing and with their hair tidy. People confirmed they were able to have regular baths, and said personal care was delivered sensitively and in private. People had been assessed for any specialist equipment they needed such as moving and handling aids, continence supplies and soft mattresses to prevent pressure sores. There were good arrangements in place for people to access their doctor, the district nurse and other health care services such as the dentist and optician. Nutritional screening was carried out to identify those people who needed additional support to take adequate food and drink, and peoples weight was checked as needed. The management of medicines in the home was safe. There were policies and procedures to guide staff, and all staff who administered medicines had received training to do so. There were good systems for ordering and receiving medicines into the home, for administering them, and disposing of any waste medicines. This meant all medicines in the home were properly accounted for. We carried out some random stock checks and found the records and stock were accurate. We saw that the supplying pharmacist visited the home occasionally to check on stock control and storage. There were lists of each persons medicines, which explained to staff what each medicine was used for. Whilst these lists were helpful, some of them were not up to date and did not include all the medicines prescribed, especially those prescribed for as required use. We recommend that there should be some written guidance for staff on the use of as required medicines, so staff know what these medicines are used for and when it is appropriate to give them. The manager agreed to do this. Seven staff had received training in palliative care at the hospice, and the care home worked in partnership with the district nurse to provide end of life care for people. We saw that advance symptom control prescriptions had been written for one person, and these drugs were in stock ready for use without delay when needed. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were encouraged to make choices about their daily lives and were very happy with the activities, entertainments and meals provided. Evidence: Daily routines in the home were flexible to peoples changing needs and wishes. We saw that people could choose whether to stay in their bedrooms during the day or use the shared lounge areas. People were free to walk about and sit where they wanted without interference from the staff. There was evidence of past activities and entertainment in the photograph albums on display. Notices advertised forthcoming monthly events, these included an outing in the Lake District, a strawberry fair, and visiting entertainer, bonfire night and a Christmas party. There was also a weekly programme of in house activities which included bingo, bowls, singing, manicures, board games and quizzes. During the inspection we saw a group of people enjoying a movement to music exercise session. The home maintained good links with the local vicar who visited people on request. The hairdresser called every week. People we spoke with told us about a recent barbecue and a visiting musician they had enjoyed. Activities and entertainment were optional and people said it was up to them whether to join in or not. Several people said they were looking forward to the Lake Care Homes for Older People Page 15 of 27 Evidence: District outing, but others wanted to see how they felt on the day. People told us the social events on offer were just the kind of thing they wanted. Visitors confirmed they saw a number of events and activities taking place. Some people also enjoyed trips out with their friends and family. One person we spoke with had a good arrangement with her family to get on line shopping delivered for personal items. This person also said the manager or staff would do little chores for her such as pick up new clothes if she asked. Birthdays were celebrated in the home and one person told us the staff always gave people a present and a card, and the cook made a birthday cake and a special buffet tea for everybody. We heard the manager discussing what present to buy for a birthday later that week. Visitors told us they were always made welcome and offered refreshments. We saw a large number of visitors during the day most of whom were well known to the manager and staff. The atmosphere in the home was good, and there was a lot of cheerful chatter taking place. Everyone we spoke with said the food in the home was excellent. The menus showed mainly traditional dishes as this is what people wanted to eat. There was a good choice of breakfast items including cooked breakfast. There was a choice of two main dishes and two desserts at lunch time and again in the evening. We joined a small group of people for lunch and there was a choice of poached salmon in white wine sauce or cottage pie, both with fresh vegetables. This was followed by strawberries and cream or bread and butter pudding. We saw one person had chicken and another had rice as requested. Everyone was seen to eat well and enjoy their meal. Staff were around to help as needed and there were plenty of drinks served throughout the day. The cook had a list, and knew about peoples individual likes and dislikes, and would cater specially for people as needed. The quality of the food served was very good indeed and people said they got plenty to eat. Menus were updated seasonally and took into account peoples views and any requests they made. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew how to raise concerns and complaints and felt confident these would be listened to and acted on. People told us they felt safe in the home and staff were aware of their responsibility to report any safeguarding concerns. Evidence: The service had a complaints procedure, a copy of this was on display, and in the welcome pack given to new people. People we spoke with all said they had no complaints about the service, saying; There is never a thing to complain about, and Everything here is perfect. People told us they knew how to raise any concerns or complaints they might have, and felt confident that the manager would listen and put things right. The manager had kept a record of complaints made and we saw this consisted of a number of minor complaints by one person, mostly about the food. We saw that the manager had dealt positively with these concerns and tried on each occasion to put things right for them. We had not received any complaints about this service since the last inspection. There were policies and procedures in place to safeguard people from harm and abuse, and the majority of staff had received training in this. Staff we spoke with were confident about recognising abusive situations and understood the process for reporting any concerns. The manager had a copy of the Cumbria multi-agency Care Homes for Older People Page 17 of 27 Evidence: guidelines for safeguarding and was aware of her responsibility to report any concerns to the appropriate authorities. People we spoke with said they felt safe living in this care home and did not think anything bad would happen here. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live a clean, comfortable and well maintained home that is suitably equipped to meet their physical needs. Evidence: The Old Vicarage is a detached older property standing in its own grounds, that has been adapted and extended for its current purpose. There is car parking to the front of the building with gardens surrounding it. There is ongoing maintenance and renewal of the fabric and decoration of the home. There is a comfortable lounge, a dining room and a large conservatory for shared use. There is also small seating area in the corridor where people like to watch who passes by. There are two bathrooms, one with a Jacuzzi bath and shower attachment, there is also a separate shower room. There are plenty of spacious toilets situated around the home. Every bedroom has a wash hand basin, and some have an en suite. There are handrails in corridors and grab rails in the bathrooms to assist people who are unsteady. The home also has two hoists and can access pressure reducing mattresses and specialist beds from the district nurse as needed. There is lift to the upper floor. Bedrooms vary in size and shape according to the nature of the building. The bedrooms had been nicely personalised and made homely, and people we spoke with were very happy with their accommodation. One person told us they had been offered Care Homes for Older People Page 19 of 27 Evidence: a larger room, but had chosen to stay in their smaller cosy bedroom. People had been able to bring in their own pieces of furniture, as space allowed if they wished to. Since the last inspection a lot of decoration and replacement of furnishings had taken place. The lounge had been decorated and had new curtains and carpet provided. Some armchairs were in the process of being re-covered to match. In response to peoples suggestions new smaller dining tables and matching chairs had been ordered, and we were able to see a set that the home had on approval. The dining room already had a new carpet and had been decorated. All corridor and stair carpets had been replaced a number of bedrooms had been decorated and also had new carpets. There were new blinds in the conservatory, the garden had been tidied and new garden furniture purchased. The manager hoped to be able to upgrade the bathrooms in the near future. People told us they were very pleased with all these improvements, and felt proud of how nice their home looked. The home was warm and comfortable with good lighting, and was clean and fresh throughout. People told us the home was always clean and said the staff worked hard to keep it so. People confirmed that the laundry was good, their clothes were nicely presented and they had regular changes of bed linen. All the towels had recently been replaced and people were given two fresh towels and wash cloths daily. There was a new washing machine. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported by a caring and well trained team of staff who had been thoroughly vetted before coming to work in the home. Evidence: The home generally has three care staff on duty during the morning and early afternoon, reducing to two staff for the remainder of the day and overnight. There had been some shortages over the summer because people were taking holidays, and one person left and another was sick. This meant there were times, such as the day we visited, when there were just two care staff on duty in the morning, one of which was the registered manager. Staff we spoke with during the day confirmed that although they preferred having three staff on duty, they were still able to provide good levels of care with two. We saw that people were well cared for throughout the day, no one was kept waiting for attention and bathing had taken place as normal. The manager had recruited a new carer who was due to commence work the following month. Other staff on site included the cook, the domestic, the laundry person and Mr Siddiqi the general manager. Both the registered manager and the general manager recognised the value of good staff training, and as such supported staff to achieve National Vocational Qualifications (NVQ) in care. We saw that 70 of the care staff had achieved this which is very good. We looked at training records and saw qualified trainers had been brought in to Care Homes for Older People Page 21 of 27 Evidence: update staff on first aid, safe moving and handling, food hygiene and infection control. Five senior staff had attended a medicines training course at the local college and seven staff had attended four training sessions in palliative care at the hospice. The manager and two seniors had attended training on the Mental Capacity Act, and further sessions in all subjects were planned throughout the year. The general manager was qualified to provide fire safety training. Staff on duty confirmed they had attended the training that was recorded in their files and were able to tell us about the content of the training and who provided it. We checked the homes recruitment procedures by looking at staff files and talking to staff about their application process. We found that all necessary pre- employment checks including written references and criminal records bureau checks had been carried out. This helps to protect people from having potentially unsuitable persons working in the home. Staff were positive about their experience of working at The Old Vicarage, and the people living in the home spoke well of the manager and her staff team. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were living in a safe, well managed home where their views were listened to and acted on. Evidence: The registered manager Alison Adair had been in post for two and a half years. She had a Registered Managers award and was in the process of completing a National Vocational Qualification at level four along with her deputy. She is an experienced and competent manager, who was being well supported by the home owners. People living in the home, and visitors, knew her by name and told us they felt comfortable talking to her. The manager generally has 18 hours a week administration time with the remainder spent working as a carer, although this had increased over the summer due to staff holidays. There was a quality assurance system in place that included surveys from people living in the home, their relatives and the staff group. We saw the results of these surveys had been used to inform the homes business plan for the coming year. Care Homes for Older People Page 23 of 27 Evidence: Things people had asked for such as smaller dining tables, new choices on the menu and improved gardens, had been provided. People confirmed that both the registered manager and general manager speak with them on a regular basis and are interested to hear their ideas and suggestions. We saw the 2009 business plan which detailed the planned spending on renewals and renovations to the home and staff training. There was clear evidence of forward planning and ongoing investment into the care home. The managers did not handle anyones personal finances, with any extra costs for hairdressing, newspapers and so on being invoiced. A number of people managed their own financial affairs with help from their families. Staff told us they received individual supervision with their designated supervisor every two months, and we saw records to back this up. We also saw records to confirm that health and safety checks and servicing to the building and equipment were up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 It is recommended that the manager provide some written guidance about each as required medicine, so staff know what these medicines are used for and understand when it is appropriate to administer them. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 27 of 27 - 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. 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