Inspection on 11/05/09 for The Queensmead

This is the latest available inspection report for this service, carried out on 11th May 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Queensmead 19/12/06

The Queensmead 23/01/06

The Queensmead 23/08/05

The Queensmead 21/02/05

The Queensmead 31/08/04

The Queensmead 19/12/03

Extracts from inspection reports are licensed from CQC, this page was updated on 21/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Queensmead Victoria Road Polegate East Sussex BN26 6BU     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: Melanie Freeman     Date: 1 1 0 5 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 29 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 29 Information about the care home Name of care home: Address: The Queensmead Victoria Road Polegate East Sussex BN26 6BU 01323487931 01323488120 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Chanctonbury Healthcare Limited care home 37 Number of places (if applicable): Under 65 Over 65 37 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 37 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home The Queensmead is registered to provide personal care for up to 37 older people, over 65 years of age. The home is situated in a residential area of Polegate, close to the towns high street with shops, the library and public transport within walking distance. There is a large lounge that is used for social activities, a separate dining room, a conservatory at the front of the building and smaller seating areas near the reception and on the first floor. There are 35 bedrooms in the home arranged over three floors; 33 of which are single occupancy (of which all have en-suite facilities) and 2 of which Care Homes for Older People Page 4 of 29 1 7 1 1 2 0 0 8 Brief description of the care home are double occupancy: one is arranged as a self contained flat providing accommodation for married couples (both double occupancy areas have en-suite facilities). Additional toilet and bathroom areas are available throughout the premises. A shaft lift enables residents to have access to all parts of the building. There are attractive gardens surrounding the home that are accessible to wheelchair users and is used by residents and staff when the weather permits, with additional seating areas to the front of the building. There is also a parking area to front of the building. Potential new residents can obtain information relating to the home via CQC Inspection Reports, Care Managers, Placing Authorities, the internet by word of mouth and by contacting the home direct. The fees charged are approximately 595 pounds per week, with additional charges made for hairdressing and chiropody. Care Homes for Older People Page 5 of 29 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Queensmead will be referred to as residents. This was a key inspection that included an unannounced visit to the home by a regulatory inspector who was accompanied by a Pharmacist inspector working for the Commission who assessed the medicine management in the home. The inspection visit was completed on Monday 11 May 2009, and follow up contact was made with two visiting health care professionals. The allocated inspector spent Care Homes for Older People Page 6 of 29 approximately six hours in the home and was able to discuss matters with the appointed manager. She also spent time meeting with residents, staff and visitors and observing practice in the home. A tour of the premises was undertaken, and a range of documentation was reviewed including the homes statement of purpose and service users guide, pre-admission assessment procedures, the systems in place for handling complaints and protecting residents from harm, staff training records, quality assurance systems and some health and safety records. The care documentation pertaining to three residents were reviewed in depth, and the inspector ate a midday meal with the residents in the dining room. Comments shared about the home during the inspection process by residents and visitors included I am happy here the girls are lovely very good here I like having my visitors Like the staff who are all very good I am able to do much as I want all well here, could not be better, good food and the cook is good, quite happy here nothing to complain about get everything you need beautiful food no complaints but get a bit bored I am full of praise for the home and the staff. What the care home does well: What has improved since the last inspection? What they could do better: In the past managers have been appointed but have not provided a suitable Care Homes for Older People Page 8 of 29 management provision, causing an instability for staff and residents. The home has now appointed another manager who has confirmed a commitment to the home, saying that she will remain in post for at least a year. The improvements that she has made now need to be embedded into routine daily practice. Although the management of medicines has been audited and reorganised, and now overall the home maintains safe systems on the handling of medicines. Some further improvements are required. The home needs to establish detailed care plans on the procedure for managing self administration and medicine prescribed for only when needed. This will ensure that staff have detailed information on why and when medicines are to be given, and will promote consistency. The home needs to provide complete documentation within the plan of care on medicine usage, so that a clear picture is available on the medicine profile, and history for each resident. 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. 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 29 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 29 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. Prospective residents and their representatives are provided with information about the home, in order to make an informed choice about whether to live at the home. The admission procedures ensure that all prospective residents are fully assessed by a competent person before admission, and are assured that their needs can be met by the home. Intermediate care is not provided at Queensmead Care Home. Evidence: The homes statement of purpose service users guide was available on request at the reception area, and it was noted that each resident had a copy of these documents, that are held within a combined folder. These documents were extensive, informative and contained useful information. The appointed manager confirmed that she would ensure that a copy of the homes terms and conditions is included within this document for reference purposes, as required. Care Homes for Older People Page 11 of 29 Evidence: The admission process has been further formalised since the last key inspection and an admission pack has been setup, this includes relevant documentation that is to be used to ensure a thorough process is followed. It was clear from residents spoken to that they had chosen to live at Queensmead with one resident saying I arrived for respite care and chose to stay for ever. The home is keen for residents to have a trail period and make a positive choice to live at the home. An assessment of the admission process included a review of the documentation used in respect of the last three admissions to the home. This confirmed that an assessment process is completed on all prospective residents, and that this is normally completed by the appointed manager. These assessments take into account information from other sources, and allows for a full discussion on what Queensmead can offer. The assessment documentation could be further improved with a record of where the assessment took place. Although the admission process on the whole was found to be thorough, and it was noted that the most recent admission to the home was provided with a letter confirming that the home could meet their assessed needs. The two previous admissions had not been written to in this way. The manager was able to demonstrate how the systems had been improved and was confident that appropriate letters would be sent in the future. All residents are admitted on a trial basis which ensures that the admission is suitable, and effective for the residents, as well as the home. Care Homes for Older People Page 12 of 29 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 individual plans of care set out residents personal and health care needs, although the care documentation needs to reflect a more person centered approach to care, with further attention to detail. Residents health care needs are met with the advice and support of community health care professionals. The homes practice ensures on the whole that residents medicines are stored and administered safely. Care is delivered in such a way that promotes and protects the residents privacy, dignity and individuality. Evidence: The care documentation pertaining to three residents were reviewed as part of the inspection process, and each of these residents were met with during the inspection visit to the home. Each resident had a plan of care and this set out the basic care needs of these individuals. On the whole these were found to be comprehensive covering the basic care needs of residents. It was however noted that they did not reflect the individuality of each person or individual preferences, and needed to contain Care Homes for Older People Page 13 of 29 Evidence: more detail. The need to record and reflect a more person centered approach to care was discussed with the appointed manager. There was evidence that the plans are reviewed at least on a monthly basis, and the manager was able to demonstrate that in most cases a discussion with the resident or their representative is recorded, somewhere in the care documentation. A clear system needs to be established to record and promote residents involvement on the planning of their care. Routine risk assessments are used to inform the care provided and include those used for nutrition, moving and handling and skin damage. Observation during inspection confirmed that residents care is tailored to them promoting a level of independence and decision making. There was evidence within the care documentation that confirmed regular contact with GPs and other health care professionals that support the home in providing a high level of care to residents. Visiting health care professionals contacted after the inspection visit confirmed that the home responds pro-actively to the health care needs of residents and put themselves out in helping residents to remain in the home, where they want to stay, as their needs change or vary. All feedback about the care provided received from residents, relatives and visiting professionals was very positive and comments included I like it here everything is nice it suites me here and I like to be here There is help if you need it it is wonderful here all well here, couldnt be better, good food and the cook is good, quite happy here noting to complain aboutI am happy here and the girls are lovely I am full of praise for the home and the staff. The Commissions Pharmacist completed an inspection visit as part of this key inspection, and assessed the medicine management in the home. The storage facilities for medicines in the home were found to be good. A third of the residents manage some, or all of their medicines themselves, and were supported to do so. This was done against a competency and risk assessment, although there was no individual detailed care plan on how the self administration is managed. Good records are available on medicines orders, receipts, administration, and disposals. On occasions administration records omitted certain details on the daily notes e.g. one medicine had been stopped but this was not recorded in the notes, and on the Medicine Administration Record (MAR) chart, it was recorded as not available and one person was not given medicines, as they were asleep the whole day. This was Care Homes for Older People Page 14 of 29 Evidence: not clear in the care notes. On the MAR chart it was recorded as asleep suggesting that this person was asleep only at medicine time. There was no indication that this person was asleep the whole day. For medicine prescribed only when needed, there was no care plan giving guidance on when to give this medicine for consistency. Many externally applied medicine were marked as see care plan. Records held within the plans of care however did not evidence that these creams had been administered. Controlled drugs records for the current situation were in order. There was one confusing record and although there was no concern regarding misappropriation of Controlled drugs, there was a need to understand the importance of clear, accurate record keeping, particularly with Controlled drugs. There were good written policies on medicine management, although there was no policy on homely remedy. The manager informed that this was to be put in place shortly. Residents were seen to be well dressed and were being addressed in accordance to their recorded wishes. Communication between residents, visitors and staff was friendly, relaxed and demonstrated a very caring approach. Visiting health care professionals spoken to confirmed that when they visit, they are assisted to see any resident in private. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides some social and recreational facilities, and links with friends and relatives are encouraged. Residents benefit from good quality food that offers choice and meets special dietary needs, and are able to make choices about all aspects of their day to day lives. Evidence: Queensmead has a relaxed atmosphere, with residents able to move around the home as they wished. During the inspection visit it was observed that people spent time in various areas of the home and were able to mix in small groups. Residents spoken to said that although they could do much as they wanted to, the level of activity in the home is now, not as good as it used to be. Comments included.outings have not been provided recently I have no complaints but do get bored The appointed manager confirmed that the home does not have a designated activities person, and although two care staff are providing some activity, she acknowledged that this provision needs to be improved and formalised. Care Homes for Older People Page 16 of 29 Evidence: She recognises the importance of external input that can provide different resources and emphasis to the activities and entertainment in the home, and intends to access suitable sources in the near future. Contact with family and friends is positively encouraged with visitors being able to attend the home at any time, and in accordance with the residents wishes. There are areas in the home that allow for residents to see visitors in private. Residents said that they liked their own rooms and it was noted that they were able to have their own possessions around them. Residents religious needs are explored and responded to, along with other lifestyle choices. During the inspection visit it was noted that one resident who was very ill, was visited by a priest at her request. Feedback received from residents about the food was mostly very positive, and the meal eaten with two residents in the communal dining room, was of a high quality. Choices were available and individual preferences were also responded to. The desserts were presented on a desserts trolley, and provided at least three choices. All residents in the dining room expressed a satisfaction with the meal served, and the chef was available in the dining room to respond to requests, and to receive any direct feedback about the food. Comments received about the food included good food and the cook is good food can be a problem and the meat can be tough ever thing you need beautiful food. The dining room is very attractive and provides comfortable facilities. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a robust and efficient complaints procedure, and the homes procedures, processes and staff training should protect residents in the event of an allegation, or suspicion of abuse. Evidence: A clear complaints procedure is available within the service users guide. The record of complaints held in the home demonstrated that two complaints had been received since the last key inspection, and that these have been fully investigated and responded to. All residents spoken to were confident about raising any concerns, if this was necessary. The home has an Adult Protection procedure. A review of this indicated that this procedure needs to be updated, to clearly record that social services must be notified of any allegation or suspicion of abuse, before an investigation is undertaken by the home. The appointed manager has a good understanding of protection issues, and agreed to update the procedure accordingly, and to ensure it takes into account the most recent local polices and procedures, which were available in the home. Staff training has been provided in the past, and the appointed manager was able to Care Homes for Older People Page 18 of 29 Evidence: demonstrate that further staff training has been organised, to ensure all staff are suitably trained on safeguarding matters. She also confirmed that she is always available, to be contacted for clarification and advice if needed. Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. Care Homes for Older People Page 19 of 29 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 home provides a comfortable, clean and safe environment for those living in the home, and visiting. Some improvement is required to ensure suitable bathing facilities are available to all residents. Evidence: Queensmead is a purpose built home located in a residential area close to the centre of Polegate. The location and layout of the home are suitable for its stated purpose. The home is well maintained, and all areas of the home, including the garden, are accessible to residents. Although the home is reasonably well maintained there is a plan to upgrade the whole home to provide a high standard of furnishing and decoration. The reception area is central to the home life, with residents and visitors referring to the receptionist, regularly for information and for conversation. The home has several separate recreational spaces, that residents can access at will, and include a separate dining room and conservatory area. The environment was found to be clean and fresh trough out, and it was noted that liquid soap and paper towels, have been provided to all communal hand washing Care Homes for Older People Page 20 of 29 Evidence: areas. It was also confirmed that the home is to purchase, and fit these at all hand washing areas, to promote good infection control practice in the home. Rooms viewed during the inspection visit were found to be personalised and appropriate to residents needs. Some rooms were found to have wall mounted heaters that were not guarded, and therefore posed a risk to residents. When this was raised with the appointed manager she checked where these heaters were, and following risk assessment and discussion with residents, all these heaters were removed. She also gave a commitment to improve the heating in any areas, where there may have been a problem in the past. As identified at the last inspection the bathing facilities are not adequate, with only two bathing facilities that can be used to assist residents with a bath or a shower. This provision needs to be improved to ensure residents can have access to a suitable bathing facility as often as they wish. The appointed manager confirmed that a third bathroom currently not in use, is to be upgraded to provide a further assisted facility. All rooms are single with en suite facilities, apart from two that can be used as shared accommodation if wanted, and requested by a couple. The ground floor has a small sluice room, that is used to clean commode pots and urinals. This cleaning is done by hand as there is no electrical disinfector. The appointed manager needs to keep the sluicing facilities and infection control practice, under review to ensure good infection control measures are followed at all times. Care Homes for Older People Page 21 of 29 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. Staffing numbers and skill mix provides a competent staff team, that meets residents health and personal care needs. Residents are protected by the recruitment practice followed. Evidence: At the time of this inspection visit the home was occupied by 30 residents. The staffing arrangements seen and recorded were found to be appropriate. Staff and residents spoken to felt that there was enough staff to meet the health and personal care needs of residents. The staffing levels provide 5 carers in the morning with 4 cares working in the afternoon and evening. The manager is in addition to this, as is the catering and domestic support. Although the duty rota confirmed the staffing levels are maintained throughout the week, it did not identify who was the senior member of staff who would be taking charge of the home, when the head of care, manager or senior carer was not on duty. The appointed manager explained that although staff had not been given a senior role, they had the competency to take responsibility for the home. She agreed however that a lead person needed to be clarified, and that this could be used as a competency assessment. Senior staff on call arrangements are in place which provides further support and advice if needed. Care Homes for Older People Page 22 of 29 Evidence: The last AQAA confirmed that over 50 of staff have a National Vocational Qualification in care at a level 2 or above, or equivalent. The appointed manager confirmed that staff training had been neglected over the past year with changes in the management of the home. She has now allocated the responsibility to arrange and co-ordinate staff training to a senior carer. There was evidence within the training diary to confirm that staff training is being re established, and that there is a commitment within the organisation in maintaining a good level of throning, and skills throughout its workforce. There have been no new staff employed since the last key inspection. Recruitment practice in the past has been good, and there was no indication that this practice had changed. All feedback received about the staff working in the home was positive and comments included I am happy here the girls are lovely I like the staff who are all very good ,staff are approachable staff are happy to put themselves out staff are always polite and considerate. Care Homes for Older People Page 23 of 29 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. A competent and skilled manager has been appointed, and is providing stability and much needed leadership to the home. Quality monitoring processes are well developed and take into account residents views, the financial interest of residents are safeguarded. Systems are in place to protect the health, safety and welfare of residents and staff. Evidence: Following the last key inspection the then newly appointed manager resigned. She has been replaced by the regional manager, who has now been appointed as the homes manager. She is progressing her registration with the commission, and has made a commitment to stay in post for at least a year. There is a recognition within the organisation that Queensmead has lacked leadership and direction, and that the managers role is key in maintaining a good quality home. The appointed manager has Care Homes for Older People Page 24 of 29 Evidence: demonstrated that she has the skills and competence to manager the home, and has previously been the registered manager of another home within the Organisation. She is providing the required stability, and works well with staff and the lcoal resources, and is supported by a Head of Care. Residents know who she is and a relative spoken to confirmed that the management of the home had improved. There has been some difficulty in the past with the lack of management that has led to a lack of communication. This has now been addressed and is now stable. The management arrangements in the home provide a structure, that identifies clear lines of accountability. Professionals spoken to praised the Head of care who is seen as very caring and this sets a standard for staff to follow. The home uses a variety of quality auditing systems, which include audits completed by other home managers in the Organisation, the required regulation 26 visits are completed by Mr Hignett, the Operations Manager. Health and safety audits, and regular feedback from residents and staff within meetings and questionnaires. The last AQAA was well completed and used as an audit and quality improvement tool. The home does not take any responsibility for any of the residents finances and most residents have family, friends or representatives who protect their financial affairs. Small deposits of money accounts are held for some residents but the number of these is being reduced. The appointed manager advised that suitable systems are in place to safeguard residents monies. Systems have been put in place in relation to the health and safety of residents and full environmental risk assessments are now completed. Care Homes for Older People Page 25 of 29 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 29 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 9 13 The home needs to establish 26/06/2009 detailed care plans on the procedure for managing self administration and medicine prescribed for only when needed. This will ensure that staff have detailed information on why and when medicines are to be given and will ensure consistency. 2 9 13 The home needs to provide complete documentation within the plan of care on medicine usage. So that a clear picture is available on the medicine profile and history for each resident. 26/06/2009 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 Care Homes for Older People Page 27 of 29 Care Homes for Older People Page 28 of 29 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). 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. Care Homes for Older People Page 29 of 29 - 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!