Inspection on 19/05/09 for Albany Park Nursing Home

This inspection was carried out on 19th 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Albany Park Nursing Home 24/05/07

Albany Park Nursing Home 20/06/06

Albany Park Nursing Home 07/11/05

Albany Park Nursing Home 05/04/05

Albany Park Nursing Home 30/09/04

Albany Park Nursing Home 04/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Albany Park Nursing Home 43 St. Stephens Road Enfield Middlesex EN3 5UJ     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: Tony Brennan     Date: 2 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: Albany Park Nursing Home 43 St. Stephens Road Enfield Middlesex EN3 5UJ 02088041144 02088047733 albany@bmlhealthcare.co.uk 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) : GSG Nursing Homes Limited care home 43 Number of places (if applicable): Under 65 Over 65 43 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 43 The registered person may provide the following category/ies of service only: Care home with nursing - Code N 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 Date of last inspection Brief description of the care home Albany Park Nursing Home is a purpose built care home registered to provide nursing care for a maximum of forty-three service users. Albany Park is to provide nursing care for older people. It is owned by GSG Nursing Homes Ltd. The home is a detached fourstorey building. All bedrooms have en-suite facilities. The home is situated in a residential area. It is close to shops, restaurants and public transport links. Fees are linked to the assessed level of nursing care that servcie users need. These range from #539 to #635 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Care Homes for Older People Page 4 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 quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the home continues to provide good outcomes for residents. The inspection took place over one day. We were assisted by Rudo Chikunguru, the acting manager, with the inspection. Comment cards were received from residents. We spoke with five people who live at the home, three members of staff and a relative. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the Care Homes for Older People Page 5 of 29 inspection feedback was given to the acting manager and the area manager, areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 7 of 29 There were no areas for improvement identified at the last key inspection. Last year an Annual Service Review (ASR) of the service was completed. An ASR is a review of the service and how it is meeting the needs of people who use the service. We found that Albany Park Nursing Home has continued to provide good outcomes for people living at the home. 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. 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 8 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 9 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. Residents needs are assessed prior to admission to the home to make sure they receive the care and support they need. National Minimum Standard number six is not applicable to this service, as the home does not provide intermediate care. Evidence: We found that the needs of the residents case tracked were within a range of those specified in the statement of purpose. The statement of purpose identified the skills and staffing resources available to meet the needs of residents. As there has been a change in the registered provider the statement of purpose will be updated. Also when the acting manager is registered with the Commission this will be reflected in the statement of purpose. The home provides a statement of purpose that is specific to Care Homes for Older People Page 10 of 29 Evidence: the home and the resident group that they care for. A resident said, Its a pretty good home. The residents case tracked had both assessments from placing authorities, and ones carried out by the home. These identified residents needs for support and care. Initial assessments were found to provide detailed information on the specific needs of residents. For example, one resident had particular nutritional needs, which meant that he required food that was pureed. There was a detailed risk assessment and care plan regarding his nutritional needs. This was based on the issues highlighted in his initial assessment. As part of the assessment process information on the needs of residents had been obtained from health professionals. This had been used to inform the homes own assessment. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for residents. Initial assessments recorded the involvement of residents and their representatives in identified areas where they needed support. Both relatives and residents told us that they had been actively involved in the initial assessment process. A resident told us, I like being here. We found that initial assessments reflected the individuals preferences and how they wish their needs to be met. Detailed initial assessments are carried out with the involvement of residents and their representatives to make sure their needs are identified. A person told us, Staff are caring. Care staff spoken to were able to explain the individual needs and preferences of the residents case tracked. We observed the interaction between staff and residents. We found this supported their continued well being. The acting manager explained that since she had been in post she started to review the skills that staff have and identify any areas where training will be needed. This will make sure that staff continue to understand how to meet the needs of residents. Admissions to the home only take place when staff have the necessary skills to meet the assessed needs of perspective residents. Care Homes for Older People Page 11 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Peoples personal, social and medical care needs are planned for. People who use the service are protected by safe procedures for the safe handling of medication. Peoples right to privacy is supported. Evidence: We found that the care plans of all the reisidents case tracked were detailed and clearly identified how their needs would be met. A resident told us, They know and understand me. Care plans were based on initial assessments of residents case tracked. The care plan of the residents who we can case tracked were generally detailed and identified how they needed to be helped. The acting manager explained that she would be reviewing how care plans are prepared to make sure that they clearly identified the needs of residents. There were clearly defined actions highlighted in the care plans to meet the needs of residents. Care Homes for Older People Page 12 of 29 Evidence: We found that residentss choices and preferences are recorded in their care plans. The care plans for the residents case tracked were found to reflect their choices and preferences. Residents commented that they had been asked about how they wish to be supported by staff. A resident said, Staff are very caring and supportive. Staff were observed to interact respectfully and sensitively with residents. Residents said that staff respected their privacy and treated them with respect. Residents told us that they felt staff understood their needs. We saw examples where staff members did relate well with people living at the home, for examples speaking to people in a way that was appropriate given their age. Residents are involved in the planning of their care that affects their lifestyle and quality of life. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. All the residents case tracked had nutritional assessments. These provided guidance on how their nutritional leads should be met Residents were being weighed regularly and action taken if their weight changed. The care plans and risk assessments for tissue viability needs are detailed. The care plans provided clear guidance on how to tissue viability needs were to be met. Photographs of pressure wounds had been taken to monitor the effectiveness of treatment. The acting manager explained that she had contacted the tissue viability nurse. Each care plan includes a manual handling risk assessment. Equipment had been provided to assist people to mobilise safely and independently. We observed staff assisting a resident to mobilise. The member of staff did this in a way that maintained the residents safety. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for residents. Diary notes showed that appropriate medical attention and advice is sought. Diary notes also confirmed that the people case tracked had access to their General Practitioner when necessary. A resident told us, The doctor visits regularly. Diary notes showed that residents had been supported to attend hospital appointments. A resident told us, Staff accompanied me to the hospital, they are very caring. Where the General Practitioner had recommended specific medical interventions these were followed up. Residents health is promoted to ensure their continued well being. The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that residents were getting their medication as prescribed by their general practitioners. We found where the General Practitioner had made changes to peoples medication this was signed to confirm the change had been made. We found that the medication for each of the people case tracked was accurately recorded. For example, two residents were proscribed Warfarin. We found Care Homes for Older People Page 13 of 29 Evidence: that the appropriate professionals were regularly monitoring this. Guidelines were in place to make sure that this medication was administered safely. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure residents safety. Medicines were stored safely. All medicines are stored at the appropriate temperature. Separate records were maintained for controlled drugs. The management team monitor staff to make sure that the correct procedures are followed when administering medication. Regular management checks are carried out to make sure that medication is administered safely to residents. Training has been provided on the safe administration of medicines. Training records confirmed that this training had taken place. We were able to observe staff administering medication, and confirmed that this was done safely. Staff understands how to administer medication safely to residents. Care Homes for Older People Page 14 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are provided with varied activities to meet their needs. Residents are supported to maintain contact with relatives and other representatives of their choice. The menu offers residents a chioce meals and a balanced diet. Evidence: We spoke with people who live at the home who told us that they are provided with regular activities. A resident told us, Activities are generally good. We observed that activities were taking place at various times throughout the day. We saw that residents were enjoying playing a broad game, painting, talking with staff and listening to music. We saw craftwork made by the residents on display in the home. This included a number of Easter bonnets that the residents had made. We spoke with the activity organiser who explained that she had spent time talking to residents about the activities they would like. She had prepared an activities program from suggestions made by residents. Residents spoken to told us that these activities are provided regularly. One resident told us, The activities are generally good. Residents interests were recorded as part of their care plans. Residents are involved in meaningful Care Homes for Older People Page 15 of 29 Evidence: daytime activities of their own choice and according to their individual interests and capabilities. We observed that staff spend time talking with residents and listening to what they had to say. Staff spoken to understood the importance of one to one contact for residents. One member of staff explained, I spend time talk with the residents, talking and getting to know them. A relative said, Staff are around and engaged more with the residents. A Relative commented that there were no restrictions on visiting the home. A relative said, I can spend time alone with my partner if I wish. Residents told us that they could see visitors in private if they wished. Diary notes showed that residents had regular contacts with family, friends and the wider community. The home supports residents to maintain and develop their family and personal relationships. The menu showed that options are offered at each meal. The acting manager explained that she would be consulting residents about the variety of meals being offered. This will support more individualise meal plans for residents. We spoke with residents who were generally pleased with the quality of the food provided. A resident said, Food is pretty decent. However, another resident commented about the choice of food offered that there was only sandwiches available for supper. Two other residents confirmed this. We spoke to the acting manager about this issue she agreed to look at the range of food provided at teatime as part of the general review of the menu. Residents told us that staff had ask them what they would like to eat. We observe that staff went round and asked residents what they would like to eat. Residents are offered a variety of meals that reflect their personal preferences and meets their dietary needs. Meals were balanced and nutritious. Residents dietary needs are recorded as part of the care plans (for example, if they were diabetic or needed a puree meal). We observed that meals were well presented in a warm and friendly way. We saw that residents were supported to eat. We saw that this was done at the pace of the residents being assisted. Residents are able to enjoy the food they prefer and like. Care Homes for Older People Page 16 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that their complaints will be listened to, taken seriously and acted upon. The homes procedures protect people from abuse. Evidence: We saw that there is a clearly defined complaints policy with agreed timescales for managing complaints in place for residents to use. We found that the policy was available for residents and relatives. Residents told us they had received a copy of the complaints policy. A relative told us, If you got a problem it will be dealt with. One complaint had been referred by the Commission to the home since the last key inspection. The home had investigated the complaint and responded to the complainant. A complaints book is available to record all concerns, allegations and complaints. We found that the complaints book recorded the actions that had been taken to address issues. The complaints record showed actions taken to resolve complaints. Residents with whom we spoke confirmed that they knew how to make a complaint. A resident told us, If I had a problem I will feel happy to talk to the staff or the manager. The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. Care Homes for Older People Page 17 of 29 Evidence: A resident confirmed that she was, happy to talk to staff about anything. There were policies on handling abuse and protection. Residents told us that they felt confident that any concerns they raised would be handled sensitively and appropriately. There had been three adult protection issues since the last key inspection. Albany Park had cooperated fully with the investigations. They made sure that any issues were addressed so that residents safety and well being was promoted. We found that staff had received training on adult protection. The acting manager explained that she would be arranging refresher training from the host local authority. This will allow staff to update their knowledge of how they protect residents from abuse. Staff spoken to could recognise the signs of potential abuse, and explained how they would respond to it. A relative said, The staff attitude towards the residents is good. People feel safe and well supported by the home, which has their protection and safety as a priority. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents need to live in a home that is appropriately decorated so that it is homely. The home is clean and hygienic. Evidence: We walked round the home and found that it was accessible for residents. We observed that residents were able to access all areas in the home safely. The home has the necessary adaptations to support residents to move around safely. Bathrooms and toilets were fitted with adaptations to meet the needs of residents. These are accessible to residents who have mobility difficulties. We checked that a fire door, which had allegedly been wedged open, it was closed. The acting manager explained that she had spoken with staff and made it clear that it was unsafe to wedge the door open. Since she did this there be no more instances when the door was wedged open. This makes sure that residents are safe. When walking round the home we observed that carpets in the hallways on all three floors were stained and worn. The paint on the walls in the public areas was chipped. We saw that this was the case throughout the home. The acting manager explained Care Homes for Older People Page 19 of 29 Evidence: that she had been waiting for a response from the Company as to when improvements to the environment would be made. It was agreed that a refurbishment plan to upgrade the decoration and carpeting of all the public areas must be put in place. This will improve the environment for residents so that they live in a well decorated home. We saw that bedrooms were personalised with items of furniture and pictures belonging to residents. One person said, My bedroom is nice. The acting manager explained that she encourages and supports residents to personalise the bedrooms. Residents had a lockable space in their rooms to keep their personal and valuable items. Residents are encouraged and supported to personalise their bedrooms. A relative confirmed that, The home is clean. We observed that cleaning of bedrooms and other parts of the home was taking place. We also saw that carpets in bedrooms were being shampooed. We found that a range of appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. Effective infection control measures are in place to make sure that residents are safe. Care Homes for Older People Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are always available to meet the needs of residents. Staff do not have all the skills to meet the assessed needs of residents. Residents are protected by the homes recruitment practices. Evidence: Residents confirmed that there was always enough staff available to meet their needs. The rota showed that a consistent staffing level was being maintained in the home. We observed that staff were available to provide individual care for residents. A resident told us that; there are always staff around to help, when you need it. Staff said that the current staffing level allowed them to meet the needs of residents. The acting manager explained that she would be carrying out a review of the staffing level. This will allow her to determine whether any changes to the staffing level need to be made to meet the needs of residents. The acting manager explained that she has begun a recruitment process to fill a number of vacancies. The home makes sure that sufficient staff are available to meet the needs of residents. We spoke with staff that had recently started working at the home. They told us that Care Homes for Older People Page 21 of 29 Evidence: they had been given a formal induction. We found records of this in their files. Training records and certificates showed that over 50 per cent of staff has achieved the National vocational qualification in care at level 2. Training records show that the majority of staff had recently completed fire safety training. The registered manager was also able to confirm that first aid training had been booked so that staff had the skills necessary to ensure residents safety. Looking at Training records we found that there were a number of areas where training still needs to be provided to ensure the safety and well being of residents. We found by looking at Training records and talking to staff that food hygiene training had not been updated. Staff needs to be trained in food hygiene so that they can handle food safely. Looking at Training records and talking to the acting manager highlighted that there was a need for training in end of life care and the Mental Capacity Act. Staff spoken to told us that not had training in these areas. Care plans and risk assessments did not provide detailed information regarding these areas of residents needs. When talking to the acting manager she told us that these were areas where further development is needed. To do this staff needs to have the relevant skills so that they can meet all the needs of residents to make sure that their well being is promoted. We looked at four staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with residents. Their employment record had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of residents. The staff group reflect the cultural backgrounds of residents. Staff spoken to confirm that they were clear about their roles. They had received a job description and specification. Residents confirmed that they felt staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of residents. Care Homes for Older People Page 22 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to make sure that residents receive the care they need. Residents are consulted about the quality of the service, and encouraged to make suggestions for improvement. Residents have their financial interests protected by the homes procedures. Residents and staff are protected by the homes health and safety procedures. Evidence: The acting manager explained that she has recently started working at Albany Park. She showed us how she has made a number of changes to care practices in the home. The acting manager has applied to the Commission to be registered as the manager of the home. Both residents and relatives commented positively on the management and leadership of the acting manager. A relative said, I feel that she (the acting manager) is interested in my views about the home. The acting manager has Care Homes for Older People Page 23 of 29 Evidence: extensive experience of managing a service for older people. She has a clear understanding of the key principles and focus of the service to make sure that people receive the care they need. A resident commented, The lady in charge comes and talks to me. She is friendly. The acting manager explained that she has in spending time talking to residents and relatives to get an understanding of their views of the home. We observed that the acting manager spent time talking to residents. The acting manager has a clear understanding of how to deliver good outcomes for residents. A member of staff said, The manager is very good. You can always talk to her. Other Staff spoken to thought that the acting manager encouraged them to improve the way they work. Residents told us that there has been an improvement in the care and support they received. The registered manager and staff work to make sure that the home is running in the best interests of residents. The home has a system for obtaining the views of the quality of the service it provides. The home makes sure that any areas for improvement are addressed. A survey of the views of residents, relatives and professionals had recently been carried out. The findings of this survey had been action to improve the home. Staff meetings take place to make sure that staff are aware of how they should support and care for residents. Residents views are sought and provide the bases for improving the quality of the service. The home does not hold money for residents. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. Residents can have confidence in the homes procedures for handling their money safely. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Fire drills were taking place and the fire alarm was tested regularly. We found that the fire risk assessment includes an assessment of all the potential fire risks in the home. We questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. We discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of residents and staff. The temperatures of the fridges and freezers were recorded and within safe limits. Health and safety checks, procedures and training make sure that residents are safe. Care Homes for Older People Page 24 of 29 Evidence: 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 19 23 The registered persons must 30/10/2009 make sure that there is a detailed redecoration plan for the home to improve the homes environment. Residents need to live in an environment that is suitable for their needs. 2 19 23 The registered persons must 30/09/2009 make sure that the hallway carpets are replaced. Residents need to live in a home that is safe and clean. 3 30 18 The registered persons must 14/08/2009 make sure that staff has food hygiene training. Staff needs to be trained in food hygiene so that food is handled in a way that maintains the safety of residents. Care Homes for Older People Page 27 of 29 4 30 18 The registered persons must 14/08/2009 make sure that staff has the necessary skills to meet the end of life needs of residents. Residents need to be supported in ways that maintain their well being at the end of their lives. 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 30 The registered persons should make sure that staff receives training that provides them with skills and knowledge to implement their responsibilities under the Mental Capacity Act. Staff needs to understand how to support residents who may have difficulties in making decisions about how they live. 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. 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