Inspection on 04/12/08 for Amersham Care Home

This inspection was carried out on 4th December 2008.

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

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

Other inspections for this house

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Amersham Care Home 454 Babbacombe Road Torquay Devon TQ1 1HW     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: Rachel Proctor     Date: 0 4 1 2 2 0 0 8 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Amersham Care Home 454 Babbacombe Road Torquay Devon TQ1 1HW 01803292762 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): lynette@piltoia.supanet.com Mr Antony John Hollick,Mrs Lynette Sylvia Hollick Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 0 15 15 dementia old age, not falling within any other category physical disability Additional conditions: 15 0 0 The maximum number of service users who can be accommodated is 15. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the service are within the following categories: Dementia - (Code DE) Physical disability aged 65 years and over on admission - (Code PD(E)) Old age not falling within any other category - (Code OP) Date of last inspection Brief description of the care home Amersham House is a converted period property, situated on the Babbacombe Road about a mile from Torquay harbour. The service provides personal care for up to 15 older people with dementia or some degree of physical disability. The home is Care Homes for Older People Page 4 of 29 Brief description of the care home equipped with aids to support people who are physically frail such as hoists in the bathrooms on the ground and first floor, a mobile hoist that can be used in bedrooms, and there are stair lifts to access the first and mezzanine floors. There are eleven single bedrooms, eight with en-suite facilities. There are also two double bedrooms, one having en-suite facilities and one without but being next door to a bathroom with disabled toilet facilities. On the ground floor there is a comfortable lounge, and a conservatory, which also serves as the dining and activities room. The Home has a minibus, with wheelchairs access, which is used for trips out. The garden is partly accessible and has raised beds and appropriate garden furniture. The front door is accessed from the main street by a shallow ramp. There is free on street parking, without time limits, outside the front of the home. Fees range from £380 to £395 per week. Copies of the latest inspection reports are available in the home or from CSCI. 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: This was an unannounced key inspection which took place on 4 th December 2008 between 10 am and 4:30 pm. During the visit a tour of the home was completed. People living at the home, staff and visitors were spoken to during the inspection. Information received from the home since the registration of new owners was also reviewed. Survey forms were returned to the Commission prior to this inspection. Some of the comments made in these and during the inspection have been incorporated into the report. Two people had their care followed as part of this inspection. This involved reviewing the persons care plan visiting the room they occupied in the home and where possible speaking to them and or their representatives. Care Homes for Older People Page 6 of 29 Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 29 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. People are given sufficient information to make an informed choice about whether Amersham house can meet their needs. The need assessment adopted should ensure that people have their health and personal care needs assessed fully. And a plan of care developed , which guides staff how their needs should be met. Evidence: The statement of purpose and service users guide had been updated. Copies of this were available in the home. These provided sufficient information to allow people to make an informed choice about whether the home could meet their needs. One relative commented that they were given information about the home prior to their relatives admission. Care Homes for Older People Page 11 of 29 Evidence: The new owners have introduced a new admission assessment. This comprehensively covers the care needs the person has including social interests, hobbies, religions and cultural needs. A plan of care had been developed from the initial assessment of needs completed, which was based on the need assessment. Two people had their care followed as part of this inspection. This involved looking at the care planning and assessments completed, visiting the room the person occupied in the home and speaking to them or their representatives where possible. The home does not provide intermediate care. However it does offer short respite stays for people whose needs they can meet. 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. People living at Amersham house have their health and personal care needs provided by a staff team who have their best interests at heart. People are treated with respect and their personal preferences and choices taken into account. One Care plan did not all reflect the persons current care needs and had not been reviewed monthly. This may mean that person was reliant on staff who know their care needs well providing their care. Medication practices and safe Evidence: At the time of this inspection 14 people were being cared for at Amersham house. Two people had their care followed as part of this inspection. Each had a plan of care, which had been generated from an assessment of their needs. These showed that people and or their representatives had been consulted about how their need should be met. Care Homes for Older People Page 13 of 29 Evidence: One person whose care would followed had their care plan reviewed in October 2008. Although there was information within the daily statements that this persons care needs had changed this had not been reflected in the plan of care. The records of weight recorded over a three month period showed the person had lost weight. However the plan of care had not been put in place regarding how the weight loss was being managed. A record of health professionals who had been involved with the person had been recorded this included the community psychiatric nurses, social worker and GP. The persons relatives were spoken to during the inspection. They said that staff are managing their relative very well and were understanding and kind and always kept an informed of any changes. Another person whose care was followed had their care plan reviewed within the last month. Relevant medical history had been included and care plans had been put in place to reduce the risks identified by the assessment. Risk assessments were an integral part of this care plan and included risk of falls, manual handling and other risks identified for the individual. The involvement of health professionals including the persons GP had been recorded. The owner advised that she was in the process of reviewing and updating all the care plans and provided a further two care plans for people living in the home. These had been updated and clearly reflected the persons care needs. These plans of care were comprehensive and looked at the person self-care ability as well as their needs for care. Where risk had been identified in the risk assessments a plan of care had been put in place to guide staff how they should manage this risk. The owner confirmed that only staff who are trained to do so assess peoples care needs. Two senior carers on duty at the time of the inspection were able to confirm this. The anonymous survey comments for what the service does well included: Each member of staff knows all the clients well and meet their individual needs. Handover is detailed and provides adequate information to carry out quality care during your shift. A routine is in place which allows the clients to feel comfortable and not disorientated. Medication was stored in a locked cupboard in the office of the home and a lockable medication trolley. Senior carers on duty take responsibility for ensuring people receive their medication. A fridge was provided for medication that needed to be kept cold. A risk assessment process was available to check if the person was able to manage their own medication. At the time of this inspection the senior carer confirmed none of the people were able to manage their own medication. Three of the staff spoken to during the inspection said they had received medication training. Care Homes for Older People Page 14 of 29 Evidence: The owner advised that the local pharmacy they used provides medication in blister packs for individuals. She also advised that the pharmacy takes medication no longer required which was recorded in a medication return book. The owner advised that the pharmacy was in the process of completing medication for people and the returns book had been sent with the request for medication. A system was in place for checking medication received from the pharmacy using individual medication sheets. Medication records were checked for the two people whose care was followed. These had been completed as expected. The senior carer in charge advised that the medication sheet was signed after the person has taken the medication. Medication practices observed during the inspection were safe. At the time of this inspection none of the people living at the home were receiving controlled drug medication. The owner advised that staff receive training regarding controlled drugs management as part of their medication training and a controlled drug register would be kept when required. The staff observed caring for people during the inspection were caring and polite to the people they were caring for. When a person asked the same question several times staff responded in the same polite and caring way each time. Care was observed being provided in the privacy of peoples own rooms. Visitors were able to see people in their own rooms or in the lounge. The care planning system records included the persons preferred name and how they would like to be addressed. Staff were observed to be using the persons preferred name. 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. Staff endeavor to provide activities that are flexible and varied to suit peoples expectations, preferences and abilities. Meal times are a pleasant experience for people living at Amersham house. Evidence: The Annual Quality Audit Assessment returned by the provider indicates that Amersham house has a welcoming and family environment for people and the visitors. They also indicated that they have provided an increased social contact and activities for people who have less support from outside the home. During the inspection staff were seen providing one to one support for individuals and a group activities making Christmas cards was being organized by the staff in the afternoon. However the staffing rota provided did not always have the number of staff on duty to allow staff time to do this. The owner advised that she had not included herself on the rota, staff confirmed that she worked along side them when she was at the home. The owner also advised that when staff do extra shift to cover these had not always been recorded on the duty rota. Care Homes for Older People Page 16 of 29 Evidence: The care plans for the people whose care was followed and two other care plans recorded what the person enjoyed and the type of activities they took part in. This enables staff to provide activities and support for people that they enjoy. Staff were observed telling people what activities were happening that afternoon and inviting them to take part. Visitors were coming and going through out the inspection, they were able to see people in their own room or in one of the communal areas in the home. Two relatives spoken to during the inspection said they were very happy with the care provided. Other comments received in anonymous surveys included. Activities, Go out shopping, games, throwing the ball etc, however with my eyesight it is hard,I dont find anything wrong with it. I am kept clean all the time and the food is really nice. The individual peoples rooms entered during the inspection had been personalized with items of their choice. This included ornaments and pictures and small items of furniture. The cook had left just prior to this inspection and a new cook has yet to be appointed. Staff were covering kitchen duties and cooking while this was being arranged by the owner. The owner advised that she had discussed how the meals and cooking should be covered with staff and they had chosen to cover this until a new cook was appointed. The member of staff doing the cooking on the day of the inspection said they had agreed to do this and extra hours had been provided to allow them to do this. The owner advised that this enable more staff to be on the floor each morning. She also advised that meals are sometimes prepared in advance to reduce the time care staff spend in the kitchen during the day. Information on safer food better hygiene was provided for staff use and training for staff included food hygiene. People spoken to during the inspection said they enjoyed the food. Other comments received in the anonymous surveys included. Always asked what I want for dinner and regularly ask if I need a drink, Promote choice and independence, respects privacy and dignity. We are always given a good choice at mealtimes, they run a happy home. The meal time was unhurried with people eating their meals at their own pace. Staff were assisting people discreetly and sensitively when they needed help. 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. The home has a robust complaints procedure displayed in the reception area. People can have confidence that any concerns they raise will be dealt with sensitively by the staff team. The arrangements for the protection of vulnerable adults are satisfactory Evidence: There was a robust complaints policy in place. This was provided with a statement of purpose and service users guide at registration. The (AQAA) Annual Quality Assurance Assessment indicated that the home has an open and honest approach to all levels of the care team. Since registration providers have had a professional audit of the premises, purchased access to 24-hour day advice line for health and safety issues. Care planning documentation has been improved, increase staff training has been put in place and a whistle blowing and bullying policy has been introduced. The complaints policy was displayed in the reception area of the home. This included time scales and the address and contact details for the Commission. Two relatives spoken to said they had been made aware of how to raise concerns but did not have any concerns at present. The office had blank copies of complaints forms for recording issues raised. No complaint had been received by the homes management team or the Commission since registration. A system for recording complaints or issues raised was Care Homes for Older People Page 18 of 29 Evidence: provided. Information regarding protection of vulnerable adults and whistle blowing policy was provided for staff in the office of the home. The senior carer in charge said staff at the home had recently received adult protection training. The staff records seen provided information regarding the training staff had received. Staff spoken to were aware what to do if concerns were raised. The anonymous staff surveys returned indicated they were clear about what to do in case of concerns. One person was new and said they would Go to the member of staff in charge and seek advice. 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. People who live at Amersham house have a pleasant homely environment that was well maintained and free from odour. This provides a safe, comfortable accommodation for the people who live there. Evidence: Amersham House is located on the main Babbacombe Road approximately a mile from the harbour and center of the holiday town of Torquay. The main bus route runs along this road into Torquay. There are a variety of shops within walking distance of the home either towards Torquay, or towards Babbacombe. There are also pubs and restaurants in these areas. As part of this inspection a tour of the home was completed. All communal areas and disabled access bathrooms and toilets were seen and some peoples individual rooms were entered. The home has been adapted and has operated as a care home for many years. It has 11 single rooms, 8 with en-suites, and two others that have a shared bathroom. It has a hip bath, shower facilities, wash hand basin and toilet. There are 2 double rooms, one being next door to a bathroom with wash hand basin and toilet facilities. There are disabled bathing facilities on both the ground and the first floor. The lounge at the rear of the ground floor has a conservatory off it that was also being used as the dining room and activities room. The (AQAA) Annual Quality Assurance Care Homes for Older People Page 20 of 29 Evidence: Assessment indicated that the home has a homely domestic environment with a relaxed atmosphere. New items had been purchased for the home including chairs for the lounge, tablecloths and napkins. The home had a pleasant relaxed atmosphere during the inspection. The lounge was attractively presented with coordinated carpets and furnishing. Two people asked said they liked being in the lounge. The owner advised that the program of decorating and refurbishing the home would continue. A small terraced garden to the rear provides private outdoor space in good weather for people who live at the home. The preinspection information provided by the new owners indicated that a barbecue, parasol and plants had been purchased for the garden. This should improve the garden for people who live in the home. The owner advised that the laundry room had been refurbished since the ownership had changed. This included fitting a hand wash sink, new flooring and providing a new washing machine. An ironing board and space to store peoples laundered clothing was also provided in this room. The owner advised of other plans to improve the environment for people living in the home. She also advised that carpets in individual rooms were being replaced on an as needed basis. A carpet fitter visited the home during the inspection with samples pf carpet for a persons room. The home was well presented fresh and clean during the inspection. People asked said their rooms are always kept clean. Other comments received in the anonymous surveys included.Nice and clean, I am kept clean all the time. Gloves and aprons were easily available for staff use. Staff were seen using gloves and aprons when providing personal care. A cleaner was working in the home during the inspection, they also advised that they carry out minor maintenance tasks as part of their duties. They confirmed that they had sufficient equipment and time to keep the home fresh and clean for the people who lived there. 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. Systems are in place to ensure sufficient staff are on duty each shift to meet the needs of the people living at Amersham house. Recruitment policys, procedures and practices are robust and should protect people from unsuitable staff. The management team have a clear commitment to provide training for staff that will equip them to do their jobs well. This should ensure that people continue to be cared for by a knowledgeable staff team. Evidence: A duty rota was available for the home, which showed the number of staff on duty each shift. The senior carer advised that shift short falls were being covered by the existing staff team. Staff spoken to said they worked together to ensure people received the care they needed and they had agreed to work extra shift. However the extra shifts care staff had been working were not always indicated on the duty rota. The owner advised that she regularly covers shift when she was at the home however these had not been included on the staff rota. In addition to the care staff the home employs a cleaner maintenance person; they Care Homes for Older People Page 22 of 29 Evidence: were working in the home during the inspection. The owner advised that she was in the process of finding a replacement cook as the previous cook had left with very little notice. Cooking was being covered by care staff who had food hygiene training. The owner confirmed that she was committed to providing NVQ training for staff. The staff spoken to during the inspection said that access to training had improved since the home had changed ownership. The (AQAA) Annual Quality Assurance Assessment indicated that nine staff had achieved an NVQ level 2 or above. This also indicated that a further member of staff was working towards this qualification. The owner advised that since the AQAA had been completed some staff had left and new staff had been appointed. Comments received in the anonymous surveys included. The staff are excellent, Very satisfied with the care provided. Two staff files were seen during the inspection. One from a newly appointed staff member and one from an existing staff member. Both contained application forms, proof of identity, references and evidence that a police check had been made before the staff member started work. Copies of contracts of employment, which included terms and conditions were contained in their staff files. Examples of training and development plans completed for staff were available. Staff spoken said they had discussed their training needs and were working towards what they had agreed with the new owners. The owner advised that mandatory training was being completed and other training courses relevant to the people being cared for at the home would be provided. Staff who responded to the anonymous survey request said they receive enough information about the people they are looking after . Two said that care plans were being updated and upgraded following the change of ownership. Training was being delivered and planned which meets their needs, and one commented that access to training was fair. One said they were doing NVQ3. Induction was being provided for new staff. Comments received from staff prior to this inspection indicated that their induction either very well or mostly covered the areas they need to know. An example of the induction template used for staff was available for inspection. This appeared to comprehensively cover the areas a new carer would need when starting work at the care home. 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. Suitable interim arrangements for the management of the home have been put in place prior to a new manager being registered. People living at the home and or their representatives are given the opportunity to influence decisions about the home and its management. Although there was a system in place to regularly monitor fire equipment checks; these had not been completed as often as they should have been. This may put people at risk in the event of a fire. Evidence: The registered manager left shortly after the new owners took over the home. A new manager had been appointed who had yet to complete the Commissions registration process for registered manager. However the owner advised that the new manager was not on duty for this inspection. The owner advised that she and senior care staff Care Homes for Older People Page 24 of 29 Evidence: were sharing responsibility for ensuring the home continued to provided good care for people living there. The senior carer on duty advised that they had good support from the new owner and felt they could contact them at any time if they had concerns. They also said the new owners had spent time at the home working along side them. The Annual Quality Assurance Assessment indicates that the provider has a strong commitment to the future of the home. Since registration they have indicated they have corrected an unfair pay system, completed a professional audit of the premises and purchased human resource and health and safety issues advice service. They also indicates they believe the home is now better organized. Staff spoken to during the inspection said they felt supported to do their work. The results of the professional audit referred to in the pre inspection information were made available during the inspection. The owner advised that copies of letters and cards sent from relatives are made available, if the person writing the letter or card agrees. She also advised that a survey for relatives and people living in the home would be completed and analyzed. The owner confirmed that no one employed at the home or the management team acts as appointee for any of the people living there. Money held on behalf of people was being recorded and kept separately. Secure facilities were provided for this. Staff spoken to confirmed they had received manual handling training. Copies of certificates were available in staff files. The training planned for staff was discussed with the owner. She advised that mandatory refresher training for manual handling, fire safety, health and safety would be completed for all staff on an ongoing basis. Chemicals used in the home were being stored securely and (COSHH) Control of Substances Hazardous to Health information was provided in the office for chemicals used. The (AQAA) Annual Quality Assurance Assessment provided information about the service of equipment and premises. Records of service checks completed were available in the office of the home. The fire log book was checked. This had not been up dated to demonstrate that fire safety checks had been completed regularly. The owner advised that these were normal completed weekly or monthly as recommended and would be completed that day. Accident record had been completed and actions taken recorded. Staff were aware of what needed to be reported to the Commission. 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 38 23 The registered person shall after consultation with the fire authority Make adequate arrangements for reviewing fire precautions, and testing fire equipment, at suitable intervals. The fire equipment must be regularly tested to ensure it is in good working order. Not carrying out and recording routine checks of fire equipment could put people at risk in the event of a fire. 06/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 All care plans for people living at the home should be reviewed monthly or sooner if the persons care needs change Page 27 of 29 Care Homes for Older People 2 8 All care plans should reflect the persons current care needs and not be reliant on information recorded in the daily statement. The duty rota should reflect the actual staff cover for each shift organized. A suitable manager for the service should be registered as soon as possible. 3 4 27 31 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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