Inspection on 21/04/09 for Arden Lea Nursing Home

This inspection was carried out on 21st April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arden Lea Nursing Home 08/04/08

Arden Lea Nursing Home 12/04/07

Arden Lea Nursing Home 22/06/06

Arden Lea Nursing Home 19/12/05

Arden Lea Nursing Home 24/02/05

Arden Lea Nursing Home 03/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arden Lea Nursing Home 25 Mayo Road Sherwood Rise Nottingham NG5 1BL     The quality rating for this care home is:   one star adequate 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: Karmon Hawley     Date: 2 1 0 4 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 31 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 31 Information about the care home Name of care home: Address: Arden Lea Nursing Home 25 Mayo Road Sherwood Rise Nottingham NG5 1BL 01159621100 01159113292 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) : Atheray Organisation Limited care home 27 Number of places (if applicable): Under 65 Over 65 27 0 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 5 Arden Lea is a 27-bed home situated close to the city centre with many local amenities and well served by local transport. All areas of the home are accessible to service users. The home provides 24-hour care with nursing for older people but 5 places may be used by people with a physical disability between the ages of 18 and 65 years. The weekly fees range from £336.43 to £429: fees are dependent upon peoples indivudal needs and the nursing determination. These fees do include the cost of chiropody but do not include the cost of hairdressing. This information is made available on the point of enquiry. A service users guide is available at the home in large print and a large print and audio version of the statement of purpose is also on display in the home to inform prospective service users of the services and facilities available. Care Homes for Older People Page 4 of 31 Care Homes for Older People Page 5 of 31 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: one star adequate 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period. A review of all the information we have received about the home from the provider and the general public since the last inspection was considered in planning this visit and Care Homes for Older People Page 6 of 31 this helped decide what areas were looked at. The main method of inspection we use is called case tracking which involves selecting the care plans of 4 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The manager, members of staff, people who use the service and visitors were spoken with as part of this visit. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of people using the service. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. The manager completed an Annual Quality Assurance Assessment (AQAA) a questionnaire about how well the service provides for the needs of the people who live there and how they can and intend to improve their service. We received this back from the manager in good time and the form was well completed and helped us to plan our visit and to decide what areas to look at. What the care home does well: What has improved since the last inspection? Some development in regards to plans of care and risk management has taken place, working towards ensuring that people remain safe and their needs are met. Plans of care are reviewed more regularly working towards ensuring consistency of care delivery. Staff training continues to take place in all mandatory areas ensuring that staff are well trained and knowledgeable in their job role. Ongoing redecoration and replacement of fixtures and fittings is taking place, working towards ensuring that people live in a safe and well maintained environment. Care Homes for Older People Page 8 of 31 The recruitment policies and procedures have improved to ensure that people using the service are protected from unsuitable people being employed. 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 9 of 31 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 31 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 using the service are assured that their needs will be assessed and that staff can meet these before they make a decision to move into the care home. The service does not offer intermediate care. Evidence: The manager visits people within the community to carry out a preadmission assessment to make sure that staff are able to meet their needs before a decision is made to move into the care home. Within case files examined there is evidence of preadmission assessments taking place. People who may wish to use the service may also visit and spend time at the home so that they can meet people and get a feel for what it would be like to live there before they make a decision to move in. Care Homes for Older People Page 11 of 31 Evidence: Staff spoken with said that they receive enough information about the support that people need before they move in so that they can assist them as needed. One person using the service told us that they had come into the care home as an emergency admission and that they was worried initially as they had not experienced living in a care home before, however they have found that everyone is nice and friendly and they have settled in well. Care Homes for Older People Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people using the service may not be fully met as plans of care are not always in place for specific needs nor do some outline peoples personal preferences. People are not fully protected from risks due to the lack of risk assessments in place as required. People using the service are not currently protected by the medication practices that take place and there is a risk that they may not receive their medication as prescribed. Evidence: A new typed format for plans of care has been introduced since the previous inspection, however these contain task focussed information in regard to the support that people require and these are not always personalised. Broad sweeping statements are sometimes used such as, keep a close eye on to prevent, which do not inform staff the actual support a person needs. There are instances where plans of care are not in place for some specific needs, such as skin care when wearing specialist appliances to ensure that people are supported Care Homes for Older People Page 13 of 31 Evidence: appropraitely. Nevertheless plans of care clearly document instructions obtained from specialists in other areas such as the dietician so that staff are fully informed of peoples specific needs in this regard. We saw that reviews do take place, however these again are generalised and simply state no changes, care plan unchanged rather than the support that a person has received. Risk assessments are in place for some highlighted risks such as the safe use of bedrails, however these are not always in place following assessments when a high risk has been identified, such as infection control and manual handling to ensure that these risks are managed and reduced. Staff spoken with are able to discuss the support that people require and how they assist them to meet their needs. People using the service mostly feel that their needs are met and two people offered the following comments; I have water tablets in the morning, the staff are so good, they are always there to help me to the toilet, I didnt know I had a care plan, I would like to be involved in it, what is going to happen and what isnt, I would like the staff to know a little bit more about me. During the tour of the care home we saw that specialist equipment such as hoists and special beds are available for people using the service. On examining plans of care we also saw that people are supported to access specialist services such as the doctor and chiropodist as needed. Staff spoken with confirm that people can access specialist services at any time needed and that there is enough specialist equipment available for people who need it. One person using the service told us that they can see the doctor whenever they need to and that they have had their glasses sorted out. Staff who administer medication have been trained to do so, however on examining medication records we saw that there is a large number of gaps in signing for medication that is administered. We are unable to audit if this medication has actually been given to people, as there is no audit trail that we can follow to ascertain this. These gaps included medication for diabetes mellitus and antibiotics, which are essential if prescribed to maintain peoples health and wellbeing. On discussing this with the manager, one administration of insulin for diabetes mellitus was stated to have been given, however the registered nurse had omitted to sign for this afterwards. Care Homes for Older People Page 14 of 31 Evidence: There are also occasions when people are out of stock of their medication for long periods of time, which again can affect a persons health and wellbeing. All other records in regard to medication, such as the controlled drugs register and disposal of medication are kept as required. Throughout the inspection we saw staff treat people using the service with respect and support them when needed. There is good banter between staff and residents and relationships are respectful and friendly. Staff spoken with are able to discuss how they ensure the peoples dignity and respect is upheld when supporting them with their needs. One member of staff states, it is important to ensure that care is individualised and that people are happy and healthy, it depends on what is important to the individual. People using the service feel that staff treat them with respect and that their dignity is upheld, staff are nice and respectful, I do what I can for myself, they help with other things that I need and the staff are nice and respectful. Care Homes for Older People Page 15 of 31 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. Most people using the service feel that the lifestyle that they experience satisfies their needs and expectations and that they are supported to maintain contacts with people that are important to them. Evidence: An activities coordinator generally offers various activities such as arts and crafts, dominoes, bingo and trips out to people using the service on a daily basis. There is evidence of art and craftwork on walls throughout the care home. We saw some people joining in a craft activity in the afternoon, which they enjoyed and during this time there was a happy relaxed atmosphere between staff and people using the service. People using the service said, I am very happy here, I have got friends, which is nice, we all get on well, there are activities on offer but I enjoy knitting, there are some activities but I am not that bothered, I would like to go to day centre, but I am not able to due to funding, there is not enough really to keep me stimulated. I enjoy doing craft work and going out into the garden; I have been shopping with staff to Tesco, but would like to go to more places. I have a TV in my bedroom, I am not really Care Homes for Older People Page 16 of 31 Evidence: bothered but I can go and watch it if want. Staff spoken with feel that there is enough for people to do to keep them stimulated. There are no restrictions imposed upon visitors so that people can maintain contacts with those that are important to them. During the visit we saw several visitors come and go and maintain good relationships with staff. Two visitors spoken with said that they are always made welcome and that they get on well with the staff. People using the service and staff spoken with confirm that there are no restrictions on visiting and that visitors may be received in private if they wish. Staff have undertaken training in the Mental Capacity Act to develop their knowledge in ensuring that peoples rights are enhanced and maintained. When spoken with they offered the following comments; people have their say, it is their right, they are treated as individuals and they get a lot of one to one care. It is important to make sure all their needs are met, that they have everything they need and they are comfortable. I love chatting to them I treat them like I would want to be treated myself and make sure that they feel wanted, we have been looking at the Mental Capacity Act and I feel that we are instinctively already maintaining this, there are no signs of staff not upholding peoples rights and choices, people can express themselves. People can make their own choices and decisions and how they spend their time. People using the service told us that they can spend their time as they wish and make their own choices which are respected; I do not get up before 06:30, I tell the staff when I want to get up, if they tried to get me up any earlier I would soon let them know I wasnt happy about it, I can make own choices. A varied and traditional menu is on offer to people using the service with choices at each mealtime. There is evidence that people using the service have had some involvement in the drawing up of a new menu. During the lunchtime meal we saw staff support people using the service in an appropriate manner. Staff spoken with are able to discuss the need for special diets such as diabetic diets and the choices that are on offer to people. People using the service tell us, I enjoyed my dinner, I had pork casserole, we get plenty to eat, I had two puddings, there is plenty of food, I was underweight but the Care Homes for Older People Page 17 of 31 Evidence: staff have helped to build me back up, I have put on two stone and I am feeling much better, I had a say at the meeting about the food, I would like more choice for diabetic puddings. Care Homes for Older People Page 18 of 31 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 are assured that their complaints will be listened to and acted upon and that they are protected from abuse. Evidence: So that people know how to make a complaint should they need to the complaints procedure is on display. People are also enabled to express any views or concerns at the resident and relatives meetings. The service has not received any complaints since the previous inspection. People using the service tell us that they can approach the staff if they have any concerns; I am upset about the TV aerial, we can not get a good picture, I spoke to staff about it but they say it is due to atmospherics, it really gets on my nerves, I have had a few issues such as bath times, but I have sorted them out myself, there is a happy atmosphere, if I was unhappy I do feel that can talk to staff. Two relatives spoken with said, the staff are very good, we have built up relationships with them as we have been coming for four years. We have no concerns about the care or way our relative is looked after, we can speak to matron if unhappy with anything. Care Homes for Older People Page 19 of 31 Evidence: Staff spoken with are able to discuss what they would do should they receive a complaint to ensure that this is dealt with effectively. One member of staff discussed the action that has been taken to address the issue with the TV aerial. The policy in regard to protecting vulnerable adults is out of date, however the majority of staff have completed training in the safeguarding of vulnerable adults and they are able to discuss their roles and responsibilities in this area to a good standard. All staff employed have a Criminal Record Bureau check in place (a police check to see if an individual has a police record or caution) to make sure that people are protected from unsuitable people being employed. Staff files examined and spoken with confirmed this. Care Homes for Older People Page 20 of 31 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 using the service live in a comfortable and satisfactorily maintained environment, however this is detracted from due to the maintenance work still needed. Evidence: During the tour of the care home we saw that some redecoration has taken place on the second floor to brighten this up and make it more homely, however there are still areas that are in need of redecoration and wood work is also in need of attention in most areas of the care home. Although the gardens are satisfactorily maintained the wood work on the outside of the window frames is rotting and the paint work is flaking. We saw that in one persons room that the window is boarded up with a perspex covering, which has uneven and broken edges. It was a very warm day on the day of the visit, this covering prevents any windows in the room being opened. The manager stated that this covering is in place as it gets very cold in that particular room in the winter, however she agreed that this matter needs addressing. All areas of the care home accessed are clean and tidy and we saw that sufficient Care Homes for Older People Page 21 of 31 Evidence: domestic staff are available in maintaining this. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by sufficient numbers of staff who are well trained to meet their needs. Evidence: Staff spoken with said, it is good working here, the staff welcomed me when I first joined the team, we all work well together, there are enough staff available to meet peoples needs, and there are enough staff, we are sometimes pushed in the mornings but the levels are safe. People using the service tell us, I am happy here, I am settled and like everyone here, I like living here, I am looked after, there are enough staff to help us, they come and help me when I need anything, there are enough staff and we are well looked after and they can be short staffed if someone phones in sick it can affect the standards. The staff duty rota examined shows us that sufficient staff are on duty throughout the day and that is people are off sick that attempts to cover these shifts are made. So that new members of staff are aware of their roles and responsibilities when they first start working at the care home the manager states that they undertake an Care Homes for Older People Page 23 of 31 Evidence: induction. There is no evidence of this within staff files, however the manager stated that this is because staff have their induction packs as they are working through these. One member of staff spoken with confirmed that they underwent an induction when they first started working at the care home; I had an induction and orientation to the home; it covered all the usual stuff such as fire, health and safety, care plans and policies and procedures. We were given time to read the care plans. I worked with someone else for a week, which helped. The majority of staff have completed the National Vocational Qualification level 2 or 3 (a nationally recognized work and theory based qualification designed to enhance peoples knowledge and skills in caring for people). One member of staff spoken with confirmed that they have undertaken this qualification and that it has helped them in their work. Staff files examined contain all the required documentation such as references, proof of identity and nurses professional identification numbers to ensure that people using the service are protected from unsuitable people being employed. Staff spoken with tell us that they had followed a recruitment process when they first started working at the care home; I had a POVA 1st (a check to see if a person has been placed on a list of people that have been known to abuse vulnerable people) before I started working at the care home. Staff files examined show us that staff continue to undertake compulsory training such as manual handling, the mental capacity act and first aid, to ensure that they have the necessary skills and knowledge to care for people using the service. Staff spoken with tell us, I have done the following training, 1st aid, food hygiene, the Mental Capacity Act, and my manual handling training is booked. I feel supported in my training and development. The Mental Capacity Act training has taught me to always ask what people want, and to respect their decisions such as if they want a lie in for a couple of hours this is their home and they can do what want, and I feel supported in my job role, I get study days no problem, I am due a manual handling update which has been booked. Care Homes for Older People Page 24 of 31 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 using the service live in a care home where they are enabled to have a say about how it is run and managed. Peoples personal finances are protected. Evidence: The manager is registered with the Care Quality Commission as a fit person to run and manage the service. She ensures that she remains up to date with all compulsory training so that she can ensure best practice is maintained. She has commenced the Registered Managers Award (a nationally recognised work and theory based qualification designed to enhance management knowledge and skills). The manager does get hours that are specifically allocated for the general management of the service, however she feels that there is still a lot of paper work to complete. She is aware of the improvements still required and is currently working on implementing the Mental Capacity Act and the Deprivation of Liberty in staff practices Care Homes for Older People Page 25 of 31 Evidence: to ensure that peoples rights are enhanced and maintained. People using the service tell us, I really like matron; I am knitting her a scarf, I am upset due to a problem with another person using the service, matron is dealing with it, she listens which is good thing. One relative spoken with said, matron sorts things out, there are problems at the moment but at least she listens, we are kept up to date about things as needed. Staff spoken with speak highly of the manager and offer the following comments; the manager is brilliant, she is down to earth, if you want to speak to her she is there, she is strict and firm when needs to be, I feel comfortable with her. She is good with the residents and works on the floor, and matron has vast experience and is great to work with. People using the service are enabled to have a say in how the care home is run and managed by way of questionnaires and meetings. Questionnaires were sent to people in November of last year and mainly positive comments were received; Arden Lea do an excellent job in all areas, however one small point I have is that staff spare an extra few minutes to put clothes away in the right persons room and these are not creased in drawers, staff should be commended as they are very good, I am made welcome, I can approach the manager. The latest minutes of the resident and relatives meeting show us that people have had the opportunity in drawing up a new menu, discussed activities and celebrations and general issues about the care home. The manager states that meetings are not held that often as it is generally the same people that attend and the support and feedback is small. One person using the service confirmed that they attended a meeting and that they had a say about the choices of food. The provider visits the care home on a monthly basis and prepares a report of their findings. We saw that both positive and negative comments are logged for staff to address if needed. Staff meetings also take place, the latest meeting minutes show us that the menu, cleanliness and tidiness of the care home, use of incontinence aids, care plans and medication have been discussed. One member of staff spoken with confirmed that these meetings take place and that Care Homes for Older People Page 26 of 31 Evidence: they are helpful. People may keep their personal money in the care home safe should they wish and they can access this money at anytime. We checked four peoples person accounts and all of these show us that accurate records are kept as well as receipts for all transactions. One person using the service said, matron has my money, I am happy with this arrangement, I can get it when I want. Most of the policies and procedures in place have not been updated since 2004/2005 and therefore do not contain up to date information. The manager said that she is aware of this and plans to address this issue. On speaking with a senior member of staff they said that although policies and procedures are not up to date, all staff do follow good practices and they have not seen any bad practice taking place. The annual quality assurance assessment tells us that routine maintenance and testing is taking place to ensure that people using the service are protected. We checked the electrical, gas and hoist certificates, which confirm that checks and servicing are tacking place as required. The fire safety logs show us that routine tests and fire drills are taking place as required ensuring that people using the service are protected from the risk of fire. Additional training for staff is also currently being arranged with the Fire Authority. Care Homes for Older People Page 27 of 31 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 28 of 31 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 7 13 Risk assessments must be in 29/05/2009 place for peoples specific needs. This will ensure that risks are managed and people using the service are protected. 2 7 15 People using the service 18/06/2009 must be involved in the care planning process. This will ensure that people are enabled to have a say in how they wish their care to be delivered and how they wish to be supported. 3 7 15 Plans of care must be in place for peoples specific needs. This will ensure that peoples needs are fully met. 18/06/2009 4 9 13 You must ensure that 19/05/2009 sufficient stocks of medication is available for people using the service and Care Homes for Older People Page 29 of 31 medication is administered as prescribed. This will ensure that people receive their medication as prescribed and their health and wellbeing is maintained. 5 19 23 You must remove the unsafe 29/05/2009 covering at the identified window. This will ensure that people using the service remain safe and they can open their windows if they wish. 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 Reviews are developed to become more personalised to reflect the actual support people have received and any changes that may have occurred. Plans of care are further developed so that these are personalised to reflect peoples individual needs and they are supported in their preferred way. A system is implemented that allows an audit trail of medication that has/has not been administered to take place, so that safe systems of work are maintained. Repair or replace the rotting woodwork on the outside of the building to ensure that people live in a well maintained environment. Address the remaining areas that require redecoration so that people live in a comfortably maintained environment. Update all policies and procedures to ensure that they contain up to date information so that staff are fully informed of best practice. 2 7 3 9 4 19 5 6 19 37 Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!