Inspection on 13/10/08 for Ardenlea Grove

This inspection was carried out on 13th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ardenlea Grove 24/10/07

Ardenlea Grove 14/06/06

Ardenlea Grove 14/03/06

Ardenlea Grove 13/10/05

Ardenlea Grove 17/02/05

Ardenlea Grove 29/09/04

Ardenlea Grove 23/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ardenlea Grove 19-21 Lode Lane Solihull West Midlands B91 2AB     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: Patricia Flanaghan     Date: 1 3 1 0 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. the things that people have said are important to them: They reflect 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 © (2008) 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: Ardenlea Grove 19-21 Lode Lane Solihull West Midlands B91 2AB 01217059222 01217059333 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: BUPA Care Homes (AKW) Ltd care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category 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 (OP) 60 Physical disability (PD) 60 Date of last inspection Brief description of the care home Ardenlea Grove is a purpose built care home, which can provide general nursing care for 60 older people who may also have physical disabilities. Ten beds are designated for a continuing care contract with Solihull Primary Care Trust. Built in 1996/7, the premises are located within a development of retirement homes and flats. The home stands in its own grounds and is situated opposite Solihull Hospital on the main thoroughfare from Solihull to the Coventry Road. It is in close proximity to local shops, local transport services and other community amenities. The building has three floors and a basement, the latter being used for utility services and staff rooms. The main part of the home is accessed from the reception area on the ground floor and has a Care Homes for Older People Page 4 of 29 0 60 Over 65 60 0 Brief description of the care home passenger lift. All bedrooms offer single accommodation and have an en suite facility including an assisted shower or bath. The home is a non-smoking environment but should people wish to smoke a garden area is available and easily accessible. The home has hoists and pressure relieving equipment to meet the assessed needs of the people living there. There are assisted toilets and bathrooms available and corridors are wide and spacious and enable residents to move around the home freely with any aids they require. Each floor has a dining room and spacious lounge. The home has a Loop hearing system fitted into the reception area, which can assist people who have hearing impairments. Previous inspection reports of the home are available from the manager should anyone wish to read them. Current fee rates are included in the homes brochure which can be obtained from the manager. Additional charges include chiropody, visitors meals, hairdressing and toiletries. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of our inspections is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. This inspection was unannounced and lasted nine hours over one day. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. This included talking to people who use the service and observing their interaction with staff, where appropriate. We also spoke with the manager, three members of staff and two visitors to the home. We also looked at the environment and facilities provided and checked records such as care plans, risk assessments, staffing Care Homes for Older People Page 6 of 29 rotas and staff files. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. Prior to this inspection the manager completed and returned to us an Annual Quality Assurance Assessment (AQAA) document. This document informs us about how providers are meeting outcomes for people using their service. Our assessment of the quality of the service is based on all this information, plus our own observations during our visit. What the care home does well: What has improved since the last inspection? What they could do better: We have made three good practice recommendations as a result of this inspection. All medicines that are administered should be in date. Any unwanted or excess medicines should be disposed of in accordance with the homes medication policies. This is to ensure the health of people living in the home. Care Homes for Older People Page 8 of 29 Arrangements should be in place to ensure staff take appropriate action where there is unplanned weight lose or gain. This will minimise the risk of further weight fluctuation and a deterioration in peoples health. Risk assessments should be developed on an individual basis for people who live in the home. These should cover daily living activities both in the home and in the community. This is to reduce any risks identified and promote the health and well being of people. 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.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 who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: The manager told us that each person living in the home has a copy of the Service User Guide. This was confirmed by two residents. A copy of the homes brochure, which inlcudes the range of fees charged, is given to prospective residents. We also saw this document in peoples bedrooms. We looked at the case files of six people, including that of a person recently admitted to the home to assess the pre-admission assessment process. We were told that it is usual practice for the manager or deputy manager to undertake an assessment of people who are considering moving into the home. The manager told us that the organisation have introduced an assessment programme which enables the home to Care Homes for Older People Page 11 of 29 Evidence: collect sufficient information to ensure they deliver person centred care. We saw comprehensive assessments on the files we looked at. From the information in the assessments the home will plan care for the person. For example, a person had been identified by both the hospital and the home as having below average weight and being at risk of malnutrition. A care plan had been developed to ensure the persons nutritional needs were met. The person was being weighed regularly and had gained weight since admission to Ardenlea Grove. The home does not provider intermediate care facilities. 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 who use this service can feel confident their personal and healthcare needs will be met and can expect to be treated with respect and dignity at all times. Evidence: We looked at the care planning documentation for six people who use this service and case tracked three of these people. We track peoples care to see if the service is meeting their needs. All of the care plans had been written following a full assessment of the persons needs. The assessment covered all aspects of daily living and identified potential risks such as pressure sores and the risk of falling. Care Plans were detailed and had been updated and reviewed monthly. We saw evidence that peoples individual needs had been taken into account. For example, one person had been identified as having limited mobility. It was recorded that the person wished to be able to walk short distances with the aid of a frame. We saw that a care plan had been put in place which set out clearly how staff could help the person mobilise safely. The person told us that they had been encouraged by staff to build up Care Homes for Older People Page 13 of 29 Evidence: their strength and try a little bit extra every day, if they felt up to it. We found that where people were judged to be at high risk the home, with a few exceptions, had taken steps to manage this. For example, as detailed in the section Choice of Home we saw where a persons nutritional needs were appropriately monitored. However, we saw that while the home had identified that another resident had lost weight, it had not prompted staff to question the weight loss, other than to put in place Plan B. It was unclear in the documentation we looked at what Plan B was. For example, the person weighed 58.60kg in August and 51.3kg in September. There was no information to show any action taken by staff to investigate or resolve this weight loss. The manager explained that the correct procedure was for the person to be referred to a dietician, but was unable to find evidence that this had been done. She undertook to follow this up as a priority. Another person regularly left the home for social occasions. There was no guidance on any action staff should take if the person did not arrive back to the home by an appointed time. The manager also undertook to address this. We saw a risk assessment had been developed where a person was assessed as needing bed rails in place on their bed. The risk assessment documented the decision to use the bed rails in the best interests of the resident. This means that staff had considered the best way of maintaining the persons safety. Evidence was available to confirm that people living in the home have access to other health professionals such as a GP, district nurse, community psychiatric nurse and optician. We also saw evidence on the files that people had been involved in planning or reviewing their own care. This was also confirmed by a resident and a visiting relative. Medication management was looked at and two trained staff were spoken with. It was found that this was managed well and improvements made since the last inspection visit had been sustained. The medication room was clean and well organised. Staff were keeping clear records of all medication that is ordered, received, stored and administered in the home. The responsibility for all ordering and administration of medication is that of the registered nurses. The Medication Administration Records were completed properly and showed when medication was given. All audits undertaken during the inspection were correct indicating that staff are giving the medicines as the doctor intended. The nurse on duty that assisted us with checking the medicines was knowledgeable about the medications prescribed for the people on that floor. The reasons for any dose changes made on the instruction of a GP were well documented and signed by two nurses. Care Homes for Older People Page 14 of 29 Evidence: Each floor has a separate locked medicine refrigerator. Temperatures were recorded on a daily basis and these fell within safe limits. We found an eye drop which had been opened on 18/09/08, in the refrigerator . Any remaining liquid left after the 5-day treatment should have been disposed of as the eye drop will be out of date and may increase the risk of further infections. The manager told us the resident is currently in hospital and made immediate arrangement to safely dispose of the remaining eye drop. Some good practice was seen. The medication policy document is kept in the medication room and is available for people to read. The document gives staff clear instruction and guidance about medication management within the home. Specimen signatures of all staff that administer medication are kept in the front of the Medication Administration Records. A record is also kept of the administering nurse for each drug round. People looked well cared for and wore clothes that were appropriate for the time to year. Staff were observed to treat people living in the home with dignity and respect and were kind, caring and attentive towards them. Residents and their visitors were observed to be at ease to call staff by their name and make requests for anything they needed within the friendly atmosphere that is maintained in the home. People spoken with during the inspection visit felt staff responded to them appropriately, respected their privacy and dignity and understood their needs. Comments included: I am very well looked after. Everyone is very nice here, they (the staff) are very attentive. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by the home in maintaining contact with their families and friends. They are able to exercise choice over their daily lives and the activities they choose to participate in, which promotes their individuality and independence. Meals are well balanced and nutritious. Evidence: The home recognises the right of individuals to live an ordinary and meaningful life appropriate to their abilities. For those people we case tracked we saw their hobbies, interests likes and dislikes recorded in their files. It was clear through discussion with these individuals that they are encouraged to follow their interests as well as being offered the opportunity to join in group activities. As seen at the last inspection, there is a dedicated activities co-ordinator and there are various in house activities undertaken on a daily basis. The manager told us that activities are also now provided at week ends. Activities undertaken include nail manicures, hand massage, quizzes, karaoke and exercise videos. External entertainment is provided from singers, accordion player, music and movement and a reminiscence group. The manager told us that a magician had been booked to perform Care Homes for Older People Page 16 of 29 Evidence: at the homes bonfire party in November. Activities are arranged on various floors, but people are encouraged to go to other floors so they meet other people in the home. For example, a number of people have formed a knitting club and are currently knitting hats for premature babies. Holy Communion is given monthly and a Catholic priest visits 6 weekly. The manager told us that no one of any other religion was living in the home at this time, but staff could assist people from other faiths to meet their cultural needs. A hairdresser visits twice weekly and people can engage in this activity if they choose. Newspapers of their choice are delivered to individual residents. We saw two people reading their newspapers and one person told us they like to keep up to date with whats happing out there. People who were able to mobilise independently were seen to access all areas on their own floor, although in theory can access all floors if they choose to do so. People living at Ardenlea Grove told us they were able to rise and retire as they wished, see their friends and family when they chose and participate in the social activities available. People are encouraged to go out into the community and the activity co-ordinator will also assist people with their shopping. Two people told us how they attend their social clubs independently. The manager has told us in the AQAA that the home are hoping to arrange more outside trips in the coming months. The home produces a newsletter and we saw from the most recent edition that people had enjoyed a Mediterranean Cruise theme week in the Summer. A photograph album was seen in the reception area which showed people participating in the various activities arranged during the theme week. For example, food and entertainment pertaining to the country being visited was provided. The home hopes to arrange a similar theme week next year. It was stated in the AQAA that two residents surveys had been undertaken to ensure the meals provided takes into consideration individual dietary needs and the likes and dislikes of people. Some people told us that they would like to see more traditional food being served. The manager said that a new chef had been appointed and they were in the process of updating the menus with help from the residents. The dining areas on all three floors were spacious and tables were nicely laid with clean linen cloths, condiments and flowers. The meal was well presented including liquidised meals in keeping with good practice. People told us they enjoyed the meal and the food generally offered at the home. Where people had chosen to eat in the lounge their meals were delivered to them plated and covered. We saw people who were unable to feed themselves independently being assisted in a sensitive and professional Care Homes for Older People Page 17 of 29 Evidence: manner by staff. People told us, there is always plenty to do, but no one forces you to do something you dont want and I like a lie in sometimes, the girls dont mind and bring me my breakfast later. Care Homes for Older People Page 18 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 using this service can feel confident their views will be listened to and acted upon. Staff have been trained to recognise, understand and take action to prevent people being harmed. Evidence: The complaints procedure is available within the home and is also available in the service user guide given to all people who live in the home. People spoken to during the inspection said they had no complaints and would know who to speak to if they had any concerns. Comments received from people include; I have nothing to complain about, except perhaps the food, and I know they are sorting that out; I would complain if I had to but the situation has never arisen. A visitor told us I have never needed to raise any concerns, but I know if I did it would be dealt with immediately. Since our last visit the home has received six complaints all of which have been appropriately investigated and the outcome recorded. We have not received any formal complaints about the home. A policy on adult protection is available in the home. The manager was aware of her responsibilities in relation to adult protection. Staff have attended training on how to recognise abuse and when questioned were able to state what they would do including Care Homes for Older People Page 19 of 29 Evidence: reporting this to the manager. Care Homes for Older People Page 20 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 live in a safe, well-maintained and comfortable home. Evidence: Ardenlea Grove is well maintained. Full time maintenance staff are in post ensuring the home and grounds are maintained to a good standard. A routine checking and maintenance programme is in place. The home is a three storey building and access is available to all areas via a passenger lift. All bedrooms have en suite shower and toilet with the exception of six rooms that have a bath. There is a dining room and lounge on each floor which are spacious and enable people who require mobility aids to manoeuvre freely around the home. It is nicely furnished with appropriate seating and quality soft furnishings. Corridors are wide and have handrails to both sides and this assists people to mobilise independently. In addition to the en suite facilities there are communal bathrooms and toilets for people to use. The grounds are well maintained and are used for a variety of purposes. During the warmer months activities and entertainment are provided in the gardens. The manager told us of plans to encourage people who are interested in gardening to assist in the greenhouse and the garden. Care Homes for Older People Page 21 of 29 Evidence: Bedrooms are well maintained and those seen were all personalised to the wishes of people occupying them. The manager told us that BUPA are implementing a five year refurbishment programme for the home. The laundry is handled in a separate area in the home and there is a good infection control policy in place. The home is clean and tidy and is maintained by a dedicated housekeeping team who keep the home pleasant for the people who live there. There was an unpleasant odour in one room which was brought to the attention of the deputy manager during our walk around the home. People living at the home told us they were happy with their surroundings. Some of their comments include:The home is always clean and tidy; My room is cleaned every day, its a very comfortable room; My clothes are always neatly put away after laundering; I like having my own pictures on the wall, it reminds me of home; This home suits me down to the ground. Care Homes for Older People Page 22 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. People living at Ardenlea Grove are supported by staff who are recruited safely, trained appropriately and who understand peoples needs. Evidence: The manager told us there were 45 people living in the home on the day of this inspection visit. It was her assessment that 10 people had high dependency care needs with the remainder having low to medium care needs. Staffing rotas examined showed an adequate number of staff and skill mix are on duty each shift. It was considered on the day of the inspection that the home was adequately covered in terms of the level of clinical and personal care input required. People spoken with made mostly positive comments about staff saying, the staff are very good; they are all very kind to me; and all the girls are lovely, all very kind and thoughtful. The personnel files of two recently recruited staff were examined and both contained evidence that satisfactory checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and references are obtained before staff commence employment in the home. Robust recruitment procedures and pre-employment checks should protect the vulnerable people living in the home. Care Homes for Older People Page 23 of 29 Evidence: A training matrix is maintained and used to record staff training and to identify any gaps in learning. Records demonstrate that all staff complete an induction programme and receive mandatory training in moving and handling, infection control, abuse awareness, fire safety and food hygiene. This should mean that staff are updated in safe working practice. Induction training is provided to all new staff in line with the skills for care induction standards. We saw evidence of completed induction training and staff confirmed they had completed training when we spoke to them. Training leading to National Vocational Awards (NVQ) is provided and 15 of the 32 permanent care staff have this qualification. The manager has told us in the AQAA that it is the intention of the organisation to enroll all care staff on this training. This should mean that people living in the home are cared for by competent staff. Additional training undertaken by care staff since the last inspection visit includes, stroke awareness and tissue viability training. Care Homes for Older People Page 24 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. The home is managed well and is run in the best interests of the people who live there. Evidence: There has been no change in the management of the home since our last visit. The registered manager has been in post since 2005 and is suitably qualified to manage the home She is a registered nurse and has completed the registered managers award (RMA). People gave us positive comments about both the manager and deputy, saying One or the other is always popping in to see how I am. A visitor told us, They have been a great help in getting my relative settled, I have peace of mind. There are clear lines of accountability within the home with the deputy manager reporting to the manager who in turn is supported by her organisational line manager. We received completed surveys from four staff members. Some of their comments include; Ardenlea Grove is run very well and efficiently Managers are very Care Homes for Older People Page 25 of 29 Evidence: approachable and their doors are always open if you need to discuss any problems. The manager comes on to the floor regularly and talks to us about different things. The managers are very approachable and you can talk to them about anything, they will always listen to you. The home holds monthly residents and relatives meetings and this gives people the opportunity to raise any concerns or to share ideas. The meetings also provide a social occasion and give people the chance to have their say about how the home should be run. Prior to the inspection the manager had completed the Annual Quality Assurance Assessment AQAA and this gave us good detail about the service provided, how it had improved and how the home wanted to improve further over the next year. The manager had a clear vision for how the home could move forward and this should ensure a proactive rather than a reactive approach. External managers provide support to the manager and complete quality monitoring visits to the home. Annual questionnaires are sent out to the people who live in the home and the information is collated into an annual report. The manager told us she intends to extend this and forward surveys to relatives and other interested stakeholders. We saw the following comment in the homes log of compliments, If she had been the Queen, she could not have been treated better. Evidence throughout this report demonstrates there are good outcomes for people living in the home. There is a robust system in place for the handling of peoples personal money and a financial audit is completed by BUPA each year. The money is held securely and there were records of all transactions with receipts. From information in the AQAA and records seen during the inspection visit, we found that all necessary servicing and maintenance of equipment and systems was up to date. Staff had received training as required, for example, manual handling and fire safety training. Action had been taken to meet the requirement made at the last inspection vsit and we saw evidence that they 5 year electrical safety test was up to date. Care Homes for Older People Page 26 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 27 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 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 8 Risk assessments should be developed on an individual basis for people who live in the home. These should cover daily living activities both in the home and in the community. This is to reduce any risks identified and promote the health and well being of people. Arrangements should be in place to ensure staff take appropriate action where there is unplanned weight lose or gain. This will minimise the risk of further weight fluctuation and a deterioration in peoples health. All medicines that are administered should be in date. Any unwanted or excess medicines should be disposed of in accordance with the homes medication policies. This is to ensure the health of people living in the home. 2 8 3 9 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!