Inspection on 19/12/08 for Ashfield Rest Home

This inspection was carried out on 19th 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

Ashfield Rest Home 21/01/08

Ashfield Rest Home 25/06/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashfield Rest Home 18 Windsor Square Exmouth Devon EX8 1JX     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: Vivien Stephens     Date: 1 9 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. 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 31 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 31 Information about the care home Name of care home: Address: Ashfield Rest Home 18 Windsor Square Exmouth Devon EX8 1JX 01395264503 01395275652 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) South West Care Homes Limited Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 25 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 home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home Ashfield is a residential home providing personal care for up to 25 older people who may have dementia or physical disability. It is situated in a quiet residential area of Exmouth approximately half a mile from the town centre. Accommodation is over 3 floors, with a stair lift between the ground and upper floors. All rooms are single occupancy. There is a central courtyard area and small front garden. Steps lead up to the front door but there is a level access through a side door. Services not included in Care Homes for Older People Page 4 of 31 Over 65 0 25 25 0 Brief description of the care home the fees are hairdressing, chiropody, papers and magazines and incontinence pads. CSCI Inspection reports are available upon request. 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: 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: Several weeks before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment. They returned this in good time. The form gave us some information about the way the home is operated and the services they provide. We sent survey forms to the home to be distributed but unfortunately only one survey had been returned to the Commission by the time this inspection took place. We agreed to wait for more surveys to be returned before completing this inspection report. On the day of this inspection we arrived at 8.45am and left at approximately 4.45pm. There were 23 people living in the home on that day. Care Homes for Older People Page 6 of 31 During the day we talked to 10 people living in the home, 2 staff, the manager and the owner. We carried out a tour of the home. We looked at some of the records the home is required to keep including assessment and care plans for four people living in the home, staff recruitment, training and employment records, records of complaints and incidents, medicines administration, menus, and health and safety records. What the care home does well: What has improved since the last inspection? What they could do better: Some of the older care plans could be improved to provide a similar level of detail to Care Homes for Older People Page 8 of 31 those that have been written more recently. The way that activities are planned and organised could be further refined by using the information gathered during the assessment stage before people move in to make sure they continue to follow regular interests and social activities. Some parts of the kitchen have become worn and damaged and are in need of repair or replacement. The home must make sure all areas can be kept clean and hygienic to prevent the risk of infection. One radiator that was not working properly should be repaired as soon as possible and the temporary radiator (that is not covered and therefore may pose a risk of accidental burns or scalds) should be removed or fixed permanently and covered. An application to register the manager should be submitted to the Commission as soon as possible in order to confirm her fitness to manage the home. 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 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. There is a good exchange of information before people move to ensure they have all the information they need to make an informed decision about where they want to live, and the home can be certain they can meet the persons needs. Evidence: Before this inspection took place the home completed and Annual Quality Assurance Assessment (AQAA). They told us that when they receive an enquiry from someone who is thinking about moving in they will liaise with other professionals and relatives as well as meeting and gathering information from the person. They also said they will invite people to visit the home and to stay for a meal if they wish. People will be given written information about the home in an information pack. This will include a copy of their Statement of Purpose. Care Homes for Older People Page 11 of 31 Evidence: We talked to one person who had recently moved into the home. She said she had visited several other homes but chose Ashfield as she felt it was the most suitable one for her. She said she felt she had made the right decision and had settled in very well. We looked at four care plan files to find out the information the home has gathered about people before they moved in. We found that they had gathered good information about all aspects of peoples needs and this information had helped them to form the basis of an initial care plan. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place to make sure that each person receives exactly the right care they need to meet their personal and health care needs. Medications are safely stored and administered. Evidence: During our visit we looked at four care plan files to find out how the home had recorded peoples care needs. We then went and talked to people to find out if their care needs had been accurately assessed. We looked at the way the staff used the information in the care plans, and the way they had recorded the actual care each person has been given. At the last inspection we found the care plans had improved but needed further development to make sure that each persons health care needs were met. At this inspection we found that the new manager had introduced further improvements and better detail to the care plans. The care plans clearly set out each persons preferred Care Homes for Older People Page 13 of 31 Evidence: daily routine and explained the care tasks that the staff should carry out throughout the day. Many of the care plans gave a brief explanation of the persons history and background that gave useful information to the staff to help them get to know the person and understand their needs. The care plans were neatly filed and this made it easy to find information quickly. Daily care reports had been completed by the care staff both at night and during the day. The way care staff had completed the daily reports had recently changed and the most recent entries showed that the care staff had followed the care plans and carried out the tasks listed in the care plans. We looked at the care plans completed by the new manager since she began working in the home. We found that her care plans contained very good detail about each persons personal and health care needs and the way they wanted to be assisted. The plans were clearly written and easy to follow. The daily recording system included a form to record all personal care tasks carried out. Each care plan file contained assessments on the persons moving and handling needs and these had been regularly reviewed. They also included assessments on each persons skin condition showing any possible risk of developing pressure sores, and the action needed to prevent this. The care plan files contained records of visits by doctors, nurses and any other health or social care professional. The files showed that the home had sought advice and treatment appropriately. We could not see any evidence to show that people had been given a copy of their care plan, or that they had agreed that the care plans were correct. We talked to the manager about this and she agreed to do this in future. The care plans have been reviewed every month and we saw evidence to show that relatives have been consulted (where appropriate) during the review to check the care plans were accurate. We observed a handover session during the afternoon of our inspection when the senior care assistant instructed a member of staff on any changes in the care needs of the people living in the home. The session was handled in a professional and thorough manner and we were satisfied that the care worker starting her duties knew about every persons current care needs. We talked to 10 people about the care they received. We asked if they were satisfied Care Homes for Older People Page 14 of 31 Evidence: with the way the care staff assisted them. Every person we talked to praised the care staff and said they were completely satisfied with the way they were cared for. They said the staff were always kind and helpful, and there were sufficient staff employed to help them whenever they wanted assistance. We heard that people could get up when they wanted and go to bed when they wanted. We saw staff accompanying people to return to the privacy of their rooms when they wanted assistance, and this demonstrated that care workers respected peoples privacy and dignity. One person we talked to said We are very happy here. We are VERY well looked after. They are such nice people here. We all get on very well. We looked at the way the home received medicines into the home, and the way they were stored and administered. The home uses a monitored dosage system supplied by a local pharmacy in monthly blister packs. The packs were stored in two secure medicine trolleys along with other daily medicines. We checked the records completed each time medicines were given out and found they were in good order. The amounts of medicines received into the home had been checked and recorded, and there was a record of the amount held in the home at the end of the month and carried forward. Any medicines that needed to be kept cool were stored in a locked fridge kept in the office. There was a record of the staff who were trained and authorised to give out medications. These were senior staff who had received detailed training on the safe administration of medicines. 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. People are offered a good range of opportunities to take part in a range of activities to suit most interests. People are offered a balanced and healthy range of meals to suit all individual dietary needs and preferences. Evidence: Since the last inspection a member of staff has been given specific responsibility for organising and providing a range of activities on two days each week. In addition to this the care staff provide a range of activities on other days, including time spent individually with people. This inspection took place a week before Christmas. In the dining room we saw printed lists that had been given out to people to let them know about the festive activities planned for the week. Something had been planned for each day. We talked to the activities organiser and also the manager about the way the home plans and organises daily activities. We heard that they have funds available to buy Care Homes for Older People Page 16 of 31 Evidence: any equipment or games that people might enjoy. We saw that the initial assessment information gathered about each person before they moved into the home included details of the things they enjoyed doing. We could not see how this information had been used to help the activities person when planning future activities. The manager said she would make sure the information was passed on to the activities person in future. We heard how the staff have talked to people to find out what they wanted to do. An example of this was a recent outing to a nearby garden centre where people went for a festive meal. Photographs had been taken of the event and we could see that many people had joined in and enjoyed the outing. Some of the regular activities provided by the home has included games and quizzes, film shows, musical entertainment and outings. A record has been kept of the activities each person has participated in. We saw people busy knitting during the day, and also heard about regular flower arranging sessions. The records we saw also showed the time spent with each person by their Key worker. This included shopping trips, manicures, time spent helping them to sort out clothes and checking that clothes were in good order, or time spent sitting and chatting to them. We heard that all staff are expected to set aside time each month for each person they are Key worker for. During the day we saw several relatives visiting the home. Some took people out for shopping trips or outings. We saw staff making them feel welcome and saw that there was good communication and relationships between the staff and visitors. The people we talked to told us their families were always made welcome whenever they visited. One lounge has recently been redecorated and refurbished and this offers a quiet and comfortable room where people can receive their visitors. We looked at the menus and how these had been planned. The people we talked to who lived in the home told us that a member of staff goes around every day with a list of the meals planned for the following day. People are offered a choice of meals. We saw that a record has been kept of the meals each person has received, and these showed that individual preferences and dietary needs had been met. All of the people we talked to said the meals were very good and always to their liking. The care plans showed that peoples weight had regularly been checked and we heard that those people who may have weight problems that affected their health had specific help and support where necessary. This included offering supplementary foods/drinks. Staff told us that they knew about those people who needed meals to be cut up or pureed and this would be carried out discretely. Care Homes for Older People Page 17 of 31 Evidence: The dining room was bright and airy and tables had been attractively laid with colour co-ordinating tablecloths and mats. We were told that this room was due to be redecorated in the near future. The kitchen was showing signs of wear and tear. The flooring was worn and a worktop next to the sink was damaged and unhygienic. Other parts of the kitchen appeared to be in need of redecoration or repair. We talked to the owner and manager about this and they told us that there were plans to upgrade the kitchen but no firm dates for this work had been agreed. They were aware that a total upgrade of the kitchen would cause considerable upheaval for the home and would need to be carefully planned. The owner said that, as a temporary measure, they would arrange to carry out immediate repairs to those parts of the kitchen that were most in need of repair, while continuing to plan a total upgrade of the kitchen at a later date. (See also Environment section). 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 can be confident that they will be protected from harm or abuse by well trained staff and good management systems. Evidence: We talked to people in the home to find out if they knew what to do if they had a complaint. They told us they felt confident they could talk to the manager or the owner when he visited, and that their complaints would be taken seriously and acted upon promptly. The manager has kept a record of all complaints, concerns, incidents and compliments they have received in the last year. We found that all incidents have been taken seriously and actions had been taken where possible to prevent any further problems from occurring. We saw a number of letters and cards from relatives expressing their gratitude for the care provided by the staff. The home has been involved in one safeguarding strategy meeting in the last year. The matter has been investigated by Devon Social Services. The home demonstrated that they have co-operated fully with all relevant professionals and they have taken any action necessary. The records showed that all staff have received training on the protection of vulnerable Care Homes for Older People Page 19 of 31 Evidence: adults. We talked to two members of staff during our inspection about the way the home deals with any concerns or complaints. They assured us that there is an open atmosphere within the home and they felt confident that any potential poor practice would be dealt with immediately. They said they were confident that the manager would address any poor practice, complaints or potential abuse promptly and professionally. 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 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 an environment that is generally clean, safe, comfortable and homely and there are signs of constant improvements. Planned upgrading of the kitchen may need to be prioritised in order to ensure all areas can be kept clean and hygienic. Evidence: Since the last inspection some improvements have been made in a number of areas. New windows and doors have been installed in most areas and this has made rooms brighter and warmer. Some new carpets have been laid and some rooms have been redecorated and upgraded. Both the main lounge and the small lounge have been redecorated and some new furniture provided. The owner and manager told us that they have plans to make further improvements to the home in the future. This includes installation of a shaft lift, further redecoration and upgrading of bedrooms, and a new kitchen. No firm dates have been set for the major works, but redecoration and upgrading of bedrooms and communal areas is ongoing. As already stated in the Daily Life and Social Activities section, the kitchen showed signs of wear and tear. The flooring, one worktop, and a patch of plaster needed attention in order to ensure these areas can be kept clean and hygienic. We advised Care Homes for Older People Page 21 of 31 Evidence: that the home should consult the Environmental Health Officer on their plans for upgrading the kitchen in order to make certain that works are carried out at a time that suits the home, while at the same time ensuring that people are safeguarded from any possible risk of cross infection. During a tour of the home we looked at the kitchen, laundry, offices and storage areas, the lounges and dining room, bathrooms, toilets and approximately half of the bedrooms. We found all areas were clean and free from any unpleasant odours. On the day of this inspection there were two cleaning staff employed. Since the last inspection a new sluice has been installed. This means that safe procedures can be followed when emptying commodes and dealing with bodily fluids. The home appeared comfortable and homely throughout. The home has recently appointed a maintenance person who has responsibility for all day-to-day repairs and maintenance and also some redecoration tasks. Those areas that had recently been redecorated appeared bright and attractive. A few areas of paintwork showed signs of wear and tear and the owner and manager said that these areas would be addressed by the maintenance person within their ongoing plan of redecoration. One of the ground floor bathrooms has recently been upgraded to provide a wet room giving level access for people who want a shower. Some of the other bathrooms and toilets appeared dated and showed signs of wear and tear. We heard that the long term plan was to upgrade all bathrooms and toilets but no date is planned yet. During this inspection we saw copies of routine servicing and maintenance checks carried out on the equipment. There is a pleasant enclosed courtyard at the back of the house that has been recently repainted. There are flower beds, ornamentals trees and seating. Many of the ground floor bedrooms open directly onto this area. 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. The home employs sufficient trained and experienced staff to provide people with the support and care they need. People are safeguarded by careful recruitment practices that ensure only staff who are entirely suitable are employed. Evidence: On the day of this inspection there were 23 people living in the home. Everyone was in general good health and there was no-one needing a high level of care. During the morning there was a manager, a head of care, 2 care assistants, 2 people working in the kitchen, and 2 cleaning staff. We saw that routines were carried out in a timely and unhurried manner and all staff were relaxed and cheerful. We looked at the files of those staff who had been recruited since the last inspection. We found the home had followed safe recruitment practices by obtaining at least two satisfactory references and a criminal records bureau check before the staff were confirmed in post. We also heard that the home was in the process of recruiting four more staff but they were waiting for references and checks to be completed before the staff could begin. The manager told us that if they can use bank staff employed by the company who own the home if they are short staffed. This means the bank staff are familiar with the Care Homes for Older People Page 23 of 31 Evidence: systems in the home and have been vetted and trained to the same standard as other staff employed in the home. The manager also showed us a copy of a nationally recognised calculation tool they regularly use to check that they have sufficient staff to meet peoples needs. We checked the training records for the staff. The company have recently introduced a new computer system in all of their care homes, and when all of the information has been transferred to the computer it will provide a quick and efficient system for checking employment and training records. The records we saw showed that staff have received a good range of training and updates on all health and safety topics, and on various relevant health and dementia related topics. We were shown the homes training plan giving a range of training topics over a 14 month period, with every member of staff expected to attend at least one training session each month. This training plan includes a range of training on dementia. Information provided by the home showed that, at the time of this inspection visit, 11 care workers were employed. Of these, 8 staff held a relevant qualification known as NVQ (or equivalent), and two staff were in the process of obtaining this qualification. 4 staff have been recruited from overseas with nursing or medical qualifications that are at least equivalent (or higher) to an NVQ. This demonstrated that there is a high level of well qualified staff and experienced staff employed by the home. The staff who have been employed from overseas who were on duty on the day of this inspection had good English language skills. The manager told us that she has arranged for all overseas staff to attend English evening classes to further improve their communication skills. The manager told us she has recently started supervision sessions for the senior staff and she intends to organise regular supervision sessions for all staff when all of the staff they are in the process of recruiting have begun work. 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. The home is well managed, although an application for the registration of the homes manager should be submitted in order to confirm her fitness for this post. Safe systems have been followed to ensure people who live and work in the home are protected from the risk of harm or theft. Evidence: At the time of this inspection a manager had been appointed and has been in post for several months. We have been told that she holds a nursing qualification and has had relevant experience. An application for registration has not yet been received by the Commission but she said an application will be submitted early in 2009. The staff and people living in the home we talked to were positive about the way the home operates and expressed confidence in the way the home was managed. The home has a range of methods of checking the quality of services provided by the Care Homes for Older People Page 25 of 31 Evidence: home. They have recently sent out questionnaires to people living in the home and their relatives and we saw the responses they received, all of which were positive. We suggested to the manager that the wording and layout of the questionnaires is adjusted in future to encourage people to make more suggestions and comments. We looked at the way the home handles cash on behalf of those people who do not want to keep money in their rooms or on their person. The cash was held in individual wallets and all transactions were carefully recorded, receipts retained, and balances regularly checked. We were told that access to this money is restricted to the manager only and the money is stored securely. Since the last inspection the home has tightened up their policy and procedure for staff receiving gifts. Where possible the home does not allow staff to accept gifts of money. Any small gifts such as chocolates are kept in the office and distributed to all staff once a year. We saw records relating to safety and maintenance procedures in the home. Equipment has been regularly services and maintained. Fire precaution records showed that fire safety has been upheld and staff have received a range of training and fire drills. Accident records have been completed and filed for all accidents and incidents occurring in the home. Staff have received training and updates on all health and safety related topics. All radiators have been covered to reduce the risk of accidental burns. However, one radiator has not been working properly in one bedroom and a portable oil filled radiator has been used on a temporary basis. This radiator did not have a low surface temperature cover, but was placed behind a chair and therefore was unlikely to pose a hazard. We were told that the maintenance person was in the process of dealing with the faulty radiator and therefore the use of the portable radiator was expected to by only for a short period. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes No X 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 31 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 19 23 The home should consult with the Environmental Health Department to ensure that all parts of the kitchen are in good repair and do not pose a health hazard. This relates to the kitchen flooring, one area of damaged worktop, one area of damaged plaster, and any fittings that are worn. The home must ensure that these areas can be kept clean and hygienic to prevent the possibility of the spread of infection. 22/02/2009 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 The home should have evidence to show that each person has seen a copy of their care plan and agreed the content. The detail in some of the care plans could be improved to bring them all up to the same standard as those written Care Homes for Older People Page 29 of 31 more recently. 2 12 Information about peoples activities and interests before they move into the home should be passed to the activities organiser so that these can be incorporated into the regular group and/or individual activity plans. An application for the registration of the homes manager should be submitted to the Commission as soon as possible. repairs should be carried out promptly to the main heating in one bedroom as soon as possible. The use of a free standing oil filled radiator in this room should be a temporary measure and carefully risk assessed only for the period while the main heating in the room is being repaired. 3 31 4 38 Care Homes for Older People Page 30 of 31 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. 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