Inspection on 15/01/09 for Ashley House

This inspection was carried out on 15th January 2009.

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

Ashley House 23/01/07

Ashley House 13/03/06

Ashley House 14/07/05

Ashley House 31/01/05

Ashley House 24/08/04

Ashley House 19/02/04

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 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashley House The Avenue Langport Somerset TA10 9SA     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: kathy McCluskey     Date: 1 5 0 1 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. 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Ashley House The Avenue Langport Somerset TA10 9SA 01458250386 01458250386 sue.ashley@southwestcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Frances Timbrell Type of registration: Number of places registered: South West Care Homes Ltd 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: Registered for 25 older persons in categories OP and DE (E) with a maximum of 6 DE(E) Date of last inspection Brief description of the care home Ashley House is situated in a residential area close to the centre of Langport. Service user accommodation is provided over two floors. There is a stair lift, assisted bathrooms and call system available at the home. Most rooms have en suite toilet facilities. Communal areas comprise of a lounge, dining room and large conservatory. The home has pleasant gardens that are accessible via ramps and wide steps. Ashley House is registered with the Commission for Social Care Inspection to provide care for up to 25 people over the age of 65 years who require assistance with personal care. Within the maximum number of 25, the home may accommodate up to 6 older people with dementia. The home is not registered to provide nursing care. The Registered Care Homes for Older People Page 4 of 30 Over 65 6 25 0 0 Brief description of the care home Manager is Mrs Susan Timbrell. The Registered Provider is South West Care Homes Ltd. The home has a social services quality rating. Social services currently have a contract for 9 of the homes beds. The home determines who is suitable to be admitted. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over one day (6hrs) by CSCI Regulation Inspector Kathy McCluskey. The registered manager was available throughout the inspection. At the time of this inspection 23 people were using the service and we were able to meet with a large proportion of the people living at the home during our inspection. We were also able to speak with staff. We were given unrestricted access to all parts of the home and records required for this inspection were made available to us. As required by the Commission, the home completed the Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well Care Homes for Older People Page 6 of 30 outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys were sent out to people who use the service, staff working at the home and healthcare professionals to seek their views on the quality of the service provided. We received completed comment cards from 7 people using the service, 3 staff and 4 health care professionals. These are some of the comments people using the service made; I feel very settled here, My experience of life at Ashley House has left me entirely satisfied and feeling completely at home, I have been here 16 months and have made this my home, I am very content thanks to the hard work of all the people who care for me. Other comments have been included in this report as appropriate. We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? At the last inspection three statutory requirements were raised. These related to required documentation for staff recruitment files (staff photogragh), staff supervision and temperature checks on bath hot water outlets. At this inspection we found that action had been taken to address these requirements. Further improvements could be made on recording systems for staff supervision and recording of water temperatures. Care Homes for Older People Page 8 of 30 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.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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information needed to enable them to make an informed decision about moving to the home. The home ensure that placements are only offered to people whose needs and aspirations can be met by the home. Evidence: The home has a Statement of Purpose and Service User Guide which provides people with information about the home and services offered. The registered manager confirmed that there had been no changes to these documents since the last inspection. We were also shown a folder which is made available to each person using the service. This contained very useful information about life at the home. We were able to speak to some people who had recently moved to the home. They Care Homes for Older People Page 11 of 30 Evidence: told us that they had been involved in the decision to move to the home and that they, or their relatives had been able to visit the home. The registered manager told us that she visits all prospective residents to ensure that their needs are fully assessed. The registered manager stated her commitment to ensuring that placements are only offered to people whose needs and aspirations can be fully met by the home. The registered manager ensures that appropriate action is taken when the needs of an individual change and can no longer be met by the home. Several examples were given to support this. Care plans examined at this inspection contained documented evidence of pre-admission assessments which had been fully completed. Assessments from health care professionals were also seen to be in place. Social Services have a contract with the home for 9 beds. The homes pre-admission procedure is followed for all referrals and the registered manager offers placements only where the home can meet the individuals assessed needs. People using the service told us that they were very satisfied with the care they received and that their needs were met by staff at the home. All staff spoken with confirmed that they had the skills and training needed to enable them to meet the needs of the people living at the home. Care Homes for Older People Page 12 of 30 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. The home ensures that peoples needs and preferences are clearly set out in their individual plan of care. People have access to a range of appropriate health care professionals. The home follows appropriate procedures for the management and administration of peoples medication. Evidence: During this inspection we spoke with approximately 12 people using the service. We also examined care plans for 3 people. We found care plans to be well maintained and up to date. Peoples assessed needs had been clearly identified and there was detailed information for staff as to how peoples needs should be met. Peoples preferences had been recorded and there was evidence that people had been involved in the care planning process. There was evidence that people had been consulted about their preferences. People spoken with during the inspection were positive about the care Care Homes for Older People Page 13 of 30 Evidence: they received; I feel very well cared for, The staff are very good and will always help you When we spoke to staff they told us that they were well informed as to the assessed needs of people living at the home; We look at care plans every day, The care plans contain up to date information about peoples needs. Staff also confirmed that they did not experience any difficulties meeting the assessed needs of people currently using the service. The registered manager gave us examples of action taken when the home could no longer meet the assessed needs of an individual. This provided us with evidence that appropriate health care professionals are consulted with and that appropriate action is taken, which sometimes results in an individual moving on to a placement which is able to provide nursing care. Seven people using the service completed comment cards for the Commission and in response to the question, Do you receive the care and support you need, all responded Always. I am very satisfied, More than sufficient and always so willingly offered, The staff attend to my every need and are always polite and caring. Three staff members completed comment cards and they confirmed that they were given up to date information about the needs of people living at the home. A range of up to date risk assessments were seen to be in place in the care plans examined. These included assessments relating to moving and handling needs, reducing the risk of pressure sores and environmental risk assessments. Care plans contained evidence that people using the service have access to a range of appropriate health care professionals. The home ensures that peoples weights are monitored each month and that any significant weight gain or loss is highlighted. Records examined at this inspection did not raise any concerns. A chiropodist, optician and hearing aid technician offer regular visits to the home. We received completed comment cards from 4 health care professionals. We asked if peoples health care needs were met by the care service. Three responded Usually and one Always. All seven people using the service, who completed comment cards for the Commission responded Always to the question, Do you receive the medical support you need? We examined the homes procedures for the management and administration of peoples medication. The home uses the monitored dosage system (MDS) with preprinted medication administration records (MAR). Medicines were found to be securely stored with no excess stocks. MAR charts had been appropriately completed. To aid identification, MAR charts included a photograph of each individual. MAR charts also contained important medical information about each individual. Discussion with staff and records examined, confirmed that only those staff who have received appropriate training are involved in the administration of medication. Care Homes for Older People Page 14 of 30 Evidence: People spoken with commented on the kindness of staff. They also told us that they were treated with respect. People looked well attired and comfortable in their surroundings. Staff were observed interacting with people in a warm, professional and respectful manner. Staff were also observed knocking on peoples bedroom doors before entering. Care Homes for Older People Page 15 of 30 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 living at the home are provided with opportunities for social stimulation. People are supported to make choices about their lives. The home ensures that people are offered a wholesome and varied diet. Evidence: The home offers people a range of activities. A four week activity plan has been developed which is based on ideas from people living at the home. In house activities include a range of board and card games, bingo, word games, indoor sport, exercise to music and reminiscence. The home has a library where books are regularly changed and there are a selection of DVDs, tapes and CDs. We were informed that outside entertainers visit the home and that trips out take place on a regular basis. A hairdresser visits weekly and holy communion is available. On the day of the inspection we observed 13 people enjoying a game of bingo which was facilitated by a member of staff. Two people were observed working together on a large puzzle. Some people chose to sit quietly reading their daily newspaper. People Care Homes for Older People Page 16 of 30 Evidence: told us that there was plenty going on if you wanted to join in and that you are never pressured into joining in, it is up to you. The home maintains records relating to activities and care plans contained information about peoples social history and activity preferences. Seven people using the service completed comment cards for the Commission and all responded Always to the question, Are there activities arranged by the home that you can take part in? The home welcomes visitors at any reasonable time in line with the preferences of each individual. A visitors policy is displayed in the reception area of the home. People told us that their visitors were always made to feel welcome and were always offered refreshments. During this inspection we observed people moving freely around the home. People told us that they made decisions about how and where to spend their day. All communal areas were seen to be utilised with some people choosing to spend time in the privacy of their bedrooms. People told us that they made decisions about what time to get up in the morning or retire to bed. Peoples preferences had been recorded in their plan of care. Each person we spoke to was very positive about the meals at the home. The home employs a cook and all meals are freshly prepared at the home. A four week menu was examined and this contained wholesome and varied menu options. A menu is displayed in the dining room and this provides alternatives. People told us that there was always plenty to eat and that snacks were available. We were able to see lunch being served in the dining room. At the request of a person using the service, the meal was roast beef and yorkshire pudding. The meal looked appetising and plentiful. In completed comment cards, people confirmed that they liked the meals at the home; The meals are always nicely presented and cooked well, The meals are good and there is always a varied menu, The food is excellent, The meals are very well presented and very appetising. Care Homes for Older People Page 17 of 30 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. Systems are in place to allow people to raise concerns. Appropriate procedures are in place to ensure that people are protected from the risk of harm or abuse. Evidence: The home displays a complaints procedure and people told us that they would feel confident in raising concerns if they had any. The registered manager told us that the home have not received any complaints in the last 12 months. No concerns have been raised directly with the Commission. Seven people using the service who completed comment cards for the Commission confirmed that they knew how to make a complaint. The four staff members who completed comment cards confirmed that they knew what to do if somebody had any concerns about the home. The home have a range of procedures in place to reduce the risk of harm or abuse to the people using the service. These include; Somersets policy on safeguarding adults, restraint, abuse, the management of peoples money and whistle blowing policy. The home also follows robust procedures for staff recruitment which include criminal record checks and checks against the protection of vulnerable adults register (POVA), before staff commence employment. Staff confirmed that they knew how to raise concerns, including how to contact Care Homes for Older People Page 18 of 30 Evidence: external agencies. Staff also told us that they would feel confident in raising concerns if they had any. Care Homes for Older People Page 19 of 30 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. The home provides a comfortable and homely environment where people can personalise their bedrooms and can choose from a selection of communal areas. The home is warm and clean and procedures are in place to reduce the risk of the spread of infection. Evidence: The home has been adapted and extended to provide accommodation for up to 25 older people. Accommodation is arranged over ground and first floor level. A stair lift gives access to the first floor. There are 21 single bedrooms and 2 shared bedrooms. Nineteen single bedrooms and the two double bedrooms are fitted with en-suite toilet facilities and three bedrooms have the provision of bathing facilities. There are three communal bathrooms, two of which provide assisted bathing facilities. We were informed at the last inspection that there were plans to refurbish a bathroom to provide assisted bathing. Work has not yet started and the registered manager informed us that they were considering the provision of a level access shower/wet room. This has also been stated in the homes completed AQAA under the homes plans for improvement in the next 12 months. Care Homes for Older People Page 20 of 30 Evidence: Communal areas are arranged on the ground floor and consist of a sitting room, spacious dining room and large conservatory/lounge. All areas seen were comfortably furnished, warm and clean. It was evident that people are able to personalise their bedrooms. We were informed that lockable space is being made available in bedrooms as furniture is replaced. This being the case, the provision of lockable space is not available is all bedrooms. The homes completed AQAA stated that they have, continued to update rooms, replacing carpet and furniture as required and providing clients with lockable drawers. People appeared comfortable in their surroundings and they told us that they were very happy with their bedrooms. As previously mentioned, all areas of the home seen at this inspection were clean and free from malodours. The home employs two cleaners who cover a six day period. We were able to see that staff had access to protective clothing and hand washing facilities. Sanitising hand gel was also seen to be available. All seven people who completed comment cards for the Commission told us that the home was Always fresh and clean. My bathroom en-suite is cleaned everyday and my room is dusted and vacumed and the cleaners are pleasant and cheerful. All areas of the home were a comfortable temperature. To reduce the risk of injury to people using the service, the majority of the radiators have been fitted with a guard. Radiators in corridors which are narrow cannot be guarded so these have been disabled. This did not appear to have an impact on the temperature of the home. Care Homes for Older People Page 21 of 30 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. Staffing levels and staff skills ensure that peoples needs can be met. Staff morale is good and people benefit from a stable workforce. The homes staff recruitment procedures offer good protection for people using the service. Evidence: At the time of this inspection, 23 people were using the service. The registered manager informed us that staffing levels were as follows; AM - 1 senior carer and 2 care staff PM - 1 senior carer and 1 carer. This increases to 3 from 1630hrs. Night - 1 waking and 1 sleep in carer The registered manager works in addition to the care hours during the week. The home also employs kitchen and cleaning staff. We were informed that the home has a very low staff turnover and agency cover has only been used once in the last year. Staff morale appeared very good and many of the staff spoken with had worked at the Care Homes for Older People Page 22 of 30 Evidence: home for many years. Staff told us that Ashley House was a nice place to work, and that they felt very well supported. All staff spoken with told us that they had received the training needed to enable them to care for people using the service. Staff told us that people living at the home received, very good care. This was also confirmed by people spoken with during the inspection. Staff told us that, with current staffing levels, they did not experience any difficulties meeting the needs of people currently at the home. No concerns were raised by the people using the service. The registered manager confirmed that staffing levels would be increased as required, to meet peoples assessed needs. The homes completed AQAA confirmed that of the 18 permanent care workers, 10 have achieved a minimum of an NVQ level 2 in care. This equates to 56 which exceeds the recommended 50 of the National Minimum Standards. The home follows robust staff recruitment procedures. We examined the recruitment files for two most recently appointed staff. Files contained all required documentation and we were able to see evidence that staff did not commence employment until receipt of satisfactory references, a criminal record check (CRB) and checks against the protection of vulnerable adults register (POVA). Files also contained evidence that staff had received an induction period. A staff training matrix confirmed that staff had received up to date mandatory training. Other training which had taken place included; death & dying, communication, dementia care, diabetes and Alzheimers. We were informed that there was a first aider on each shift. Four comment cards were received from health care professionals. In response to the question, Do the care staff have the right skills and experience to support peoples social and health care needs?, three responded Always and one Usually. Care Homes for Older People Page 23 of 30 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 appropriately managed and the registered manager promotes an open and inclusive style of management. Systems are in place to enable people using the service to express their views. The homes quality assurance programme could be further improved. Procedures are in place to ensure the health and safety of persons at the home. Evidence: The registered manager is Susan Timbrell who has managed the home since 2002. Susan has over 14 years experience in caring for older people and she has achieved an NVQ level 4 in management. The registered manager promotes an open and inclusive style of management and is very much hands on. Staff and people living at the home told us that they found the Care Homes for Older People Page 24 of 30 Evidence: registered manager very approachable. Through observation and discussion with the registered manager it was very apparent that she had a good knowledge and understanding of the needs and preferences of the people using the service. People appeared very relaxed and comfortable in her presence. We were informed that formal staff meetings take place three times a year and that meetings for people using the service take place twice yearly. The registered manager told us that people are encouraged to express their views on a daily basis and that the frequency of formal meetings was appropriate given the size of the home. The home has a quality assurance programme and as part of this, questionnaires are sent out to people using the service. Some completed surveys were seen at this inspection and comments were positive. The homes quality assurance programme could be further improve if the home sought feedback from other stakeholders such as relatives and health care professionals. Copies of the homes inspections reports completed by the Commission were seen to be available in the reception area of the home. The responsible individual for the company is required to undertake monthly unannounced visits to the home, in line with the Care Homes Regulations 2001 and complete a report, a copy of which must be maintained at the home. No reports were available at the home. A requirement has been raised. We were informed that the home currently assists 6 people to manage small amounts of money. Appropriate records of transactions are maintained and receipts were seen to be in place. Two staff sign to confirm each transaction. We checked the monies held against two records of transactions and these were found to be correct. All monies were seen to be securely stored. At the last inspection we required that improvements were made with regard to formal supervision for staff. At this inspection the registered manager informed us that this was an area which she had not yet fully implemented. We examined records and found that only basic recording systems were in place. We have recommended that a standard form is developed which covers the topics identified in the National Minimum Standards. This will ensure that topics discussed can be recorded along with any training needs. This should then be signed by the home and the employee. We were able to see that all staff had signed a supervision agreement confirming that they would receive supervision 6 times a year. Records seen did not confirm that all staff had received this frequency of supervision last year. A recommendation has been raised. Although a formalised system needs to be introduced, staff spoken with told us that they felt very well supported by the registered manager and could regularly discuss any issues or training needs with her. Care Homes for Older People Page 25 of 30 Evidence: We looked at the homes procedures relating to health and safety. This included a tour of the premises and examining a selection of records. Fire safety records were found to be up to date and records indicated that staff had received up to date training in fire safety. Servicing on the homes mobile hoist, stair lift and two bath seats is due in June 2009. To ensure the safety of people using the service, upstairs windows have restricted openings, wardrobes are secured to the wall and radiators are fitted with a guard. As previously mentioned in this report, radiators in a narrow corridor which cannot be guarded, have been disabled to reduce the risk of burns/scalds. As required at the last inspection, we were able to see evidence that the temperature of bath hot water outlets are being checked on a monthly basis. Currently records do not include the actual temperature taken. To demonstrate that temperatures are within the Heath & Safety Executives safe upper limits of 44c for bath hot water outlets, it has been recommended that the temperature of each outlet is recorded. Care Homes for Older People Page 26 of 30 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 30 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 33 26 The registered person must 20/02/2009 ensure that monthly unannounced visits are conducted in line with this regulation and that copies of reports are maintained at the home. These visits must be conducted in line with Regulation 26 of the Care Homes Regulations 2001. 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 22 The bathroom on the first floor should be suitably adapted to provide assisted bathing facilities for people using the service. As part of the homes quality assurance programme, consideration should be given to seeking the views of other stakeholders such as relatives and health care professionals. The registered person should develop a formal recording system for staff supervisions to include topics set out in the National Minimum Standards. Records should be signed by Page 28 of 30 2 33 3 36 Care Homes for Older People the person conducting the supervision and the employee and a copy should be made available to the employee. Staff should receive supervision at least six times a year. 4 38 The registered person should ensure that the actual temperature of the bath hot water outlets checked is recorded on the records currently maintained. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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