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Inspection on 17/09/09 for Bowland Lodge

Also see our care home review for Bowland Lodge for more information

This inspection was carried out on 17th September 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents speak highly of the home and the staff. One said, "The home is very friendly and staff are helpful". Another resident said, "The home takes care of all I require. It could do nothing better". Other comments included, "I am well looked after by the staff. The home is peaceful"; and, "I am happy here". Health and social care professionals also speak very highly of the home. One social worker commented, "Service users who I have been involved with have always received a good service in terms of care and support". Another said, "Bowland Lodge provides an excellent residential environment for its service users, especially for those with alcohol dependency issues". A third commented, "I have always felt that the care given to residents of Bowland Lodge has been very good". The manager carefully assesses the needs of each person referred to the home to make sure that the home can meet those needs. Social workers and district nurses confirm that the home does meet the needs of their clients. Each resident is treated as a unique individual. Staff respect their different lifestyles, and provide each resident with a unique package of care. Each resident has a detailed care plan for each area of need that has been assessed. This is in place when they come into the home. Residents` health needs are carefully assessed and are fully met. Health and social care professionals spoke of the speedy improvement in the physical and mental health of residents after they are admitted to Bowland Lodge. Residents are treated with great respect by the staff, and their privacy is upheld. Residents are very happy with the food and say there is plenty of choice. Their relatives and friends may join them for meals, at no charge. The spiritual needs of residents are assessed and met. There is a religious service in the home every week. Any complaints are taken very seriously by the manager and staff and are quickly resolved. Residents are protected from abuse. The home has strong links with its local community and provides a service mainly to the people of that community. This means that residents are in familiar surroundings, can continue to use local shops, pubs etc where they are already known, and are close to their families, who are encouraged to visit and be part of the home. The home is kept clean and tidy and a pleasant environment for residents, who enjoy living there. The home is well managed, and the manager leads by example. She keeps abreast of changes in legislation and keeps care practices up to date. She operates an `openoffice-door` policy. The staff group is experienced, knowledgeable and well motivated, and nearly all have achieved a National Vocational Qualification (NVQ)`.

What has improved since the last inspection?

The home now carries out a more thorough risk assessment when a new resident is being considered for admission. Care plans are now being regularly updated. Staff training is better organised and is being brought up to date. Improvements to the fabric of the building and to the fire safety systems in the home have been started, and a longer term programme of refurbishment and redecoration is being drawn up. Night staffing levels have been increased significantly.

What the care home could do better:

The registered persons must ensure that all issues highlighted by the recent fire in the home and ensuing enforcement action by the fire service and the CQC are promptly resolved. In particular, the building fire risk assessment has yet to be approved by the fire service; and a clear, dated programme of upgrading of the building has yet to be submitted and carried out. The registered persons must respond in writing to the comments and concerns expressed in the annual survey of the views of residents and their representatives.

Key inspection report Care homes for older people Name: Address: Bowland Lodge Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alan Baxter     Date: 3 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Bowland Lodge Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP 01912734187 F/P01912734187 lindaparkin@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Ram Perkesh Malhotra,Mr Darshen Kumar Malhotra care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One OP bed to be used to accommodate a named person in category DE, for a period of eight months from 5th December 2005 Date of last inspection Brief description of the care home Bowland Lodge is a care home that provides personal care to 36 older people and people with dementia. The home is located within a residential area of the west end of Newcastle upon Tyne. The three-storey property is converted from two adjacent Victorian houses. There is a passenger lift to all floors. There is easy access by public transport and to local amenities and shops. The fees payable are from £373 to £383 per week, with extra payments for hairdressing, toiletries and newspapers. 3 0 Over 65 12 21 Care Homes for Older People Page 4 of 27 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 is an overview of what the inspector found during this inspection. The quality rating for this service is 2 star. This means that people using this service experience good quality outcomes. Before the visit we looked at information we have received since the last key inspection on 20th September 2007, and since our random unannounced inspection of 18th to 24th August 2009. We looked at how the service has handled any complaints or concerns since the last visit, and whether there have been any changes to how the service is run. We looked at the providers view of how well they care for people, and also the views of people who use the service, their families or representatives, and the staff. An unannounced visit was made to the service on 17th September 2009, with a follow up visit on 30th September 2009. These visits took seven hours in total. During the visit we talked with the residents, the staff and the manager. We looked at information about the people who use the service and how well their needs are met. We looked at other information that that must be kept. We checked that the staff have the knowledge, skills and training to meet the Care Homes for Older People Page 5 of 27 needs of the people they care for. We looked around parts of the building to see if it was safe, clean and comfortable. We checked what improvements have been made since the last inspection. We told the registered manager what we found. Care Homes for Older People Page 6 of 27 What the care home does well: Residents speak highly of the home and the staff. One said, The home is very friendly and staff are helpful. Another resident said, The home takes care of all I require. It could do nothing better. Other comments included, I am well looked after by the staff. The home is peaceful; and, I am happy here. Health and social care professionals also speak very highly of the home. One social worker commented, Service users who I have been involved with have always received a good service in terms of care and support. Another said, Bowland Lodge provides an excellent residential environment for its service users, especially for those with alcohol dependency issues. A third commented, I have always felt that the care given to residents of Bowland Lodge has been very good. The manager carefully assesses the needs of each person referred to the home to make sure that the home can meet those needs. Social workers and district nurses confirm that the home does meet the needs of their clients. Each resident is treated as a unique individual. Staff respect their different lifestyles, and provide each resident with a unique package of care. Each resident has a detailed care plan for each area of need that has been assessed. This is in place when they come into the home. Residents health needs are carefully assessed and are fully met. Health and social care professionals spoke of the speedy improvement in the physical and mental health of residents after they are admitted to Bowland Lodge. Residents are treated with great respect by the staff, and their privacy is upheld. Residents are very happy with the food and say there is plenty of choice. Their relatives and friends may join them for meals, at no charge. The spiritual needs of residents are assessed and met. There is a religious service in the home every week. Any complaints are taken very seriously by the manager and staff and are quickly resolved. Residents are protected from abuse. The home has strong links with its local community and provides a service mainly to the people of that community. This means that residents are in familiar surroundings, can continue to use local shops, pubs etc where they are already known, and are close to their families, who are encouraged to visit and be part of the home. The home is kept clean and tidy and a pleasant environment for residents, who enjoy living there. The home is well managed, and the manager leads by example. She keeps abreast of Care Homes for Older People Page 7 of 27 changes in legislation and keeps care practices up to date. She operates an openoffice-door policy. The staff group is experienced, knowledgeable and well motivated, and nearly all have achieved a National Vocational Qualification (NVQ). What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 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 9 of 27 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. The home carefully assesses the needs of all new residents, to make sure that those needs can be met in the home. Evidence: All ten residents who returned a questionnaire said that they had been given a written contract when they first came into the home. Those who could remember said that they were given enough information about the home before they decided to move in. The care records of three residents were examined. All had been fully assessed by their referring social workers or care managers before the home had agreed to admit them. All had comprehensive assessments and social services care plans on file. In addition, there was evidence that the manager also carries out her own assessments of needs before admission, to make sure the home can meet all the needs. These assessments included activities of daily living, handling, diet, mental health, spiritual, and social assessments. A more detailed risk assessment, the FACE assessment, has Care Homes for Older People Page 10 of 27 Evidence: been introduced. All pre-admission visits to the home are fully minuted in the care record. Care Homes for Older People Page 11 of 27 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 provides a very good level of care for its residents, and meets their health and personal care needs. Evidence: The care plans of three residents were inspected. A very good match was found between the list of assessed needs and the list of care plans. Care plans are sensitive and give an appropriate amount of detail to guide carers. They also cover all areas of the individual residents needs, including social and spiritual issues as well as health and physical needs. They are drawn up on the day of admission to the home. This is good practice. The care plans are evaluated every month and any changes needed to the plan are recorded in these evaluations, and the care plan is updated from this (care should be taken to date such amendments). Study of the care records of the above residents showed that their mental and physical health needs are properly assessed by the social worker and the home. Care Homes for Older People Page 12 of 27 Evidence: Care records also show that these assessed needs are fully met, using the normal range of community based health provision (general practitioners, district nurses, opticians, chiropodists and dentists) and, where necessary, referral to specialists such as consultant psychiatrists, speech and language therapists, rehabilitation and intermediate care services, dietitians and occupational therapists. The manager keeps a central log of all contacts with health professionals, from the most routine chiropody appointment to an emergency admission to hospital, and is thus able to show the full range of health-related activities within the home. Residents are weighed every month, and nutritional care plans put in place, where necessary. Records are also kept of daily grooming, where this has been identified as an issue. The home has copies of recently released guidance and protocols on pressure ulcer monitoring, and on transfers to and from hospital or other care establishment. The home has three beds that are registered for persons under pensionable age who suffer from alcohol-induced dementia, and has developed considerable expertise and experience in this specialist area. The manager has applied to increase the number of beds available for this client group. One social worker who frequently places clients who have poor health and who often display challenging behaviours said that my clients show a vast improvement in both medical and emotional health in just a few weeks. Another social worker commented, Bowland Lodge provides an excellent residential environment for its service users, especially for those with alcohol dependency issues. Study of the Medication Administration Records (MAR) showed that all medicines administered to residents are promptly recorded; that all handwritten entries in the MAR are signed and dated; that a list of staff names, along with the initials used by them in the MAR, is being updated to allow for proper audit; and that a photograph of each resident has been attached to his or her page in the MAR, as a means of correct identification. The manager is pro-active in asking general practitioners to review residents medications. She also prevents the build up of unnecessary stocks of medicines by requesting drugs such as painkillers and laxatives on an as and when required-only basis. This is good practice. Care Homes for Older People Page 13 of 27 Evidence: Four persons are currently prescribed with a controlled drug. The storage of and recording of controlled drugs were checked and found to be acceptable. Only trained senior staff administer medications. Residents said that the staff treat them with respect at all times. They also said that staff respect their privacy and always knock before entering their bedrooms. Care Homes for Older People Page 14 of 27 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. Residents are given good support in enjoying the daily life that they choose, with a good range of social activities and enjoyable meals. Evidence: In surveys, residents confirmed that there are regular activities for them to take part in. Activities include karaoke, bingo, darts, quizzes, crafts, board games, aromatherapy, and music appreciation. Each resident has had an individual assessment of their social needs, and a personal care plan drawn up to meet their social needs. The home organises regular trips out. There are special theme days, such as an Hawaiian day; and the usual celebrations take place on Bonfire night, Valentines Day, Halloween etc, and on residents birthdays. Different entertainers visit the home about every six weeks. Care Homes for Older People Page 15 of 27 Evidence: There are many old photographs of the home and of the local area, and lots of other memorabilia, making it a stimulating environment for residents. The home actively encourages families to visit their relatives in the home. An example of this very positive policy is the fact the family members may take meals and other refreshments in the home free of charge. The home has many links with the local community and most of the residents are local people. This means that residents are in familiar surroundings, can continue to use local shops, pubs etc. where they are already known, and are close to their families, who often already know each other. Visitors are always welcome; however, residents may also refuse to see any visitor, if they so choose. Staff will escort residents where they are unable to go out independently. Residents confirmed that they are encouraged and supported to exercise choice and control over their lives. They chose what to eat and when; when to get up and go to bed; what they are called; what they wear; where and when to go out; whether or not to see visitors; whether or not to join in activities, and many more examples. There is a four week menu. In a survey, seven out of ten residents said that they always enjoy their meals; three said they usually do. A full cooked breakfast is available every morning. There is a choice of meals for lunch, and vegetables are specified. There is a hot and cold choice for the tea meal. Residents may have drinks and snacks at any time, day or night. Residents may take their meals in their rooms, if they so choose. The homes manager is undertaking a food safety course. Care Homes for Older People Page 16 of 27 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. Residents are properly protected by the homes policies regarding complaints and safeguarding of vulnerable adults. Evidence: No complaints have been received in the past year. Records showed that previous complaints had been addressed appropriately. Nine out of ten residents who returned surveys said that they knew who to talk to if they were no happy about anything, and the same number said they knew how to make a formal complaint. They also said that staff listen to them and act on what they say. There has been one episode that called into question the homes fire safety and this was appropriately referred to the local social services Safeguarding team. Remedial action is currently being taken. Mental Capacity assessments are carried out for residents, where appropriate. The manager is also well aware of her responsibilities regarding recent deprivation of liberty legislation, and is undertaking a four day train the trainer course to enable her to give training to the staff group. A key pad is being fitted to the front door, to enable the free movement of residents (subject to risk assessments). Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical environment of the home has been neglected in recent years and now requires significant investment to bring it up to a safe and comfortable standard. Evidence: As a result of a fire in the home on the 18th August, a joint inspection of the building was undertaken by officers of the Tyne & Wear Fire and Rescue Service and the Care Quality Commission on 20th August. This identified a number of significant environmental deficits in the building that compromised the fire safety of the home. Enforcement action was taken, with the homes proprietors being required to produce a prompt action plan to remedy these deficits. The focus of this present inspection was to check that the necessary work had been carried out, or, depending on the timescales set, was in the process of being carried out. Some fire risks, in the form of soft furnishings and other furniture in corridors, had been removed. The temporary ramp leading from the north end of the homes annex had been made good, thus removing trip hazards. External lighting has been installed for the length of fire escape route from the annex. Care Homes for Older People Page 18 of 27 Evidence: Fire doors are currently being replaced and now incorporate smoke seals. Emergency lighting is in the process of being upgraded, and smoke and heat detectors being fitted, throughout the building, with the end of October as the completion date. A fire risk assessment on the building has been carried out. However, this has not been deemed sufficiently detailed by the Fire Service, and is currently being redrafted for approval at a meeting with the Fire Service and the Care Quality Commission on 14th October. Corridors within the home have been compartmentalised, by the fitting of self-closing fire doors at appropriate intervals. It is planned to replace Window frames, and this proposal has gone to the Council planning department for approval. A programme of routine maintenance and renewal of the fabric of the building and decoration is being drawn up, and is at draft stage. This will cover repair of water damage previously noted, replacement of carpets and replacement of unsuitable bathing facilities. The building works immediately to the rear of the home have been safely cordoned off. At a recent Environmental Health inspection, the home was awarded four stars out of a possible five for the cleanliness of the kitchen. Care Homes for Older People Page 19 of 27 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 has a stable and experienced staff team who are well qualified and trained to meet the needs of the residents. Evidence: The staffing levels at the time of this inspection were four care staff between 8 am and 8 pm, and six care staff overnight. The latter figure reflects advice given by fire officers following a recent fire at the home, pending ongoing improvements to the homes fire safety. The manager is reviewing the staffing levels in the home, on a monthly basis, to make sure that they meet the assessed needs of the residents. Catering hours are 8 am to 3 pm, daily. Domestic cover is provided each day between 8 am and 2 pm. The homes handyman works between 9 am and 3 pm, weekdays. Laundry hours are 10 am to 2 pm, on weekdays. The manager is supernumerary to the rota. She is currently advertising to fill a domestic post, a second handyman position, and a part time administrator post. Other than this, she describes a stable staff group, with little turnover. In a survey, all ten residents who responded said that staff are always available when they need them. Care Homes for Older People Page 20 of 27 Evidence: The personnel records of two staff employed in the past year were studied. All the required elements were in place, including fully completed application forms, Criminal Records Bureau checks, written references etc. The manager has amended the interview record to include prompts to check that any gaps in an applicants application form or employment history are picked up and challenged. There was evidence of thorough induction training taking place over the first month of employment, with new staff having to read and sign key policies such as infection control, whistle-blowing, and equal opportunities. Fourteen of the sixteen care staff have achieved the National Vocational Qualification (NVQ)level 2 in care (eight staff have also gone on to achieve NVQ level 3 in care). Most staff felt that they are given training that is relevant to their role, helps them understand and meet the needs of the people they care for, and keeps them up to date with new ways of working. Since the last inspection, a staff training programme has been put in place to identify and meet gaps in individual staff members mandatory training by the end of March 2010. All staff have had fire safety training within the past month. One social worker commented The staff work very well with individual clients, dealing with them as individuals, tailoring a service and response to each persons individual needs. Care Homes for Older People Page 21 of 27 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 and is run in the best interests of the residents. Evidence: The manager, Mrs Parkin, holds the Registered Manager Award. She has eleven years experience in managing care homes, and twenty two years experience in the care of the elderly. There are clear lines of accountability within the home, but the manager is aware that she needs to delegate some functions that could well be taken over by other staff members. The home is currently seeking to employ a part-time administrative assistant. Formal staff supervision takes place every two months. Meetings are recorded in good detail. Minutes showed that the manager is very supportive of good practice, but also clearly identifies any areas where improvements are needed. Staff are encouraged to give their opinions and input to these meetings. In surveys, some staff felt that they needed more support from their manager. Care Homes for Older People Page 22 of 27 Evidence: Residents meetings take place, and they are well recorded. One resident acts as a representative for the others, and passes on comments from those who dont wish to speak in public. The manager also seeks the views of residents, relatives and other stakeholder by means of an annual survey of their views, the most recent of which took place in December 2008. The feedback regarding the staff, the management and the care was generally very good. However, there was a strong consensus between the residents, their relatives, and health and social care professionals that the physical environment needs urgent attention. It was noted there is currently no written response made to the comments received in this consultation process. The registered persons must make a report available to residents and their representatives, setting out their responses to the issues raised and the comments received in the annual survey of views. A requirement is made in this report to this effect. Maintenance and servicing records were examined and found to be kept up to date. A comprehensive series of risk assessments is in place, all of which have recently been reviewed. However, as noted in the Environment section, above, the building fire risk assessment is still being developed. The fire log book shows that all the required checks and tests of equipment and systems are carried out at the appropriate frequencies. Fire drills now include the periodic evacuation of the building. There is a daily safety audit of the building. All staff have been given fire safety refresher training. The manager is researching a train the trainer course to allow her to give internal fire safety training to the appropriate level of expertise. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 19 23 The registered persons must 30/09/2009 ensure that the building complies with the requirements of the local fire service. This is to improve the safety of service users. 2 19 23 The registered persons must 30/09/2009 ensure that a programme of routine maintenance and renewal of the fabric of the building and decoration is produced and implemented with records kept. In particular, window frames must be replaced, fire doors upgraded with smoke seals, water damage repaired, unsuitable baths replaced, and carpets replaced where necessary. This is to improve the safety and comfort of service users. 3 22 23 The registered persons must 30/09/2009 ensure that grab rails, hoists and any other aids assessed as being necessary are provided in bathrooms and toilets used by service users. This is to improve the safety and accessibility of facilities in the home. Care Homes for Older People Page 24 of 27 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 4 31 23 The registered manager 30/10/2009 must undertake further fire safety training to allow her to give the appropriate level of training to her staff. This is to improve the safety of service users and staff. 5 38 13 The registered manager must ensure that appropriately detailed risk assessments are carried out for all safe working practice topics and that any significant finding of risk are recorded and addressed. This is to improve the safety of the service users. 30/09/2009 6 38 13 The registered persons must 30/09/2009 ensure that the health and safety of residents and staff is maintained by providing a safe environment. This is to improve the safety of service users. Care Homes for Older People Page 25 of 27 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 24 The registered persons must 31/12/2009 respond in writing to the issues and concerns raised in the annual survey of the views of residents and their representatives. This is to make sure that the views of the residents and their representatives are being listened to and used to improve the quality of care in the home. 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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