Inspection on 07/04/09 for Brookthorpe Hall Care Centre

This inspection was carried out on 7th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookthorpe Hall Care Centre 21/04/08

Brookthorpe Hall Care Centre 14/12/06

Brookthorpe Hall Care Centre 06/03/06

Brookthorpe Hall Care Centre 05/09/05

Brookthorpe Hall Care Centre 13/01/05

Brookthorpe Hall Care Centre 27/05/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookthorpe Hall Care Centre Stroud Road Brookthorpe Glos GL4 0UN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janice Patrick     Date: 0 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Brookthorpe Hall Care Centre Stroud Road Brookthorpe Glos GL4 0UN 01452813240 01452814394 admin@brookthorpe.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Frampton Residential Homes Limited care home 32 Number of places (if applicable): Under 65 Over 65 0 30 learning disability old age, not falling within any other category Additional conditions: 2 0 That service users under 65 years of age must be over 50 years of age. Two beds can be used for service users under the age of 65 years of age. Date of last inspection Brief description of the care home Brookthorpe Hall is registered to provide personal care for 30 older people, with an additional category for two people with a learning disability. This Care Home therefore does not provide nursing care. The home is very spacious and provides easy access with a staircase and shaft lift accessing all four floors. The home uses contracted caterers offering a good degree of choice of meals for residents. The home has an activities co-ordinator and provides opportunities for social activity and interests. The home is situated off the main road into Stroud from Gloucester. Bus stops are Care Homes for Older People Page 4 of 29 Brief description of the care home situated within walking distance from the home. There is also a local public house within walking distance. The home fees range from 525.00 pounds to 560.00 pounds. Hairdressing and Chiropody (footcare) are not included in these charges. The home makes available some information about the service to prospective service users and those that visit. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before we visited the service we took into consideration the information supplied to us by the service within their Annual Quality Assurance Assessment (AQAA). We also considered additional information which comes to us from the home in the way of notifications. We also revisited the last inspection report and made note of any previous requirements made in the last inspection in 2008. A site visit was carried out by one Inspector and was done on one day between the hours of 10.40am and 7.20pm. During our visit we were able to speak to several people who live in the home, several staff and one visitor. We also discussed areas of the inspection with both Registered Providers, the Registered Manager, Deputy Manager and other staff. Care Homes for Older People Page 6 of 29 We case tracked three peoples care in detail as well as looking at areas of other peoples care. We examined a selection of care records, staff records and policies and procedures. What the care home does well: 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are arrangements in place to identify peoples needs prior to admission so that the home can be sure that they can meet these. There are also arrangements in place for people to receive information about the home before they arrive and after, although the latter would be more beneficial if it were updated and the most current. Evidence: We inspected two peoples care files to see if the home had carried out adequate pre admission assessments. The content of these showed that this process has improved since the last inspection. The documentation has altered and what is written down is more comprehensive, therefore giving staff in the home a better idea of the potential persons needs. Both the above files demonstrated that an assessment had been carried out by a Care Homes for Older People Page 10 of 29 Evidence: senior member of the care home staff prior to the persons admission and, in each case the County Council had also completed their assessment of needs and had forwarded this to the care home. Once admitted, both people had been subject to more detailed assessments which are designed to identify any specific risks that relate to potential pressure sores, nutrition, safe moving and handling and falls. This means that the requirement made in the last Key Inspection in April 2008 in relation to ensuring peoples needs are adequately assessed prior to admission, has been complied with. There was evidence to show that one person had been sent a copy of the homes brochure prior to their admission. In the reception area we saw the homes Statement of Purpose and Service User Guide (last reviewed in October 2007) on display although it was hidden behind other information. An inspection report written by the former Commission for Social Care Inspection (CSCI) dated December 2006 was also on display but there was no copy of the homes last Key Inspection which took place in April 2008. We have made a recommendation that any information about the home which is on display should be up to date. We were told that people are welcome to visit the home prior to their admission, whenever they wish, in order to look around and meet staff. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are being identified and staff have access to a clear plan of how their needs are to be met. This helps all care needs to be accounted for and helps the care to be delivered in a consistent way. Arrangements are in place to ensure peoples medicines are administered safely and recorded correctly so that people are not put at risk. Evidence: We inspected three peoples care plans in detail and two further peoples files for further individual areas of care. We also inspected the file of one person who had recently been assessed by the Speech and Language Therapist (SALT). We could see that the care plans were in more detail compared with those seen in our previous inspection in April 2008. Peoples needs were being identified and care planned for in a way that was specific to that person. Two examples of this were seen in relation to a persons diabetic needs and in another persons bathing preferences. This detail was also seen in peoples care plans who were in for short periods of respite Care Homes for Older People Page 12 of 29 Evidence: care. This is also an improvement from the last inspection. This means that the requirement made in the last inspection report to ensure that peoples care plans are relevant to their needs, so that staff are given sufficient guidance, has been complied with. We were told during this inspection that the home is currently changing its care documentation so some care plans had already transferred to the new format and some were waiting. The care plans we read had the individual persons signature on them, implying that they had been devised in consultation with the person they are about. We inspected the medication system and saw that medicines are stored safely and that all administration records were completed correctly i.e. there were no gaps against the times medicines were recorded as needing to be administered. Peoples allergies were recorded and the majority of the handwritten entries on the records had double signatures, demonstrating that arrangements are in place to reduce the risk of errors during the transcription of instructions for medicines. We checked specific stocks of some medicines and cross referenced these with the administration records to see if the stock of medicines corresponded with the number of tablets administered and this showed no discrepancies. Medicines were being dated on opening. One persons use of a night sedation was sporadic so it really required a care plan to give specific guidance to staff as to why and when this medicine is to be used. This helps staff to be consistent in its use and avoids the potential misuse of the medicine. We spoke to the Deputy Manager about medication that is used on an as required basis, particularly in relation to those that could be open to misuse and strongly recommended that an associated care plan is devised. During this inspection we observed people being spoken to in a respectful manner and staff knocking on bedroom doors before entering. This demonstrated to us that staff were aware of the need to uphold peoples right to privacy and ensure that their dignity is preserved. The need to uphold peoples privacy was also acknowledged in the guidance given to staff in some peoples care plans. One person we spoke to told us that staff were very respectful toward her and she specifically commented that staff are not condescending toward her. Care Homes for Older People Page 13 of 29 Evidence: We also saw that the home were making arrangements within their documentation to consider peoples mental capacity as required by the Mental Capacity Act 2005. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ethos of the home is to support those that live there to make independent choices and to aim to meet peoples specific preferences. Evidence: The care planning and feedback from people in the home suggests that peoples preferences and choices are respected. The information supplied to us from the home in the form of their Annual Quality Assurance Assessment (AQAA) also tells us that this is one of the homes main aims. The managers are also aware of who to go to if people require advocacy and they are aware of their responsibilities under the Mental Capacity Act 2005 and are learning about the new Deprivation of Liberty Safeguards. The staff help people to take part in an activity each afternoon, which includes Saturdays and Sundays. The people who want to participate decide on the activity, this may vary from a quiz to a music and movement session. If people do not wish to partake, as was the case for four people who were sitting in the second lounge during this inspection, then this is perfectly alright explained one member of staff. One of these people explained they do not particularly like joining in big groups and prefer to chat quietly. Another said they enjoyed sitting in this room because of the extended views over the countryside which they found relaxing. Care Homes for Older People Page 15 of 29 Evidence: Staff told us that there was no one currently requiring one to one time with a member of staff during activities, although there were a group of people who preferred to play a board game in a smaller group on a weekly basis. We were aware of one person going out with family members which they are fee to do when they wish. One relative told us that their relative always enjoys a trip out in the car and because they have now settled in the home, will speak of it now as returning home. In previous inspections we have been aware of one person who likes to go on holiday each year. During this inspection this person told us they were due to go abroad soon. It was explained that two staff members pay for their own travel and accommodation and care for the person whilst on holiday. We observed lunchtime which for most people takes place in the main dining room but, for some it is in their bedrooms as this is their personal choice and sometimes it maybe they are poorly. We observed a range of support being given by staff from feeding people to prompting and supervising. Many people were able to eat independently and those that we asked about the food, said they were enjoying the meal. The catering is organised by an external catering company who cook the food on site. Meetings with those who live in the home enable people to have a say in what they like to eat. The AQAA tells us that choice at mealtimes is important and uses an example to demonstrate specific involvement. One person, via their satisfaction questionnaire, which is given to people by the home to complete annually, commented that it would be nice if eggs and bacon could be one of the options at teatime, so this has been started. There are also weekly meetings between managers and the catering team to discuss such things as forthcoming birthdays, catering on days when the home has entertainment or making the kitchen aware of any alterations to peoples dietary needs. There were two examples of this; one person had been assessed by a healthcare specialist as requiring a puree diet and one person was due to be admitted in a few days time who required a specific diet. The AQAA told us that the servery area which is off the dining room, had been refurbished. It also told us that people who have been assessed as being capable of preparing themselves a drink safely, could now do so. We asked staff if there was anyone able to take advantage of this and the staff said no. The AQAA tells us that peoples individual religious preferences are acknowledged and Care Homes for Older People Page 16 of 29 Evidence: supported. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements in place to ensure that people know how to make a complaint and that complaints are then responded to. The home recognises the need to protect people from harm and abuse and has made several arrangements for this to put into practice, but, they are in danger of compromising all of this good work by not ensuring that a robust recruitment process has taken place for each person employed. Evidence: The home has a complaints policy which outlines the time frame for responding to a complaint and explains that all complaints will be taken seriously and will be investigated. The procedure for making a complaint was seen by us on the homes notice board which is in a prominent position within the home. We noted in the last relatives/visitors questionnaire, sent out by the home, that only one person commented that they were unaware of how to make a complaint. We have not received any complaints about the home in the last year. The Dataset on the AQAA was not completed in relation to numbers of complaints received by the home but managers confirmed during this inspection, that they have not received any. The home also has a Safeguarding Adults Policy and some amendments that were suggested in the last Key Inspection had been made. During this inspection we Care Homes for Older People Page 18 of 29 Evidence: suggested that in some situations it may be necessary for the home to make a referral to the Countys Safeguarding Team and that this should be added to the guidance given for staff. The Safeguarding Policy links into various other policies that are designed to ensure that people living in the home are protected from harm and abuse, such as the recruitment policy. There are shortfalls in maintaining this protection(see Staffing outcome within this report). All staff attend training in the Protection of Vulnerable Adults (POVA), usually through the County Council. It is also part of a staff members induction training. Managers also explained that they want to improve relatives awareness on the subject. This is because sometimes staff feel relatives have a misguided expectation about what the staff can do and make their relative do. An example was given to us where a relative may think that the staff can make their relative do something, such as have a bath when they refuse to bathe. Staff are clearly very aware of peoples personal rights and choices and are aware of what could be termed as abusive practice and sometimes need relatives to understand this. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that acknowledges their wishes to have some of their personal affects with them and which is well maintained and clean. Evidence: The owners of this home have an annual development plan which is linked to a designated budget for redecoration, replacement and refurbishment. The AQAA tells us that since the last Key Inspection in 2008 the following has been completed: improvements to the external drainage system, purchase of two new industrial tumble dryers, refurbished servery area, replacement of kitchen equipment to include crockery and cutlery, redecoration of four bedrooms, hall and ground floor corridor. The building provides very spacious accommodation with high ceilings and large windows to the main communal rooms and some bedrooms. There are ample communal bathrooms and toilets with appropriate equipment being available to assist the older person and their needs. The bedrooms are mainly painted in neutral colours and are usually decorated when vacant but people are able to bring with them on admission, pieces of furniture and other items that help personalise their bedrooms. Each bedroom has a toilet and sink Care Homes for Older People Page 20 of 29 Evidence: area. The lounges are comfortable with domestic furnishings and a choice of seating. The dining room is presented in an attractive way at mealtimes with table clothes and matching napkins. An extra effort is made to provide fresh flowers in the reception area. What we saw of the garden and car park area, looked well maintained. Internally the home looks clean and there were no offensive odours, suggesting that there are ample cleaning staff who are achieving their task well. Staff receive infection control training so that good practices in this can be implemented and maintained. We were informed that one member of staff has a lead on this and will be carrying out an infection control audit to ensure that everything is in place that needs to be in place and that it is having the desired results. We saw plastic gloves and different colour aprons for use by care staff during care tasks and mealtimes. We observed different care staff washing their hands at various times of the day. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to staff the home appropriately with well trained staff so that peoples needs can be met as required and appropriately. The repeated shortfalls in the homes recruitment practices continue to put people at risk and must be addressed. Evidence: The evidence we have gathered through this inspection leads us to believe there are enough staff on duty to meet the needs of the people living in the home. Certainly the staff feel there are adequate care staff and the home is extremely clean and has plenty of domestic support. We inspected the homes training matrix and spoke to staff about their training opportunities. All mandatory subjects are provided such as First Aid, Food Hygiene, Infection Control, Health and Safety, Safe Moving and Handling, Fire awareness and Protection of Vulnerable Adults. All staff have attended initial training on the Mental Capacity Act 2005 and Deprivation of Liberty guidance. Four senior staff have attended more in depth training on both these subjects, helping them to implement what is required in the home. Several staff have then attended or are in the process of attending, various other care related courses at various levels of study. These include medicine administration, certificate in Infection Control, training in nutritional risk Care Homes for Older People Page 22 of 29 Evidence: assessment and feeding, falls awareness, Osteoporosis awareness and palliative care. A high percentage of their staff are also trained to National Vocational Qualification (NVQ) level in care. In previous inspections there have been shortfalls in ensuring robust recruitment practices. Requirements have been made in relation to this and repeated. The last requirement made in relation to this had a compliance date of August 2008. We inspected two staff recruitment files during this inspection, both staff had clearances from the Criminal Records Bureau and against the Protection of Vulnerable Adults list prior to working in the home. However, there were unexplained gaps in both peoples employment and in one case no references on file. It was explained by the Registered Provider that these people had been recruited by a recruitment agency on behalf of the home and that the agency would have obtained references before forwarding the staff to the home. Regulation 19 of the Care Home Regulations 2001 states: The Registered Person shall not employ a person to work at the care home unless- he/she is satisfied on reasonable grounds as to the authenticity of the references in respect of that person. It also says: A full employment history, together with a satisfactory written explanation of any gaps in employment must be obtained. A further requirement has been made in this report requiring the Registered Providers to be satisfied that all the criteria in Regulation 19 has been complied with before employing someone. They must also ensure that Schedule 2 and 4 of the Care Home Regulations 2001 are complied with. This requirement must be complied with to avoid the Commission taking further action to secure compliance. All staff attend induction training which is based on the Common Induction Standards and then their practice is monitored by senior staff in the home until they are considered competent. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do live in a home that in many ways is run in their best interest, but all this is compromised by the management team failing to ensure robust recruitment practice. This means that the Care Home Regulations are not being complied with which ultimately places people at risk. Evidence: This home has a manager that is registered with the Commission but the Deputy Manager is very involved in the management of the home along with the Registered Providers. The Deputy Manager has completed her Registered Managers Award and is gaining experience in management issues. The Registered Manager works alongside her and both are included in the numbers of staff on duty caring for those living in the home. The Deputy Manager confirmed that the Registered Manager and herself get a few supernumerary hours per month. She also confirmed that there were a few shifts that overlap; this time is sometimes used to review care documentation so that the numbers on duty delivering the care are not reduced. Care Homes for Older People Page 24 of 29 Evidence: The Registered Providers currently take responsibility for all maintenance checks and organising contractual servicing of utilities and equipment,. They are predominantly involved in and carry out all the general administration and the running of the business, coordination of staff training and organising recruitment. They are therefore regularly on the premises. Staff meetings are held quarterly as are resident and relatives meetings. The homes Annual Quality Assurance Assessment tells us that care plans are audited to make sure they are being completed correctly and are relevant. We understood that the recruitment files were also being audited to ensure all criteria was met but this has clearly not been effective. The homes policies and procedures are also updated regularly and contain the right guidance to help protect people. The fact that a requirement relating to recruitment practice has been repeated twice is giving the Commission concern. The people responsible for recruitment are not ensuring that the Care Home Regulations on this are being met and are clearly not following their own policies and procedures on this and therefore not discharging their responsibilities in respect of this. The home are interested in the views of those that use the service and the views of those that visit, not just socially but professionally. We saw returned questionnaires that demonstrate that views are being given on the service and many comments were very positive. The AQAA has told us what the home has improved on and responded to as part of its Quality Assurance. The home does not keep any personal monies for safe keeping, instead Hairdressing and Chiropody charges are invoiced to the person responsible for payment. In most cases this is a relative or in one case a representative of the Court. If people are able to manage their own finances and wish to so then this is fully respected. We saw records that indicate that all utilities and equipment is checked and serviced on a regular basis. We also saw records pertaining to basic Health and Safety checks that take place. The home has an updated fire risk assessment and fire alarm testing and fire drills take place. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 The Registered Person must make arrangements, by training staff or by other measures, to prevent services users from being harmed or suffering abuse or being placed at risk of harm or abuse. In this case by being satisfied that all stages of the recruitment process have been satisfactorily met even if staff are employed via a recruitment agency on their behalf. So that people in the home are fully protected from harm or abuse. 31/08/2009 2 31 10 The Registered Provider and 31/08/2009 Registered Manager shall carry on or manage the care home with sufficient care, competence and skill. This is in relation to recruitment practices within the home. Care Homes for Older People Page 27 of 29 So that people are adequately protected and the Care Home Regulations 2001 are complied with. 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 1 Any information on display about the home, including inspection reports would be more beneficial if it were updated and current. Any medication that is prescribed on an as required basis should have an associated care plan that gives clear guidance to staff as to why and when it should be used. This will provide a written record of why staff chose to use the medicine at any given time. We recommend that a recruitment checklist be implemented covering all the required criteria in Regulation 19 and Schedule 2 & 4 of the Care Home Regulations. We suggest the person is not employed to work in the home until the Registered Persons are satisfied that all criteria has been met and that it can also be demonstrated. 2 9 3 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!