Inspection on 03/08/09 for Chester Court

This inspection was carried out on 3rd August 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chester Court 19/08/08

Chester Court 27/07/06

Chester Court 28/11/05

Chester Court 08/08/05

Chester Court 16/11/04

Chester Court 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Chester Court Choppington Lane Bedlington Northumberland NE22 6LA     The quality rating for this care home is:   one star adequate 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: Karena Reed     Date: 0 3 0 8 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 32 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 32 Information about the care home Name of care home: Address: Chester Court Choppington Lane Bedlington Northumberland NE22 6LA 01670820111 01670822001 ally.jackson@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Ltd care home 41 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) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: Should either of the named service users within the categories LD/LD(E) leave the home, the Commission for Social Care Inspection must be notified immediately. Date of last inspection Brief description of the care home Chester Court is a purpose built care home on one of the main roads in the town of Bedlington. It is situated within easy access of local amenities and services. It is of brick build and apex tiled roof construction of a modern and up to date design. It has an open aspect to the front utilising large windows and glass doors to offer light and air to the building. The home is designed in a cluster of bedrooms and lounge areas. The car parking is to the side and front of the building and landscaped gardens are provided to the front. There is level access to the building and to all areas of the home with the use of the two lifts. Some of the bedrooms have their own door from their rooms directly into the garden area. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information Care Homes for Older People Page 4 of 32 Over 65 1 39 1 0 0 3 0 9 2 0 0 8 Brief description of the care home about services provided by the home and relevant charges. Care Homes for Older People Page 5 of 32 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: The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit: We looked at information we have received since the last inspection, how the service Care Homes for Older People Page 6 of 32 dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on August 3rd 2009. During the visit we talked with people who use the service and staff. We looked at information about the people who use the service and how well their needs are met.We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: Care and support should be provided to service users respecting their dignity. Local authority multi-agency safe guarding training should be provided to all staff. Staffing levels should be reviewed during peak times so the care and support needs of individuals can be carried out in a timely way. The identified bedroom wall and lounge should be decorated in the interests of comfort of people living at the home. Staff communication should be improved within the staff team and to external agencies in order to communicate the care needs of people living at the home. Care Homes for Older People Page 8 of 32 A daily log must be kept of all food provided by the kitchen. 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 9 of 32 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 32 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. Assessments of people who are to use the service are carried out before they move into the home to ensure all needs can be met. Evidence: The Statement of Purpose and service user guide were examined. The statement of purpose is a pre-printed document which requires the provider to input individual information about the service. It contained the necessary information as required by the Care Homes Regulations 2001.They had been up dated with details of the new manager who took over management of the home in December. The documents contain a lot of important information that will help people to make an informed choice about the home. In surveys received people who live at the home and their relatives felt that they got enough information from the home and other agencies to make a decision about whether to use this home. Records for four people who live at the home showed that when they were admitted to Care Homes for Older People Page 11 of 32 Evidence: Chester Court an assessment of their care needs had been carried out before their admission by a social worker or health care professional. This assessment is forwarded to the home for the manager to look at to determine if the needs of the person can be met. The manager or senior staff carry out a pre-admission assessment to ensure that the staff can meet each individuals needs. The person living at the home and relevant people are involved in the assessment.These initial assessments are used to create care plans. The manager said that any person interested or needing to use the service or relatives are encouraged to visit the home to have a look round and meet the staff. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual.Comments include: Front of house staff are friendly and will show prospective clients/families around the home. The home does not provide intermediate care. Care Homes for Older People Page 12 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate arrangements in place to ensure the health and personal care needs of people living at the home are met by staff.This is not always carried out respecting the rights of the individual and promoting their dignity. Evidence: The care files of four people that use the service were looked at during the visit. Files contained a detailed assessment of needs for the person, evidence of nutritional screening, moving and handling assessments and a history of the person including interests, family details and other important and useful information. Following assessment of the person care plans are developed. People who use the service looked cared for and staff showed respect in their actions and in the way they spoke to people they were attending to. There is clear evidence of the involvement of GPs, District Nurses and other health care professionals such as chiropodists. People living at the home confirmed that if they were feeling unwell, the GP would be called. A nurse practitioner Care Homes for Older People Page 13 of 32 Evidence: commented;The home is happy to work with us at the local GP practice. A number of people that use the service were spoken to during the visit. People in general were happy with care received, however some surveys returned did state that nurses working at the home do not communicate well with professionals and families. Comments from some professionals included: There is lack of communication to other professionals and relatives. At times communication between staff members could be improved. Social workers/care managers should be kept up dated with clients admissions into hospital and deaths. People spoken to confirmed that their privacy and dignity was respected however some comments received from people living at the home and professionals did not maintain this.The comments indicated the quality of care was basic in some areas. Comments include; There could be better personal hygiene for people in the mornings and after toileting. People have to wait a long time for assistance to use the commode. I would prefer not to sit in a wheelchair all day. General basic care is good. There should be more attention to detail, cleanliness, individual needs and more interaction. Basic care needs are not met. The care is not person centred. The home could provide better end of life care. The individuals personal needs should be managed appropriately. Care is sometimes provided at times to suit the carers and not the residents. The general standard of care provided is good. Care Homes for Older People Page 14 of 32 Evidence: People who use the service are assessed on a regular basis by nurses working at the home to determine if they are at risk of developing pressure sores. Pressure relieving mattresses are available for those people assessed at risk or who have developed a sore. During the inspection arrangements for receiving, storing, administering, recording and disposing of medication were observed and examined. Examination of medication records and observation of a medication round took place. Appropriate records of medication coming into the home and those that are destroyed are kept. An audit of current medication in stock and records showed that medication was signed for and given appropriately. Care Homes for Older People Page 15 of 32 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. Appropriate and enjoyable activities do take place at the home and people are able to exercise choice and control. Food provided is enjoyed, providing people that use the service with a varied and well balanced diet. Evidence: Residents files contained personal histories and entries about their likes and dislikes and preferences regarding daily life. The home employs a part time activity co-ordinator to plan, arrange and take part in activities at the home for people that use the service. The activity co-ordinator works in the afternoons over five days, the days of which can vary.The programme of activities include ;quizzes,kareoke,art,reminiscence,bingo,gardening,memory games,old time music, sing a long, hairdressing and pamper sessions, a minister also visits.People also enjoy film afternoons and evenings with popcorn and choc ices. Sherry is also served on Sunday. Seasonal activities and entertainment also takes place such as Easter egg competitions, summer fayres, Burns Night Supper and Christmas parties. A recent 60s and 70s themed event proved very popular with residents staff dressing up in clothing from the times. Entertainers such as accordionists,comedians and singers also visit. There is an active resident ands Care Homes for Older People Page 16 of 32 Evidence: relatives committee that meet regularly at the home,the last meeting was held on June 4th. Some residents also attend regular social sessions outside of the home run by Mind Active, a voluntary group. At the time of inspection the home was busy preparing for a competition called the Best of British,organized by the Company.The aim was to prepare and produce a British themed menu.The home had some good local sources to provide them with typical types of produce e.g. the leek club and allotment association. The homes Annual self assessment ,(AQAA) stated they planned :To become more involved in the local community and access more transport to enable residents to visit areas of interest. The home does have access to a minibus but it is parked at another home in South Tyneside which is not very near to the home and could make it awkward to access regularly. They have used the bus for a week recently so people living at the home could enjoy visits into the community. Trips include:Heighley Gate,garden centre,Amble,Cramlington and Tynemouth. Staff ask each person about their wishes, interests and choices. Staff have had training about memory loss. This training should help to ensure that people living at the home are given more choice in order to keep some control in their lives. There are plans for a resident to be invited onto the kitchen comittee so they can give comments about the menus and food and feedback views of the people living at the home to catering staff. Visitors are welcomed to the home and staff encourage and provide support to people living at the home to miantain contact with relatives. The manager stated she was planning to build upon involvement with the local community for the benefit of people living at the home. A four weekly menu is used in the home. The home does provide for special diets e.g pureed and diabetic. Cooked breakfast is available and a substantial alternative is served at main meals. On the day of inspection lunch served was;steak and ale pie, cauliflower cheese, carrots and potatoes or sausages and vegetables followed by trifle or yoghurt. Tea was to be potato and leek soup ,sandwiches and strawberry shortcake. There was a comment from surveys that supper was not available however I was informed by staff that supper was available for people living at the home. Comments include: The home should supply supper. Care Homes for Older People Page 17 of 32 Evidence: Care Homes for Older People Page 18 of 32 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. The home has a complaints and protection system, which helps to protect people who live at the home. Evidence: The homes complaints procedure is given to new people as they move into the home. The procedure assists and supports them and their relatives to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within the home. There is a complaints procedure on display within the home for the use of residents and their relatives. The home keeps a record of complaints. Two complaints have been received about the home since the last inspection, one was upheld. There have been three safe guarding incidents using the council safeguarding strategy,one of these is still under investigation but is near to completion. A comment included: The service should be open and honest about thier failure to care for clients leading to safe guarding issues. Surveys returned stated people living at the home or their relatives knew how to complain if they needed to. The home has a copy of the Local Authorities Vulnerable Care Homes for Older People Page 19 of 32 Evidence: Adults procedure. This provides staff with clear guidance on how to deal with adult protection concerns. Staff have received internal training about Protection of Vulnerable Adults from the manager. There are plans for all staff to receive safeguarding training from the local authority, this is multi-agency strategy training, which describes the procedures to be followed by staff when allegations of abuse are made about a person. Staff have also received training about whistle blowing which shows the procedure for staff to follow to report if there were ever concerns about bad practice to people living at the home. Staff have received training about dementia care,Yesterday,Today,Tomorrow to give staff more insight into the needs of people with memory loss. Care Homes for Older People Page 20 of 32 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 standard of the environment within the home is good providing people that live there with a homely and comfortable place to live. Evidence: The home is accessible and placed in the centre of a local community in a residential area. There are some shops and pubs quite nearby. There is an ongoing programme of decoration and refurbishment around the home. Since the last inspection the carpet has been replaced up stairs and redecoration has taken place. Bedrooms observed were comfortable and well decorated apart from bedroom 24 which had a wall which was marked and scuffed and the large lounge which requires decoration. Furniture and fittings were domestic in design and the home was well decorated and comfortably furnished. All people living at the home enjoy their own bedrooms. They are personalized and furnished in some cases with some of the residents own items of furniture. Comments from people living at the home include: Care Homes for Older People Page 21 of 32 Evidence: The lounge areas are pleasant and there are also additional places to sit which have nice open views. The bedroom is generally clean and tidy. There could be more attention to detail such as cleanliness. The home is clean. The home has an appropriate amount of sitting, recreational and dining space. There was emergency lighting around the home. The washing machines have the specified programme to meet disinfection standards. The home was observed to be clean and odour free. There was a plentiful supply of protective clothing which included plastic pinnies and gloves to help to prevent the spread of infection. Care Homes for Older People Page 22 of 32 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. The homes recruitment procedure is robust, which helps to ensure that people are protected. Insufficient staff at busy times could impact on the care given to people that use the service. Evidence: At the time of the inspection there were forty people using the service, thirty nine people were on site. 28 of the people living at the home require 2 or more carers to assist them with their needs. The homes duty roster and discussion with the manager showed that there were two nurses on duty and five care staff during the day and evening. On night duty there was one nurse and three care staff. These numbers do not include the manager. There is a senior staff member on each shift when the manager is not on duty. Other members of staff are employed for duties such as cleaning and food preparation. Three people spoken to during the visit made comments that they did not think that there were enough staff on duty particularly at peak times. Surveys also maintained that they did not believe sufficient staff were on duty. On the day of inspection, Care Homes for Older People Page 23 of 32 Evidence: upstairs where 22 people are accommodated, only three staff were on duty in the morning due to a member of staff being absent, four staff members were available in the afternoon however. Upstairs particularly after lunch, it was observed that buzzers and the shouting of residents took a while to be answered ,two carers were attending to service users whilst the nurse attended to paper work at the nursing station. Downstairs service users were assembled in the lounge, falling asleep in their wheel chairs,some were waiting to be taken back to their bedrooms. Discussion took place with the manager about this.Comments made include: People have to wait a long time for assistance to use the commode. I would prefer not to sit in a wheelchair all day. The right number of staff on each floor should be employed day and night. Sometimes more staff bank or permanent would help matters. There should be continuity for staff working on floors i.e to remain on the same floor for full working week or month. Chester Court has been subject to too frequent changes of care staff and managers. The basic staffing problems have never been fully addressed and resolved. Only the issue thathits the headlines is dealt with. Good staff regularly leave Chester Court because of the poor quality of staff support,this leaves clients frequently experiencing multiple changes of carer. The home should not stick to rigid staff rotas, staff availability. Care provided at times is to suit the staff and not the residents. At the time of inspection the manager was recruiting staff members to create a bank of regular staff to work if permanent staff members were unavailable to work. A sample of staff files were examined.The necessary checks are carried out before a person is appointed to work at the home. Two written references were available on staff files examined. An application form had been completed for each staff member. Employment histories were available. Care Homes for Older People Page 24 of 32 Evidence: CRB checks are carried out before a person is appointed. Staff photographs were available on staff files examined. There is a good level of staff training. 15 of 23 carers have achieved a National Vocational Qualification(NVQ) at level 2. 5 staff members have also achieved an NVQ at level 3. There are seven qualified nurses employed at the home who keep up to date with practice as required by the Nursing Midwifery Council. Staff have received the necessary statutory training and developmental training is carried out to help ensure that staff can meet specialist needs of people.Training carried out includes: infection control,moving and handling, first aid, health and safety, food hygiene, peg feeding,continence, equality and diversity,cross infection,customer care,catheter care, tissue viability, podiatry, bereavement, end of life- palliative care, safe handling of medication person centred care planning. Comments include: Ample job-related training is available and staff are encouraged to make use of it. The home should celebrate some of the excellent unqualified care staff on their abilities to play a part in the team. Further training in basic skills is required:blood taking. How can carers look after residents that are EMI nursing when they have not been trained. Staff seem to usually do their best,to put the patients needs at the centre of care. At times communication between staff members could be improved. Staff seem to be polite and cheerful and patient and the home has a friendly relaxed feel when I visit. Staff are generally pleasant and caring- (but there are cliques of staff who dominate the behaviour of others). Managers need to be aware of training needs of staff and act on these appropriately. Care Homes for Older People Page 25 of 32 Evidence: Care Homes for Older People Page 26 of 32 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 living at the home live in a home that is becoming better run and run in their interests and where the welfare of all is promoted. Evidence: The manager Pamela Towers has the relevant qualifications for managing the home. She is a qualified nurse and has several years of experience managing homes providing nursing and personal care. She began employment at the home in December and has prioritized areas where most work needs doing. There has been a high staff turn over at the home and Pamela is trying to create a staff team in order to provide continuity of care to people living at the home. The homes AQAA has identified changes to be made and plans for the future in order to provide more individualized care to people living at the home. In order for the home to become better run, communication needs to be improved as comments in section 2 stated. The manager is creating an ethos of involving staff and residents in the running of the home. Residents are also becoming more involved in decision making in their daily living and in the running of the home e.g a resident representative to be invited onto Care Homes for Older People Page 27 of 32 Evidence: the kitchen committee. Staff meetings take place and resident and relatives meetings. The meetings enable the home to inform people of important information, discuss future events, discuss any concerns and talk openly about the home. Supervisions take place every two months with each staff member,as well as an annual appraisal when staff will help identify their training needs. Comments include: The manager works hard at developing/maintaining rapport with families of residents. There was a good standard of record keeping and documents detailing fire safety and other statutory records were all up to date. A random sample of health and safety records were examined. Records were available to confirm that the fire alarms, gas boilers and hoists had been serviced within the last twelve months. The kitchen staff were reminded a record must be kept of all food provided to people living at the home on a daily basis in the interests of health and safety. Lockable facilities are available for residents to keep their own money if they wish. Staff training relating to health and safety was up to date. Independent auditing is carried out on a yearly basis to ensure that the home is run in the best interests of people that use the service. The home carry out their own quality assurance exercise in which they send questionnaires out to people that use the service to see if they are happy with the care provided. Weekly tests of the fire alarm service were recorded. Records were available to confirm that water temperatures were taken and recorded monthly. Care Homes for Older People Page 28 of 32 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 29 of 32 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 37 13 A daily record must be kept of all food provided by the kitchen to people living at the home. This is to ensure the health and safety of people living at the home. 07/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 18 All staff should receive the Safe guarding training provided by the local authority. This multi-agency training will give staff more awareness of the procedures to follow if an allegation of abuse was made. The identified bedroom wall and lounge should be decorated in the interests of comfort of people living at the home. The registered person should carry out an assessment on people using the service to determine if there are enough staff on duty particularly at peak times. This will help to ensure that the care needs of people using the service are met. 2 19 3 27 Care Homes for Older People Page 30 of 32 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 4 32 Communication should be improved between staff within the home and outside agencies. Care Homes for Older People Page 31 of 32 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). 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. 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