Inspection on 01/10/09 for College House

This inspection was carried out on 1st October 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

College House 08/07/08

College House 13/07/07

College House 04/01/07

College House 07/10/05

College House 13/12/04

College House 27/05/04

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Fairfields Country Rest Home

Poldhu

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Stallcombe House

Belma

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Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for older people Name: Address: College House 20 College Road Fishponds Bristol BS16 2HN     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: Vanessa Carter     Date: 0 1 1 0 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 28 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 28 Information about the care home Name of care home: Address: College House 20 College Road Fishponds Bristol BS16 2HN 01179651144 NONE benoograh@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Highcleeve Limited care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 21 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Mental Disorder, excluding learning disability or dementia (Code MD[E]) - maximum number of places 6 Date of last inspection Brief description of the care home College House is a detached Victorian private residential home, which provides accommodation for 21 elderly people. The homes main objective is to create a family atmosphere in an ordinary home where problems and disabilities are no longer the focus of attention. The staff team consists of waking night staff and provides 24-hour care. The home can be found in College Road, Fishponds. The house has been extended over the years to provide further accommodation. There are 21 bedrooms 11 Care Homes for Older People Page 4 of 28 Over 65 6 21 0 0 Brief description of the care home of which are en-suite and arranged over two floors. The communal areas include three lounges, which are colour coded; one of the lounges overlooks the rear garden, which is well maintained. There is a large dining room where residents can have their meals together. There are enough bathrooms, which contain appropriate aids and adaptations for residents. There are enough parking spaces for numerous vehicles. The home is internally and externally well maintained. The Fishponds area of Bristol has easy access into the town centre; there are bus routes into Yate, Kingswood, Hanham and the surrounding neighbouring areas. The home is near local shops and other amenities. The home is privately owned and managed by Mr and Mrs Oograh. Care Homes for Older People Page 5 of 28 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 last inspection of this service was undertaken on July 2008 and our overall judgement about the quality of the service provided for the people who live in College House was considered to be adequate. There were a number of areas where improvements were needed to ensure that people receive a good service. After that inspection we planned to visit again within the year - we did not achieve this and followed up this inspection after 15 months. The registered manager submitted their annual quality assurance assessment (AQAA) in June 2009 when we asked for it. This is a self assessment document that focuses on how well outcomes are being met. The assessment had been completed in detail and told us about the improvements that have made over the last 12 months and identified those areas where they felt they could do better. During the inspection we looked at records kept by the home, including care records and those that are kept in respect of the running of the home. We spoke to those staff Care Homes for Older People Page 6 of 28 on duty, the assistant manager and one of the registered providers. The registered manager was unavailable. We observed the interactions between the staff and the people who live in the home. We also spoke to people and asked them what it was like to live in the home. At the time of this report the fees for placement in the home range between 375 and 425 pounds per week. Additional charges may be made for other services and these are detailed in the homes brochure. Care Homes for Older People Page 7 of 28 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 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is clear information about the home so that people will know what they can expect in College House. Their care needs will be assessed prior to admission so they can be assured that their needs will be met. Evidence: The Statement of Purpose and Service Users Guide were last reviewed and updated in May 2008 and remains a true reflection of the service and facilities at College House. Copies of the documents can be provided by the home manager upon request, although a copy of the service users guide and the last inspection report are kept in the main foyer. This means that any prospective person who may visit the home or want to live in the home, will be able to make an informed choice about whether College House is the right place for them. Before any admission is arranged an assessment of care needs will be undertaken to ensure that the home is able to care for the person. We looked at the process followed Care Homes for Older People Page 10 of 28 Evidence: for the most recent admission in to the home. We saw that the home had gathered information from the person, and health and social care colleagues in order to make a judgement that the placement was apropriate. The person had visited the home to have a look around along with their social worker and had decided to move there from their own home. Information is recorded on an Initial Assessment document and this covers all aspects of personal and healthcare support. The home provides placement for people who require support with their personal care needs only - any nursing care will be provided by healthcare professionals who are requested to visit the home. Any new person and/or their relatives are encouraged to visit the home prior to placement being offered. Placements are arranged on a months trial basis with a review of how things have gone, taking place at the end of this period. This will involve all the necessary parties. Care Homes for Older People Page 11 of 28 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. People will be well looked after and can be assured that they will be cared for in the way that they wish. They will be treated respectfully and with dignity. Evidence: Three care files were looked at, including that of the most recently admitted person. This was so that we could see how the home arranges their service to meet the care needs of each individual person. During the assessment peoples preferences are determined and this information is incorporated into the care plans. This evidences that the person is involved in the drawing up of their plan of care and they will be cared for in the way that they want. The care plan will state what the person needs help and support with, how often and by whom. Information was recorded about peoples personal care needs, important domestic tasks, medication needs, choice and control over immediate environment, cultural and religious needs and night care. The plans were of an excellent quality and contained a very detailed and clear picture of the persons needs. The care plans had been signed by the person where this was possible, and had each been reviewed on a monthly basis and a full account of any issues and amendments made. People spoken with during the inspection made the Care Homes for Older People Page 12 of 28 Evidence: following comments I am very well looked after and very happy, We are all friends here and when I was ill recently the girls were so kind and did everything for me. From what we were told by people who live in the home and from the dicussions we had with members of staff, it is evident that people are very well thought of and that all care needs will be met. The care plans are supported by a number of risk assessments, for example in respects of the likelihood of falls, nutrition, anxiety or depression and medications. One we looked at in respect of a persons mental health needs detailed early warning signs, this is likely to happen if, things that have helped in the past and who I feel most comfortable with, in a crisis and contingency plan. This is commendable and evidences the skills of those arranging how peoples care needs are met. We spoke to staff during the inspection about moving and handling tasks, and were told that people who live in College House are generally independently mobile and they do not have to lift or move people. In those instances, when for a short time people are less able because of poor health, people may need support with moving and transferring from one place to another - manual handling risk assessments must be undertaken that result in a safe plan of work being devised. A daily evaluation note is recorded for each person and evidence what has happened during that day. We saw that records of GP visits, community district nurse visits, hospital appointments and family contact, are noted, along with information about peoples healthcare status and other significant events. We were told that the people who live in the home are registered with three local health surgeries for their medical care. The district nurses visit some people on a daily basis. Flu vaccinations were in the middle of being administered. We were told that in general all people who live in College House will need support with their medications and the level of support is included in the care planning documentation. One person likes to administer there own creams but has assistance with all other medications. The home does not have a homely medicines policy and staff are only able to give out those medicines that are prescribed by the GP. We talked through the process for ordering and receiving medications in to the home and safe procedures are followed. We have had no concerns raised by health care professionals about medication procedures. Medication administration records (MAR charts) are auditted by the assistant manager on a regular basis and there have been no drug errors. The pharmacy who supply all medications visits on a yearly basis and does staff training and audits arrangements in the home. Only those staff who have completed safe medication administration training will be involved in giving out drugs. Care Homes for Older People Page 13 of 28 Evidence: During the course of the inspection the staff were heard conversing respectfully with the people who live in the home. There was a great deal of friendly banter - one person said we are like a great big family here, we all look after each other. Staff were present in the communal areas throughout the day and there was a great deal of interaction and stimulation. The home has in the past continued to look after people who become poorly or have reached the end of their life and are dying. They can only do this when supported by the GP, district nursing services and the family. This ensures that the person is cared for by staff who are familiar with them. The home does not admit people in to the home who are already at the end of life stage. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to participate in a range of different activities both inside and outside of the home and will be provided with well balanced and nutritious meals. Evidence: During the course of the inspection people took part in a range of different activities, some people chose not to. One person said I prefer to spend my time quietly away from all the hustle and bustle. We saw that other people spent their time in their own bedrooms. On the day of the inspection,in the morning a large group of people listened to a CD story telling session in the main lounge and in the afternoon there was an armchair exercise class. One person is supported to continue with external activities and day centre attendance was making use of the garden. Others said they liked to watch day time television, and enjoyed chatting with each other or the staff. One person made the comment that each person who lives in College House dont all have the same needs, but they look after us all so well. It is evident that people are able to choose what they would like to do. If people are able, they can go out to the local shops that are only a short walk away. There are regular visits by a piano player - we all enjoy the sing-a-long. There have been a number of trips out in the homes minibus to the seaside and The Downs for example. Care Homes for Older People Page 15 of 28 Evidence: The home has an open visiting policy and visitors can come and go at any reasonable time. There were no visitors to the home on the day of the inspection. The home has a three week planned menu and people are provided with a varied and balanced diet. Two roast meals per week, a vegetarian meal and traditional fish on friday is served. We were told that they often introduce new suggestions to the menu, that fresh fruits have been introduced and that spaghetti bolognese was served on the day of inspection. Specific dietary needs will be catered for as necessary. Care Homes for Older People Page 16 of 28 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. People can be assured that any complaints they have will be listened to and acted upon. More robust procedures in respect of staff recruitment will ensure that people are safeguarded. Evidence: The homes complaints procedure is included in the homes statement of purpose and a copy is displayed in the hallway. Those people we spoke with during the course of the inspection said they were happy and contented - everyone is so kind here - and that they would talk to the staff if they were unhappy. There are regular resident get togethers and the managers ensure that people are happy with the service they are receiving. These meetings are scheduled monthly where satisfaction and any issues are discussed. We have not received any complaints about this service, or been advised that those who commission placements in the home have any concerns. The home maintains a log of all complaints and compliments received. We noted that there was a number of compliments on file. Thank you for your excellent care of our mother and a note from a family conveying sincere thanks for looking after their relative during a period of illness, were logged, evidences that families are very satisfied with the care people who live in the home are receiving. The home has policies and procedures in place to ensure that people are safeguarded from harm. The staff team have been provided with safeguarding of vulnerable adults Care Homes for Older People Page 17 of 28 Evidence: (SOVA) training and have a copy of the South Gloucestershire Council locally agreed reporting protocols. Those staff we spoke to during the inspection were unaware that the home also had a copy of the Bristol City Council No Secrets guidance and contact telephone numbers. The manager must ensure that the staff team are aware of the location of this document so that they know who to refer to if necessary. Those staff members spoken with during the course of the inspection demonstrated a clear understanding of safeguarding matters and of their responsibilities. Recruitment processes however do not safeguard people, because new staff start work in the home before full vetting procedures have been completed. The registered manager must ensure that new recruits have not been barred from care work before they take up their duties in the home. This shortcoming has the potential to place people at harm, by being looked after by staff who may be unsuitable for care work. An immediate requirement notice was issued at the time of the inspection, in respect of those staff for whom these checks had not been completed. This will be referred to again in the staffing section. Care Homes for Older People Page 18 of 28 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. College House is a comfortable, safe and well maintained home. Evidence: College House is a four storey detached period property - the basement floor contains offices and storage rooms, and the very top floor is private living accommodation. Accommodation for the people who live in the home is spread over the ground and first floors. It has been operating as a care home since 1985 but Mr and Mrs Oograh have been the registered providers for six years. The front of the property is laid to car parking with established shrubbery around the edges and areas of outside seating. The gardens to the rear of the home are secluded and have a ramp and rails installed so that people with impaired mobility are able to access the gardens. The communal rooms are all on the ground floor. There are three lounges, one referred to as the TV room and the two others are quiet rooms. There is a separate dining room. All rooms are well decorated and furnished appropriately with domestic style furniture that is appropriate for older people. Stairs lead off from the main hallway to the basement area where the managers office is located. Stairs up to the first floor have a stair lift fitted. There are communal toilets located in the living areas, and shared toilets by those bedrooms without an en-suite facility. There are plans to convert one shower room on Care Homes for Older People Page 19 of 28 Evidence: the ground floor into a level access wet room. There are two other assisted bathrooms in the home. Some bedrooms are located on the ground floor. Eight are in the rear ground floor extension and each has en-suite facilities of a toilet and wash handbasin. There are two other ground floor bedrooms. Remaining bedrooms are on the first floor. All bedrooms were seen during the inspection, they were clean tidy and well decorated. People are encouraged to personalise their rooms and can bring in small itmes of furniture and mementos to make the room their own. The home has a variety of equipment installed in the home to aid the people who live there. There are no hoists or stand aids in the home therefore people will need to be mobile, albeit with walking aids. Grab rails are sited at various locations throughout the home, there are raised toilet seats, ramps and commodes available. We were told that staff can use a banana board or a handling belt if they need to help people to transfer from one place to another. A number of people need to use walking frames to get around, and the layout of most parts of the home enables people to move around independently. A number of the bedrooms however, have a couple of steps up or down. The laundry room is on the ground floor and the care staff take it in turns to attend to laundry tasks. There is designated domestic staff. On the day of the inspection the home was clean and tidy. One bedroom had an unpleasant odour and measures should be taken to make this room more pleasant. Care Homes for Older People Page 20 of 28 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. People will be looked after by staff who are well trained and competent but recruitment practices are potentially unsafe and unsuitable workers could be employed. Evidence: There has been minimal changes in the staff team at College House since the last inspection, and new staff have been recruited to replace those that have moved to work elsewhere. We were told that agency staff are not used and that any shifts that need filling are covered by the existing care team. The staff rotas showed that during the day there are three carers plus the manager and domestic support, in the evenings this reduces to two care staff and over night there are two waking staff. The registered providers/manager is always on-call to deal with any emergencies. Rotas are generally arranged on a rolling basis. This means that people will be looked after by staff that are familiar with their care and support needs. The girls are all very kind and helpful and nothing is too much trouble and they work so hard were comments made during the inspection. The home has a staff team of 20 carers of whom 14 have already achieved a National Vocational Qualification (NVQ) at level 2 or an equivalent qualification. In the AQAA that was submitted to us in June 2009, the home manager stated that staff are encouraged to train up to level 2 and 3 in NVQ health and social care and several of Care Homes for Older People Page 21 of 28 Evidence: the staff we spoke with were registered nurses in their own country and now studying at the University. It is evident that the registered providers and manager have a real committment to training and ensure that the people who live in the home are cared for by competent and skilled staff, who are able to meet their needs. There have been a number of new members of staff recruited since the last inspection, and we looked at the recruitment files of four staff members. This is so that we could check the process the home follows to ensure it only recruits suitable staff. What we found was that serious shortfalls in the pre-employment checks could potentially mean that care workers who should not be employed have been taken on to work in the home. Criminal record bureau checks (CRBs) and POVA1st checks are not alway being completed before employment. CRBs are not portable from other care services and new disclosures must be requested as part of the recruitment process. For two members of staff CRB checks had not been submitted despite the fact that they were already working in the home therefore the manager did not know whether they were barred from care work or not (POVA1st status). For a third person they had worked in the care home for a two month period before their POVA1st no match exists for this person status had been confirmed. We issued an Immediate Requirement Notice and were told that the manager temporarily suspended those members of staff concerned, and they will not work again until the checks have been completed. The home must ensure that they follow safe vetting and recruitment procedures at all times, in order to protect the vulnerable people who live there. The manager must ask for written application for employment, must make interview notes, obtain two satisfactory written references from relevant sources and ensure their authenticity is verified, and CRB disclosure completed (including a request for a POVA1st check) prior to employment starting. If new workers are being started after receipt of a POVA1st check but before the full CRB disclosure has been received, the manager must ensure that there are stringent arrangements for the supervision and training of the employee in the interim. The manager must ensure that the fitness of all new workers is rigourously checked and must do this in line with all current recruitment guidance and regulations. The home has a training plan that includes induction and mandatory training such as manual handling,food hygiene, first aid, health and safety, safeguarding adults, infection control and fire awareness. Although staff do not undertake moving and handling tasks with people they complete manual handling training - this should be updated on a yearly basis and not three yearly. Staff spoken with during the inspection confirmed that they have received induction training and regular training there after. We were told that the induction-training programme for new recruits meets required standards. The sample of staff training files that were looked at were Care Homes for Older People Page 22 of 28 Evidence: all in order and evidenced that the staff team have attended a range of different training courses. Care Homes for Older People Page 23 of 28 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. College House is well managed and run in the best interests of the people who live there. Evidence: The registered providers are Mr and Mrs Oograh and Mr Ben Oograh is also the registered manager. He is supported in the running of the home by an assistant manager and Mrs Oograh. Mr Oograh is a registered general and mental health nurse and has already completed management qualifications. The aim of the home is to provide a family atmosphere for the people who live there and this is achieved. Regular residents meetings are held and people have a say in what activities are arranged, what meals are served, and complaints and comments are discussed. We saw the records kept following the last four meetings. These evidenced that people are encouraged to have a say about how they want to live their lives. The home ensures that the service they provide meets peoples expectations by completing a quality assurance questionnaire. The last one was completed in January Care Homes for Older People Page 24 of 28 Evidence: 2009 and evidenced a lot of positive outcomes for people. Relatives and friends are asked about how staff welcome them to the home, whether they can visit their relative in private and whether they are kept informed of changes or significant events. People who live in the home are asked whether their needs are met, how the staff treat them, whether they are satisfied with the service and if they feel able to raise concerns. These measures ensure that the quality of service provided is regularly monitored, however the manager has further plans to strengthen these arrangements. The home has procedures in place to look after money for people but the records were not checked on this occasion. The home have previously demonstrated that they have good systems in place to safeguard peoples money. Staff told us that they receive regular formal supervision with either Mr or Mrs Oograh, or the assistant manager. Records seen confirmed these arrangements. Staff said that they felt well supported by the management team and their work performance and any training or development needs are discussed. A look at the fire safety records evidenced that the staff team has attended fire drills and training at regular intervals. The checks on the equipment and alarm system have all been completed at the appropriate intervals. The manager or assistant manager have responsibility for fire safety in the home. Fire training is included in the induction training programme for new staff and is then updated regularly. No health and safety concerns were raised as a result of this inspection. Although the homes maintenance records were not checked on this visit, these have previously always been in order. We looked at the accident records and saw that there had been a significant number of unwitnessed trips and falls. The records showed that all falls are followed up actions taken are recorded. It would be good practice for the manager to keep an accident log for each individual faller, so that any trends could be indentified and measures put in place to reduce or eliminate the frequency of falls. Care Homes for Older People Page 25 of 28 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 28 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 1 29 19 The registered person must 09/10/2009 ensure that safe and rigorous recruitment procedures are followed This is so that the people who live in the home are protected 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 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 8 Where needed, manual handling risk assessments should be completed so that staff are aware of safe systems of work when they need to be involved in moving and transferring tasks. The manager should ensure that a copy of the Bristol safeguarding adults protocols along with contact numbers, is available for staff to refer to if they need to report any safeguarding issues. Better monitoring of the incidences of falls for an individual would enable the manager to identify trends and put preventative measures in place. 2 18 3 38 Care Homes for Older People Page 27 of 28 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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