Inspection on 22/01/09 for Elreg House

This inspection was carried out on 22nd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elreg House 18/03/08

Elreg House 29/05/07

Elreg House 11/04/06

Elreg House 05/09/05

Similar services:

1 Marten Road

Daubeney House

Three Gables

Deepdene Care Centre

Aldwick House

49 Glendale

Ferndale Residential Care Home

David Gresham House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elreg House 58 Rosslyn Road Shoreham By Sea West Sussex BN43 6WP     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: Annette Campbell-Currie     Date: 2 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Elreg House 58 Rosslyn Road Shoreham By Sea West Sussex BN43 6WP 01273454201 01273453431 elreghouse@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Anthony Robert Brown Name of registered manager (if applicable) Karen Hearn Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 23. The registered person may provide the following category of service: Care home only(PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Elreg House is a care home registered to provide personal care and accommodation for twenty-three older people who have dementia or a mental disorder. The home is located near to the town centre of Shoreham-by-Sea, West Sussex, with the usual amenities of a small town. Care Homes for Older People Page 4 of 30 care home 23 Over 65 23 23 0 0 Brief description of the care home Elreg House is a two-storey building with a single storey extension to the rear. Fifteen of the residents bedrooms are single and four have the benefit of en-suite facilities. There is no passenger lift. There is an enclosed rear garden that is accessible to residents. Elreg House is privately owned by Mr Anthony Brown. Mrs Karen Hearn is the registered manager responsible for the day-to-day running of the home. The web site address is: www.elreghouse.com Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 previous key unannounced inspection was carried out on 18th March 2008. Since then Mr Brown has become the sole owner of Elreg House and the registration certificate is being changed to reflect this. The current fees are from 410 to 600 pounds per week. Annette Campbell-Currie carried out the site visit over six hours. Mrs Hearn, the registered manager and Mr Brown, the provider, assisted with the inspection. The information and documents required by us (the Commission) were available. There were twenty people living in the home at the time; one person was in hospital. Care Homes for Older People Page 6 of 30 The manager completed an annual quality assurance assessment form (AQAA) before the inspection. The AQAA provided information that was used to help plan the site visit. During the site visit most of the people staying in the home were seen and two people were spoken with. Time was spent with two members of staff. Surveys were sent out to people living in the home, staff and health and social care professionals, to find out what people think about the service. Two healthcare professionals, four staff and four people living in the home returned surveys. Three people had support completing the survey. The information gathered has been used to help make an assessment of the service. A tour of the building included communal areas, the kitchen, laundry, bathroom and toilet facilities and a number of bedrooms. The following documents were read: the case records of three people living in the home, the complaints records, recruitment records for three newly appointed members of staff, some training records and a sample of medication records. Time was spent in the dining room at lunchtime and the medication round was observed. The outcomes for people living in the home have been assessed in relation to twentytwo of the thirty-eight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. What the care home does well: What has improved since the last inspection? What they could do better: The health and safety of people living in the home must be protected by ensuring that all areas of the home are safe and that this is monitored on a daily basis. Pipe work that could cause a risk of burning must be made safe. Worn carpets or other floor covering that could cause a trip hazard must be made safe. Areas of the home that could be used by people living in the home must be kept warm to protect people who may want to use their rooms during the day. Heaters must be protected to prevent the risk of burns. A requirement has been made regarding these matters. The Royal Pharmaceutical Society Guidance regarding the storage of medicines must be followed so that medication is not stored in the toilet area. A requirement has been made regarding this matter. The manager must ensure that staff understand the importance of following moving and handling guidance provided in their training so that they do not cause a risk to themselves or people living in the home. A requirement has been made regarding this matter. Rigorous quality assurance systems and Regulation 26 reports must be provided so that shortfalls in the service or the building are kept under review and addressed. A requirement has been made regarding this matter. Care Homes for Older People Page 8 of 30 Information should be provided in a format that is easier for people who have a dementia to understand. Thought should be given to making the environment more suitable for people who have a dementia, for example pictures on doors to help people with memory problems and warning indicators on stairways. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An assessment is carried out with each person before a decision is made about them moving to the home. Evidence: The majority of people who move to Elreg have been referred by staff from the social services department. Holistic assessments have been carried out to make sure that this would be a suitable home. The manager also carries out a pre-admission assessment to make sure that the staff in the home would have the skills to meet the persons needs. Information is also gathered from relatives and other professionals involved in the persons care. The manager said that sometimes there are specialist mental health assessments available that provide detailed information. The case records for three people were seen and showed that care management assessments had been obtained and that the manager had carried out an assessment Care Homes for Older People Page 11 of 30 Evidence: before a decision was made about the person moving in. The assessments included information about peoples personal care and medical needs. There was also some information about peoples interests, spiritual and cultural wishes. The manager said that she is intending to expand on this part of the assessment and is thinking of ways to find out more background information about peoples lives so that a more person-centred approach can be taken to care planning. The manager said that it is not always possible for people to visit the home before they move in but she encourages people to visit if they can. In order to help people settle in, relatives are asked to bring the persons possessions to the home so that they have familiar items around them. A member of staff is assigned to each person when they move to help them to settle in. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are set out in a plan of care. The medication storage facilities do not comply with current legislation in order to protect people. People are treated with respect. Evidence: When people move to Elreg a care plan is drawn up; this includes information gathered during the pre-admission assessment. The case records of three people were seen and showed that care plans had been drawn up and these documents included information regarding sight and hearing, personal care needs, mobility, skin care, night time routine, dietary needs, medication taken, and history of falls. The care plans were clear and provided guidance to staff about the way people prefer their care to be provided. Peoples interests are noted and a comment on one file was: benefits from one-to-one however it was not clear when this time would be allocated or how it should be spent. Care Homes for Older People Page 13 of 30 Evidence: It was clear that healthcare needs are noted, monitored and people are referred for further input from healthcare professionals when required. A note on one persons file said: prone to urinary tract infections and requires a lot of fluid intake also requires prompting to eat. Fluid and food charts have been set up to be used when necessary and completed copies of these were seen. Observation charts for everyone at night are in place so that people are monitored at least two hourly. Completed charts were seen and had been signed by night staff. Everyone is weighed once a month and their weight monitored. Daily evaluation sheets are completed and signed by staff there is also a daily report book. The daily sheets that were seen were detailed and had been signed. Wound assessments are carried out if necessary and body charts are used to log any bruising found with the cause noted or the circumstances in which the person was found. The manager said there is a good relationship with the local primary care team and visits from the GP or community nurse are noted with a record of the outcome of their visit. Risk assessments had been carried out and guidance provided to staff where a risk had been identified. Risk assessments had been carried out for slips, trips and falls, mobility, continence and mental capacity. No one in the home is able to administer their own medication. The medication storage and samples of records were seen. The storage of medicines in the home does not meet the Royal Pharmaceutical Society guidance as the medicine trolleys are currently being stored in a toilet area. A requirement has been made regarding this matter. The records have photographs of each person to avoid any errors in medication. Staff who administer medication have all attended training so that they are competent to do so. A medication round was observed and medication was being administered and recorded appropriately. A pharmacist inspects the home twice a year to make sure that policies are being followed. Currently no one living in the home has been prescribed controlled drugs; if this situation changes the manager must ensure that storage facilities comply with current legislation. Staff are given guidance about the way to provide personal care as part of their induction. During the day staff were seen to be communicating well with people and providing support in a respectful and sensitive manner. Care Homes for Older People Page 14 of 30 Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in some activities in the home however there is little opportunity for staff to spend time with people individually. People are encouraged to maintain contact with their families. People are supported to make some choices in their lives. People are provided with a balanced diet, however more support is needed at meal times to ensure that people have a hot meal and the help they need to eat their food. Evidence: The manager said in the AQAA that peoples preferences for leisure and activities are taken into account during the pre-assessment process. The manager said that a member of the care team is responsible for coordinating the activity programme that meet the needs of people who have a dementia. The case records seen showed that there were some notes about peoples interests but not very much detail about peoples lifestyles before they received a diagnosis of dementia. With this information a more individual plan of activities could be set up to include time for people to have one to one support with a member of staff. There was a recording sheet on file to show what activities people had taken part in; not all of these had been completed. Care Homes for Older People Page 16 of 30 Evidence: The manager said that people tend to be more alert in the afternoons and some activity times have been changed from morning to afternoons. An outside facilitator comes to the home every third Wednesday and sets up a memory quiz with handouts to help people. The manager said that he is very good at encouraging people to join in. Every Monday someone comes to the home to provide musical activities; this is now on alternate mornings and afternoons. There is a new television screen in the dining area that is used to show films and a new television screen in the lounge; this area of the lounge is divided off so that people who do not want to watch can have a more quiet area to sit. The manager said in the AQAA that a live pantomime is provided up to four times a year and that special events are celebrated in the home. During the morning people were sitting in the lounge or in their rooms. Some were dozing and others were watching television. There were more people in the lounge during the afternoon however there were no activities arranged that day. Comments made by people who returned questionnaires sent out by the home included: there is a regular programme of entertainment, which they all enjoy and often they are just sitting in the lounge, it would be nice to come in and see them doing an activity. It is recommended that a more individual approach should be taken to activity planning as well as the outside entertainment that is in place. Staffing levels should be sufficient to allow for care staff to spend one to one time with each person and this should be part of each persons care plan, so that people receive the stimulation that they need to support them to maintain their mental wellbeing. The manager said in the AQAA that people are supported to maintain contact with their relatives and friends. Visitors are welcome to the home although the manager said that some people do not receive visitors. People are supported in their cultural or religious beliefs and the manager said that the home would arrange for people to go to church; at the moment no one in the home has expressed a wish to do this. The manager said that staff are encouraged to help people make choices in their lives. The manager is developing the use of picture cards to help people to make choices. There are photographs on the wall of the dining room to show the meal being provided that day. The manager said this process takes time but she feels that it helps people. The increased use of materials that would be easier for people to understand would help people to make more choices in their daily lives. The menus were seen and people are provided with a nutritious diet. It was clear from case records seen that peoples nutrition is monitored and addressed if there are any concerns. There was a relief cook on duty at the time of the visit; he had been to the home before so was familiar with the needs of people in the home. The manager has Care Homes for Older People Page 17 of 30 Evidence: purchased table clothes to make the dining room more attractive; some new furniture has also been purchased for the dining room. There is not room for everyone to eat in the dining room and some people take their meals in their room or in the lounge. There were three care staff on duty at lunchtime and due to time pressure some people did not have their meal until twenty to two. Staff were doing their best to help people who needed support with eating; while one member of staff was administering medication there were only two staff to assist people; to clear up and serve the dessert. The manager said that lunch is normally served earlier however there should be sufficient numbers of staff on duty to make sure that everyone has a hot meal in good time and those who need assistance are supported in a relaxed manner. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are listened to and acted upon. There are measures in place to protect people from abuse. Evidence: There is a complaints policy that is provided to everyone in the home. This is not yet provided in a format that would be easier for people with a dementia to understand. The manager said that she is planning to improve the way the policy is presented to help people understand how to raise a concern or to make a complaint. There is a system for recording complaints and the home has received two since the previous inspection. It was clear that the complaints had been investigated appropriately. The manager was advised to set up a recording system that shows actions taken with outcomes and timescales so that the complaints process can be more easily monitored. The home follows the West Sussex multi agency policy and procedure regarding the protection of vulnerable adults. All staff have attended training about adult abuse and reporting procedures. The staff spoken with were clear about their responsibilities regarding protecting vulnerable people and their duty to report any concerns. Incident reports are kept in the home and any bruising found is logged on a body map and monitored. Examples of this were seen on case files. Two safeguarding referrals have been made to the social services department. These were investigated by staff from Care Homes for Older People Page 19 of 30 Evidence: social services and no further action was required. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not always provide a safe environment for people living there. The home was clean with no offensive odours. Evidence: Mr Brown, the owner of Elreg said that he has a development plan for the home and plans for an extension have been submitted to the local council for planning permission. The extension will provide better dining facilities, improved washroom facilities, a new laundry, additional bedrooms and an enhanced garden area. Improvements have been made to the home including new carpet in some areas of the home; new windows have been fitted to the front and top floor of the home. Flooring in some areas of the home is worn and is a trip hazard; the manager said she would arrange for this to be rectified as soon as possible. The manager said in the AQAA that the home meets the requirements of the local fire service and the environmental health department. The manager was advised to seek the advice of the fire officer regarding propping open doors in communal areas. There is a fire risk assessment in place. The communal areas of the home were warm however the upstairs floor and rooms and corridors downstairs were cold. The manager said that at four oclock in the Care Homes for Older People Page 21 of 30 Evidence: afternoon staff put the heating on and make sure that bedroom windows are closed. People should have the choice and opportunity to spend time in their rooms during the day if they wish to and to be able to do this in the warmth. In a downstairs corridor an electric heater was being used to warm the area; this was very hot to the touch and could have caused a burn; Mr Brown removed this to keep people safe, however the corridor remained cold. It was noted that some pipe work in a downstairs corridor had not been protected and would present a risk of burning if someone were to fall against it. Mr Brown said this would be dealt with as soon as possible. A flat roof has been repaired as water had been leaking through the ceiling into a bedroom. The ceiling in the persons room had not been redecorated; Mr Brown said the area was not damp but would need to be especially treated to ensure that further damp did not appear. He was advised to make sure that this process would not cause a threat to the health of the person staying in the room. The home is not suitable for people who use a wheelchair. A stair lift has been fitted to help people to access the first floor. The manager said an occupational therapist had provided advice about this. There was a risk assessment for one person who uses the equipment. The manager was advised to make sure that a general risk assessment is carried out so that staff have clear guidance about the use of the stair lift. Two bedroom doors had pictures to help the person identify their own room. The need to provide an environment to meet the needs of people who have memory difficulties was discussed with the manager. There were some pictures in the communal areas reminiscent of past times. The use of symbols, pictures, photographs and sensory stimulation in the home should be considered to act as triggers for people who have a level of confusion and memory loss. Also warning indicators for steps and stairways should be provided. The laundry facilities are cramped and there is no hand washing facility; antiseptic gel has been provided for staff. The care staff are responsible for laundry duties. There is a member of staff for domestic duties during the day. The home was clean and hygienic. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels do not fully meet the needs of people living in the home. People receive care from by staff who are trained and supported to do their job. The recruitment procedure protects people living in the home. Evidence: Samples of staffing rotas were seen and showed that there are fewer care staff on duty each day than was noted at the previous inspection. There are three carers on duty in the morning and two in the afternoon. The manager said in the AQAA that staff numbers are increased at peak times however this was not evident at the time of the inspection and as already mentioned staff were under pressure to provide people with the care they needed at lunch time. There was little time during the day for staff to encourage small group or individual activities. It was noted that some staff work a high number of hours during the week. It was noted that two people were on the rota to work ten eight hour shifts over a two week period. The manager said that staff have agreed to this working arrangement and two staff spoken with said they are happy with their working hours. This matter was raised at the previous inspection as there is a concern that staff working for many hours over the course of a week could put their own health and the wellbeing of people living in the home at risk. This matter was discussed with the manager. Care Homes for Older People Page 23 of 30 Evidence: Six of the fourteen permanent members of staff have completed a National Vocational Qualification (NVQ) at level two or above and two people are registered for the award. Four of the six people have achieved an NVQ at level three. There is a recruitment policy in place and people interested in working in the home complete an application form. The manager said that she carries out interviews and would explore any gaps in employment at that time. Two written references are requested and an enhanced Criminal Records Bureau (CRB) check is carried out. People do not begin work until all the checks have been received to make sure that people living in the home are protected. Records seen have shown that this is the case. There is an induction and training programme to make sure that staff have the knowledge and skills they need to do their job. The induction programme meets the Skills for Care standards and includes a workbook that staff complete with the support of their supervisor. All staff have attended the mandatory training. Training sessions that are due to take place include: dementia care, medication, palliative care and fire training. Staff who returned surveys and those spoken with indicated that they receive the training and support they need to do their job. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is experienced and qualified to run the home. The home is not involved in supporting people with their finances. The quality monitoring systems do not fully ensure that the health, safety and wellbeing of people living in the home is protected and promoted at all times. Evidence: Mrs Karen Hearn is the registered manager for the home. She is an experienced manager and holds the Registered Managers Award (RMA). Mrs Hearn is committed to her ongoing training and development. She has provided a range of updated information on legislation and national policies that have an impact on the service. This information is readily available to staff so that they are kept informed of current requirements and good practice. Questionnaires are sent out every year to people living in the home, their relatives and professionals involved with the home, to find out what people think about the service. Care Homes for Older People Page 25 of 30 Evidence: Samples of returned surveys were seen and comments included: I review one person regularly in the rest home, she is being very well cared for in an holistic way to ensure that her needs and those of her family are attended to and staff are always polite and friendly. The results have not yet been collated and published. The manager said that Mr Brown normally carries out Regulation 26 visits to the home each month however there were no written reports for the past three months. The provider must ensure that there are robust quality monitoring systems in place and that a written report of Regulation 26 visits are provided, so that shortfalls in the safety of the building or the care service are noted and addressed. A requirement has been made regarding this matter. The home does not support people with their finances, this is the responsibility of relatives, solicitors or the local authority. The manager said in the AQAA that the equipment in the home is serviced as required. A fire risk assessment has been carried out and the home complies with fire regulations. The manager must seek the advice of the fire officer regarding propping doors open. Staff have attended mandatory training. A number of health and safety issues were noted in the home and have been discussed under Standard 19 regarding the environment. Incidents and accidents are responded to and recorded as required. Someone living in the home had a fall during the visit. Staff attending to the person were in a rush and although they had attended training in moving and handling techniques they did not follow the correct procedure. This could have caused a risk to their own health and wellbeing and that of the person who fell. The manager assisted and handled the situation well however she must ensure that all staff are reminded to use safe practices when an incident occurs. A requirement has been made regarding this matter. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered provider must ensure that the facilities for storing medication meet the requirements of the Royal Pharmaceutical Society in order to protect people from harm. 28/02/2009 2 19 13 The registered provider 28/02/2009 must ensure that all areas of the home are safe and warm at all times in order to keep people safe. 3 33 24 The registered provider 28/02/2009 must ensure that the quality of the home and the service is kept under review and that written Regulation 26 reports are provided each month to ensure that shortfalls in the environment or service are monitored and adressed without delay. Care Homes for Older People Page 28 of 30 4 38 13 The registered manager 28/02/2009 must ensure that staff understand the importance of following guidance on safe moving and handling in order to keep people safe from harm. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 30 of 30 - 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!