Inspection on 20/01/09 for Faversham House

This inspection was carried out on 20th January 2009.

CSCI found this care home to be providing an Excellent 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

Faversham House 22/01/07

Faversham House 23/03/06

Faversham House 18/05/05

Faversham House 29/09/04

Faversham House 20/05/04

Faversham House 03/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Faversham House 59 Church Road Urmston Manchester M41 9EJ     The quality rating for this care home is:   three star excellent 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: Elizabeth Holt     Date: 2 0 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Faversham House 59 Church Road Urmston Manchester M41 9EJ 01617485998 01617494915 rachel@favershamhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Rachel Hind Name of registered manager (if applicable) Mrs Rachel Hind Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: A maximum of 20 service users who are over 60 years of age may be accommodated. A maximum of 5 service users who are below 60 years and over 50 years of age and who require care by reason of physical disability can be accommodated within the overall maximum number of 20. Date of last inspection Brief description of the care home Faversham House is a care home providing nursing care and accommodation for up to 20 older people. Five people between the age of 50 to 60 years may also be accommodated within the total number. The home is a converted two-storey property that includes a purpose built ground floor extension. There are eight single bedrooms and six double bedrooms. There are three communal toilets, two assisted bathrooms and a large ground floor shower room. The communal space on the ground floor comprises of two lounge areas and a new conservatory. Care Homes for Older People Page 4 of 29 care home 20 Over 65 20 0 0 5 Brief description of the care home The home is located in the Urmston area of Manchester. There are local shops, a market and other amenities within a short distance of the home. The home is close to Urmston train station. There is a well-maintained garden to the rear of the home. There is a car park at the rear of the property. Faversham House fees range from 525.00-600 pounds per week. There are additional charges for chiropody (private) and hairdressing. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection included a site visit on the 20th January 2009 and is based on information we (the commission) have gathered since the home was last inspected in January 2007. An annual service review (ASR) was carried out in March 2008. This involved the manager filling out an annual quality assurance assessment (AQAA) and people who use the service and staff filling out surveys to tell us their views of the home. We then considered this information and the judgement was the outcomes for people who used this service remained good. Before this inspection we sent surveys out again to people who use the service and to staff who work at the home so they could tell us what they thought about the service. Nine surveys were returned from people living in the home and six surveys were sent back from staff members. Comments from these surveys are included in this report. Care Homes for Older People Page 6 of 29 The manager of the service was asked to fill in another AQAA which gave them the chance to tell us what they feel they do well, what they needed to do better and what had changed since the last key inspection and ASR. The AQAA told us what they thought they did well and what they planned to improve on. We considered the responses and and information the manager provided and have at times referred to this in the report. During this site visit all the key inspection standards were assessed and information was taken from various sources. This included observing care practices, talking with people who use the service, their relatives and members of the staff team. Records and files relating to people and records about how the home is run were also seen and a partial tour of the home was made. What the care home does well: What has improved since the last inspection? Since the last inspection the policies and procedures had all been updated to give staff clear up to date guidance. Care Homes for Older People Page 8 of 29 The manager has updated the Statement of Purpose and the Service user guide to show more clearly the service the home provides. Meal times have been made more flexible since the last inspection and people have more choice in relation to food and drinks. Since the last inspection the building of a conservatory has been added with the intention of creating a more pleasant dining arrangement for people living at the home. This will make mealtimes a more sociable occassion and provide more choice in areas where people would like to spend their day. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information about the home and a full assessment of prospective peoples care needs are made before they move into the home. Evidence: A service user guide is available to prospective people prior to admission at Faversham House. A copy of this was available in the hallway of the home and contained the necessary information about the service provided. In response to the recommendation made in the previous report the manager had reviewed and improved the statement of purpose and service users guide. From information received from nine people who filled in surveys, they stated they had received enough information about the home before they moved in so they could make a decision if it was the right place for them. One person wrote, My nephew and niece looked at three or four homes and found this one the best with regards information given to them and I have been very happy since arriving here. During the visit one relative said, It was the friendliness of the staff Care Homes for Older People Page 11 of 29 Evidence: and the homeowner and the bedroom for Mum that helped us make the decison for her to come here. One of the staff members who filled out a survey form said that they were usually given up to date information about the needs of the people they support or care for. Most relatives are very informative and relevant information can be obtained from them, especially when they are admitted from home. If a person develops a new problem whilst they are in the home this is written down in the care plan and staff are made aware of the persons new needs. The staff at the home showed how they did their best to meet the individual needs of new people moving into Faversham House and supported them through this process. Comprehensive needs assessment information was gathered as part of the admission process for two people looked at during this visit. The assessment involved meeting the prospective person, their representative and other relevant professionals. Staff used the information gathered in the assessment process to start the care plan which showed how the persons needs were to be met. The home does not provide intermediate care however they have the provision for respite care for one person. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The promotion of peoples health and personal care were met in the way they liked by staff that showed respect for their privacy and dignity. Evidence: The three care plans looked at gave information about the needs, choices and wishes of the people living at the home. Where care needs were identified, care plans were in place to show how these needs were to be met and gave staff instructions on how to meet each persons needs. Examples were seen of care plans being reviewed on a monthly or needs basis. In the self assessment, the AQAA, the manager stated that where appropriate service users are involved with care planning. We offer to do this by consultation, assessing, planning, delivering and evaluating the care given. We develop care plans with the inclusion of risk assessments and a variety of relevant screening tools. In two of the three care plans looked at this was seen to be the case. The system in place included the use of risk assessments, for one person there was evidence to show the nutritional risk assessment and care plan had been updated as the persons needs changed. The recording of the daily statements were not always Care Homes for Older People Page 13 of 29 Evidence: linked to the care plan but did reflect the care carried out on the day. People living at the home and visiting relatives were all satisfied and happy with the way the staff supported people to have their care needs met. One relative said,the staff are very kind and considerate and although we are not here all the time we would know if Mum was not happy, she seems happy in herself generally and thats what matters. Some of the detailed information for one of the care plans was missing for example, where a person had been found on the bedroom floor, the information was recorded in the daily statement only. A recommendation was made for the use of a body mapping tool to show the size and areas where the brusing was seen. Use of this tool was seen in other care plans to show the skin markings present. Care plans were reviewed where wound care management was needed, for one of the people the nurse in charge could not locate the specific wound care plan. The daily statements in the care plan for this person showed that dressings were due for renewal and these dressings had been changed a few days earlier. A recommendaton was made for the care plan to include a specific wound care plan and for this to include the onoging evaluation and updates of this. For another person a detailed wound care plan was in place however in order to clearly follow the progress and current treatment of the wound some of the detail had not been updated. A discussion with the lead nurse showed that regular evaluations should be carried out to fully monitor the progress of the wound and the any changes in the wound treatment plan should be noted in the care plan. Policies and procedures were in place for the management of medication in the home. The home had a monitored dosage system in place and Controlled Drugs were appropriately stored and recorded. A sample of medication administration charts were looked at, these were generally well recorded although one persons chart which had been handwritten by the registered nurse did not include the nurses signature or the signature of a witness to check this as an accurate record. The chart did not include a record of the number of tablets received into the home and there was no photograph of the person due to receive the medication on the chart. A procedure was in place for the safe disposal of medications however medicines which were awaiting collection for destruction had not been recorded and therefore records could not show that medicines could be fully accounted for. The care plans showed records of involvement of healthcare professionals such as General Practitioners, speech and language therapists, dieticians, physiotherapists, chiroprodists and tissue viability nurses. One GP who was visiting the home spoke very positively about the professional way in which the staff communicated with his practice and how well they carried out instructions for the benefit of the people receiving medical care and support. Care Homes for Older People Page 14 of 29 Evidence: Three people who were visiting the home spoke positively about the way the staff dealt with them and the way in which thier relatives were supported in Faversham House. Two people who spoke about how their care was delivered were pleased with the way the staff supported them. One person said, I have been very happy with the carers here ever since I came, the atmosphere is friendly and warm and everyone does what they can to help me. Nine people returned surveys and all nine stated that they always received the care and support they needed. People spoken to felt the staff respected their need for privacy and dignity. One person said, the staff always knock on my bedroom door and talk to me in a respectful way. A high number of the staff have been trained in palliative care and in the AQAA the manager stated that,The care home accepts many more service users, some at the very end of their life and pride ourselves on the standard of care delivery both to the service user and their families and friends. Letters of thanks from relatives and friends confirmed the quality of care felt by the families. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to take part in activities that suit their lifestyles and are provided with a choice of food which they enjoy. Evidence: The home employs an activities organiser on a part time basis who encourages people to join in with group activities, games, reminiscence therapies and one to one activities. One of the people living at the home said, I do enjoy some bingo and I did a jigsaw the other day and even played cards which I hadnt done for ages but thoroughly enjoyed. The home continues to use the services of a private physiotherapist and a complementary therapist who provides treatments as requested. The manager provides a bar service providing a range of acoholic and non alcoholic drinks. One person said, I have a nightcap every night which is just the job! There was some information in the care plans of daily activities carried out and some information about peoples likes and dislikes in relation to social activities. There was information in the care plans looked at to show that peoples religious and social needs had been taken into consideration. Where possible people living at the home were encouraged to join in local events Visiting relatives said they were always made to feel welcome and were aware they could visit at anytime. Care Homes for Older People Page 16 of 29 Evidence: The menu of the day was displayed which showed the main meal of the day. A choice was made available to meet the likes and dislikes of individual people. Two people were seen enjoying egg and chips rather than the meat dish which was their choice. There was a choice for people to eat their lunch in the privacy of their bedrooms or in the lounge over small lap tables. Following the addition of the conservatory the manager plans to create a dining room which may make mealtimes a more sociable occassion for people living at Faversham House. One of the staff members confirmed this. Three people spoken to said they were quite happy with the current eating arrangements. One person said, I rarely get hungry because I havent moved barely all day. A staff member spoken to said it was difficult because of the work currently being done on the conservatory. Six people commented in the surveys that they usually liked the meals at the home and three people said they always liked the food. One person commented that, I really enjoy my breakfast, sometimes I find the main meal a little overfacing but an alternative is always offered. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by the complaints and safeguarding procedures in place, which the staff understood. Evidence: A copy of the complaints procedure was available to people in the Service Users guide. The AQAA stated that the service listened to service users and their advocates concerns well, took them seriously and acted upon them. The manager stated that comments and feedback led to change and improvement within their service and service users were confident that the care they received would not be affected as a result of them raising their concerns. Compliments were also seen,one person wrote, A little note to say thank you for everything you did for my Grandad. You and your staff certainly went on to demonstrate your home is different from all the others. It was such a relief after being in hospital for Grandad to be so well cared for. We knew we could do nothing more than make sure he was comfortable and you did that. Thank you for enabling him to have a pleasant and dignified final two weeks of his life. Another person wrote, I know he was only with you a very short time but you treated him and his family with great kindness. The home had a copy of the policy on Protection of Vulnerable Adults. All staff were checked against the Protection of Vulnerable Adults list (POVA) before they started to work at Faversham House. Some staff had training through Trafford consortium but it Care Homes for Older People Page 18 of 29 Evidence: was not clear how many. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a safe, comfortable and well maintained home that has had a number of improvements. Evidence: There is a clean, homely environment for the people living there and there is a maintenance programme in place. A partial tour of the home was carried out. A sample of bedrooms were looked at which were personalised and homely. One person said, I like my room with my new tv and my things around me. Great improvements have been made by the addition of a large conservatory which was not in use on the day of this visit due to the flooring being attended to. The AQAA showed that the conservatory will also combine as a dining room which will have a positive effect on the daily lives of the people at Faversham House. Other improvements since the last inspection included the fitting of new windows throughout the home and a programme of updating bedrooms and providing wall mounted televisions for each person. All nine people who filled in surveys said that the home was always fresh and clean. Another person said, It never smells here. A variety of equipment was available in the home to make sure the physical care needs of the people can be met. Equipment included specialist beds and adapted baths. Care Homes for Older People Page 20 of 29 Evidence: In the AQAA the manager stated that the infection control policy is clearly adhered to. Study days are held quarterly by the infection control specialist from the primary care trust. Twenty four staff members attended the training session in August 2008. Staff spoken to were aware of the homes policy on infection control. During this visit a recommendation was made to provide liquid soap in the staff toliet on the ground floor. The home provides the services of a full time house keeper and a laundry assistant seven days a week. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported by sufficient numbers of appropriately qualified and experienced staff. Evidence: On the day of this visit there were 19 residents in the home and the staffing numbers and skill mix of the staff was sufficient to meet the needs of the people living at the home. A look at the duty rota confirmed that there are generally two registered nurses on the morning shift who are supported by three or four care workers. At night there are two care workers and one qualified nurse. Staff are supported by cooks and a kitchen assistant, a housekeeper and a laundress. One staff member stated in the survey that, The duty rotas always accommodate the needs of the residents, however unexpected sickness can affect this, fortunately our sickness levels are low. Another staff member stated that, I think the care of residents is to a high standard regards their well being and individual needs. Information provided by the manager in the AQAA stated that out of 15 permanent care workers 10 had gained the NVQ Level 2 in Care or Health and Social Care, two carers had almost completed this qualification, 4 carers were studying for NVQ level 3 Care Homes for Older People Page 22 of 29 Evidence: and 2 carers were studying for a management award. Staff who returned surveys felt they were well supported by management to carry out studies to assist them in their career. Five staff members records were looked at. There was evidence of completed application forms and 2 written references for the five files looked at. The records showed confirmation of Criminal Record disclosure checks for all staff. A recommendation was made for the files to include a passport photograph of each staff member in post and copies of passports. For one staff member the records on staff file did not clearly show that mandatory training had been carried out since a Moving and Handling update in October 2005 and fire safety in October 2006. For another staff member there was a record of training in the following areas infection control, moving and handling, palliative care, food hygiene and safety. A discussion was held that a system should be introduced to include a staffing matrix so that it is possible to see clearly when staff have carried out training and when updates are due. Staff spoken to showed they had knowledge of policies and procedures available in the home. Records were in place to show that the most recently recruited staff members had followed the Skills for Care Induction modules based on fire safety, care of client, induction, policies and procedures. Files included records of staff supervision which covered their devlopment needs. From the records looked at it was unclear when staff had received training in Adult safeguarding and two staff spoken to were clear about the action they would take in the event of an allegation of abuse however they were not clear when they had last received training in adult protection. Training in Adult safeguarding needs to be included in the training plan. Copies of the Registered Nurses Personal Identification numbers with the Nursing and Midwifery Council were on file which showed they were on the professional register. Staff surveys were returned from six staff members. One staff member stated that they felt, I have many years experience and knowledge and I feel well supported by the staff around me including my manager and home owner. I feel we offer an excellent service in every way to our residents. The six staff confirmed that they felt the training given was relevant to their role. One staff member stated that ,There is access to lots of training, many varied courses available to all staff from trained nurses to ancillary staff. We hold regular staff meetings and clinical supervision and appraisals are updated every three months. Care Homes for Older People Page 23 of 29 Evidence: When asked whether they felt they had the right support, experience and knowledge to meet the different needs of people who use the services? One staff member answered, I feel everybody who works here has the support and knowledge to meet the needs of different people as we all have the opportunities to go on courses and are all trained to NVQ 2 standard. Another staff member wrote, There are regular indepth thorough reports at the start of every shift. Many staff have worked here for a number of years. It is rare to have agency staff and information is generally passed on by reports, a daily care book and a diary. I feel the way information is passed on works well. The staff team were seen to be happy in the home and the atmosphere was relaxed and friendly. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and relatives were confident the home was run in the best interests of the people living at Faversham House. Evidence: There have been no changes in the management arrangements for the home since the last inspection and the owner/manager communicates with us as necessary. In the AQAA the manager stated that the service users benefit from the ethos, leadership and management approach of the home which is an open style. Surveys from the six staff members confirmed the manager was very supportive. One staff member commented that, The manager is very supportive. She is prepared to help us if we have a problem, be it personal or work related. She helps us towards our study fees too. One of the relatives stated that the manager would make herself known to us, If I had any concerns I would not hesitate in calling her. At the time of the visit the manager was not present in the home and although the staff said the manager visited regularly and was readily contactable, there was no record on the duty rotas of the hours the Care Homes for Older People Page 25 of 29 Evidence: owner/manager spent at the home. Some visitors spoken to clearly knew who the manager was and stated she was always approachable. It is recommended the managers hours are included on the duty rota or are made available to show the time the manager is present in the home. The home has arrangements in place for the management of money belonging to people who live at Faversham House. People were encouraged to manage their own money where possible or family members took on this role as needed. Both formal and informal quality assurance methods were in place to gather the views of people who used the service. A questionnaire had been sent out to people who had stayed at Faversham House and or their representatives and some of these had been returned. The nurse in charge was made aware to make sure these were dated. We were advised that action was taken following recommendations made as a result of these views. As the sample returned was small there was no current report available of the findings. Staff said they listened to the views of people living at the home and made changes as necessary so they could influence the way the service was run. One persons comments included the following, I am very pleased that we are informed immediately when something goes wrong. My Mum has come on leaps and bounds since coming into Faversham and we feel reassured she is well looked after. A sample of the maintenance records were looked at which included fire equipment, means of escape, fire alarms and emergency lighting. Records of fire drills were in place. The last fire inspection and a review of the fire risk assessment was carried out in August 2008. Policies and procedures had been updated since the last key inspection and staff had access to these at all times. An accident report log was in place that met with the requirements of the Data Protection Act 1998. A number of the records were attached to the log and not stored individually. There was evidence to show an audit was carried out of accidents or incidents that had occured and entries were also made in the care plan. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 7 It is recommended that staff use a body mapping tool to record any changes in a persons skin condition so that staff can monitor the progress of any markings, wounds. It is strongly recommended that any unwanted medication must be disposed of by keeping a full record of the returns to show that medicines can be fully accounted for. It is recommended that if medication administration charts have to be handwritten in the short term, these are signed and witnessed by two staff members to check they are accurate. It is recommended that liquid soap is available for the staff and people living at the home to use at all times in communal toliets to prevent the risk of cross infection. A system should be introduced to include a staffing matrix so that it is possible to see clearly when staff have carried out mandatory training and when updates are due. It is recommended the managers hours are included on the duty rota to show the time the manager spends in the home. 2 9 3 9 4 26 5 30 6 31 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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