Inspection on 11/09/08 for Highfield Private Rest Home

This inspection was carried out on 11th September 2008.

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

Highfield Private Rest Home 15/09/06

Highfield Private Rest Home 24/01/06

Highfield Private Rest Home 01/08/05

Highfield Private Rest Home 03/11/04

Highfield Private Rest Home 21/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Highfield Private Rest Home 77 Seabrook Road Hythe Kent CT21 5QW     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: Christine Grafton     Date: 1 1 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 27 Information about the care home Name of care home: Address: Highfield Private Rest Home 77 Seabrook Road Hythe Kent CT21 5QW 01303267036 01303261669 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Simon Proctor Type of registration: Number of places registered: Mr David Leonard Wadmore,Mrs Brenda Ann Wadmore care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Home comprises detached premises, with gardens to the front and rear, and parking for approximately ten cars. The Home is situated a short drive from the nearest town, with shops, health centres, churches, a library and other facilities, and is short walk from the sea front. The service provided includes varying levels of assistance with personal care. The Homes ethos is to provide an environment, which is as relaxed and homelike as possible. A great emphasis is placed on encouraging Residents to remain as active and independent as possible, and a variety of activities are provided within the home to assist with this. Fees for this service range between 465 pounds - 605 pounds per week. 0 Over 65 31 Care Homes for Older People Page 4 of 27 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: The quality rating for this service is 3 star. This means that people who use this service experience excellent quality outcomes. This was a Key Inspection of the service, which means that we reviewed all the information we have received since the last inspection and it included a visit to the home. We carried out an unannounced visit to the home on 11th September 2008 between 10:00 hours and 17:00 hours. We spent time talking with people that live in the home, plus a visitor, the manager and staff. We also joined in with a group activity and observed the home routines, staff interactions with the people that they look after and Care Homes for Older People Page 5 of 27 staff practices in general. We looked at some records, went round all the communal areas of the home and saw a sample of bedrooms. The manager sent us some information prior to the visit, in the form of the homes annual quality assurance assessment. This gave us all the information we asked for and has been used in the planning of the visit and the overall assessment of the service. Information from the previous inspection and that received since then has also been considered. At the time of the visit, there were a total of 28 people living in the home. The atmosphere was warm and welcoming. The fees at the time of this visit range between 465 pounds and 605 pounds per week. What the care home does well: What has improved since the last inspection? They have acted upon the things we raised at the last inspection and made further changes as a result of their own assessment of how they are doing. They have improved the medication procedures to make sure that people who are prescribed any medicines receive the right dose at the right time. They have made sure that staff are trained so that they can help people to move safely. They have increased the level of activities offered to people, including outings and entertainments brought into the home. Care Homes for Older People Page 7 of 27 They have made changes to the way that meals are dished up after listening to peoples views. They have continued to keep the environment homely and safe, by ongoing redecoration and maintenance work. They have continued to send staff on a wide variety of training courses to develop their skills. This has resulted in the home continuing to provide good care for the people living there. They have developed the way they monitor the quality of life of the people living in the home. They have done this by using a number of different methods to get the views of everyone involved and have acted upon suggestions, or have plans in place to address them. People can therefore be confident that they will be listened to and that their views really matter. 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.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 8 of 27 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 27 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 considering moving into the home benefit from being given excellent information about the home in general and the service provided. This makes sure that they can decide if it is the right place for them. They have an assessment that tells staff about them and the support they need, so they can be confident that when they are admitted to the home, their needs can be met. It is not the general policy of the home to admit residents for specialist intermediate care, so standard 6 was judged as not applicable. Evidence: People coming into the home are given a highly informative Welcome Pack that is written with warmth, in a very clear way. It contains a wide range of detail that covers everything people need to know about the home, the type of service provided and the standard of care to expect. The information is given in a way that makes it interesting Care Homes for Older People Page 10 of 27 Evidence: and meaningful for people. A copy is also kept readily available in the entrance hall for anyone to read, together with copies of the last inspection report and reports from two other quality monitoring associations. The home also has an informative Website with pictures of the home, staff and details about the fees and services. The manager visits people who are considering moving in, to assess their needs and find out about the type of care they will need and want. We saw that this is well recorded, so that when a person moves in, staff will know how to look after them. The manager also obtains a copy of the assessment completed by the persons care manager, if they have one. A comprehensive plan of care is drawn up, following admission, involving the person and written in a highly individualised way. It is seen as an important document that shows staff everything they need to know about the person and the care they need. We looked at three care plans. We saw that the home has looked at the needs of the person, satisfied itself that it has the capacity to provide the right care for them and considered any risks, putting plans in place to reduce them. The home makes sure that any equipment needed, for example, to aid mobility, is obtained. We spoke to eight people who live at the home and one visiting relative. They each expressed that the staff are competent and look after all the people at Highfield very well. One person expressed that they had visited the home before moving in and had felt comfortable the first day they came in, saying, I shouldn’t want to leave here, I like it here. Another said, I love it here, Ive settled in great. Care Homes for Older People Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from having their own personal plan of care that has everything staff need to know to make sure that they get good health care. People can be confident that staff will understand all of their needs, no matter how diverse, and everything is done to make sure these are met. They can be assured that their medication will be dealt with safely and they will be treated with respect. Evidence: Each person has a plan of care that they have been fully involved in drawing up. This is important so that people can say what support they need from staff and the things they like to do for themselves. The plans give all the relevant information to staff so that they know what to do to help people with their daily living, for example, things like, getting up, washing, dressing and moving about. Care plans cover general health and a whole range of other diverse needs, including sight, hearing, oral health, foot care, mobility, continence, aids used, dietary needs, and personal safety. We saw that the little extra things have been included to give staff expert knowledge Care Homes for Older People Page 12 of 27 Evidence: about the persons preferences when delivering care to them. One good example of this related to the care plan instructions for how to apply denture fixative, which were highly detailed. We saw two more different care plan examples demonstrating good practice. Both relate to mobility needs and associated risks. One has pertinent information about how the person walks, describing their gait as walking with a shuffle and sometimes holding onto furniture, with the risk that this could make them loose their balance. There is detailed guidance recorded, telling staff what they should do to reduce this risk and ensure the persons safety. The second relates to a person at risk of falls. This was identified at the pre-admission stage and a detailed plan was put into place straight away, so that when the person came, in staff knew what to do to keep the person safe. This involved discreetly monitoring the person when they were in their bedroom, keeping records of checks, making sure the call bell was near to them and describing how to help with moving and transfers, using a moving belt and walking frame. The care plan had been reviewed monthly. We saw that the risk of falls had been reduced even further, when the person had been given the opportunity to move to a bedroom that can be reached without needing to go up any stairs. The person, their relative and care manager had been fully involved in this decision and all are pleased with the outcome. Any falls are well documented and show action taken. We saw staff sensitively assisting people to move about, or discreetly observing them, being ready to help if needed. Each care plan provides a real sense of the person. At present, it is mainly the manager who writes the care plans. We discussed with him that care planning could be further developed by involving care staff more in the writing of them and to record monthly reviews more fully. Peoples general health is regularly monitored and health care professionals are fully involved as needed, for example, a persons weight gain is being investigated. We saw that a number of people have seen their own doctors since the last inspection and some have seen the community nurse for things such as dressings. We looked at the way peoples medicines are managed. Some people look after their own medicines and we saw that this has been agreed after careful consideration to ensure safety. Other people have their medicines managed for them by staff. We saw that the recommendation made at the last inspection has been acted upon. The manager has tightened medication procedures and ensures that medicines are only given out by trained staff. He has started a drugs received record, more staff have Care Homes for Older People Page 13 of 27 Evidence: received medication training and he has written guidance for the giving of medicines prescribed as required. He has also introduced medication audits and a discrepancy had been picked up through this that was being dealt with properly. We saw that the medication procedure makes sure that the right medicines are given to the right person at the right time. We spoke to eight people living in the home and one visiting relative about the care provided at the home. They all say they are very pleased with the care that they get. One person summed it up by saying They look after you very well here. The relative expressed that they are very happy with the care and everything about the home. People praised the staff, saying that they are kind and helpful. One person said, All staff are nice - very friendly. We saw staff talking to people in a friendly, but respectful way. Peoples privacy is respected - staff knock on doors and wait to hear a response before entering bedrooms, or other rooms where they know people wish to be private. People are helped to wear clean, neat clothing, so that they can feel good about their appearance. We also noted that staff support people to use the bathroom with sensitivity, by discreetly helping them to leave their armchairs and accompanying them. All of these things support the statement in the Annual Quality Assurance Assessment that the homes health and personal care is thought to be excellent by our clients and families. Care Homes for Older People Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home enjoy a stimulating lifestyle, benefiting from the wide variety of opportunities for them to take part in activities of their own choice. Contacts with families and friends are encouraged and they can lead their lives the way that they want. They benefit from the varied menu and enjoy good food. Evidence: Peoples lifestyle preferences are recorded in their care plans, along with such things as social functioning, community living, support networks and culture. Things learnt from this are then considered in the planning of activities and people have a say about what is offered in the home and in the planning of outings. We saw that people have a wide range of interests and are supported to continue with these. Peoples views are sought in a number of ways, including meetings where everyone living in the home is invited, residents representative group meetings with the provider and surveys are used to include: relatives, staff and outside professionals, as well as the people living in the home. These have covered interests and hobbies and this survey is done annually. We saw that they have developed this over the last year and have acted upon the recommendation from the last inspection. The Annual Quality Care Homes for Older People Page 15 of 27 Evidence: Assurance Assessment states they have increased the level of activities as a result of listening to people living in the home. We saw people socialising with each other, chatting with staff, reading newspapers and books, sitting in the garden and participating in a group exercise to music activity, which was being thoroughly enjoyed. People say they have lots of things to keep them occupied and stop them from being bored, for example, they have outings to tea rooms, garden centres and country drives. There is a garden fete that is held every year and people can invite their relatives and friends. There are also lots of indoor activities, including a reminiscence group, quizzes and a variety of games. People are supported to celebrate their faith in the way that they want and the home has visits from local church groups. People say they like living at Highfield and have lots of freedom, and choice to do what they want. They are encouraged to make their bedrooms their own. We saw examples of bedrooms with lots of personal possessions displayed, some with small items of their own furniture. People say they enjoy good food and have plenty to eat. There is a four-week menu plan that offers a varied diet with a range of alternatives. The cook knows their likes and dislikes and attends the residents meetings where menus are discussed, so that preferences can be incorporated. We saw the lunch time meal being served and noted that is was a leisurely affair where people were socialising with each other. Staff assist people who need help with eating. Care plans cover nutritional needs and we saw that any special needs are catered for. Cold drinks are freely available. We saw jugs of different squashes kept in each lounge and there is a hot drinks making facility available on top floor. Care Homes for Older People Page 16 of 27 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 any complaints will be listened to and sorted out and staff practices will make sure they are kept safe. Evidence: People say that all the staff are very approachable and if they have a worry or concern they know that staff will sort it out for them. They praised the home saying that they do not have any complaints. They are confident to approach the manager about anything as well. The manager and staff say that they encourage people to tell them if they have a worry, so they can sort it out before it escalates. We saw that this happens in practice and when it does, a record is kept showing how it has been resolved. The residents meetings and surveys provide additional mechanisms for people to air their views and concerns. There is a well written complaints procedure kept in the entrance hall with the service users guide and each person is given their own copy. A visiting relative told us that she is confident her mother would say if anything is wrong. Staff have an awareness of things to be alert for that might indicate something not being right with a person. They know the signs that might indicate a suspicion that Care Homes for Older People Page 17 of 27 Evidence: some form of abuse might have occurred and the home has written procedures in place for them to follow. Staff have done some training about this in the past year and the manager has plans in place for all staff to receive further training on this in October and November. The people say they feel safe and secure living in the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a clean, comfortable and homely environment at Highfield. They are protected by the practices followed in the home to maintain hygiene and prevent the spread of infection in the home. Evidence: We looked at all the communal areas of the home and a sample of bedrooms, which people were happy for us to see. People say they like the environment in which they live and several commented about the beautiful back garden, which has been landscaped and arranged so that people in wheelchairs can access it easily. A parttime gardener is employed to keep it looking attractive. We spoke to a person sitting on a garden bench, who said that they like to walk in the garden and sit outside most days, weather permitting. We saw that the home is well decorated and maintained, with adaptations to help people get about, such as hand-rails, stair lifts and a shaft lift. There is a varied range of furnishings throughout the home, such as attractive bureaus, a china cabinet and bookcase. The bedrooms we saw were of various sizes and shapes and highly individual, reflecting the personal tastes of the people living in them. People we spoke to said how much they like their bedrooms and the beautiful views from them. The homes annual quality assurance assessment states that all bedrooms have views of Care Homes for Older People Page 19 of 27 Evidence: the garden or the sea and this was the case in those we saw. One person, who likes spending time in the garden, showed us their bedroom and said how much pleasure they get from looking out of their window over the garden. Another person who has a bedroom at the front, was sitting in an armchair by the big bay window and said how much they like looking out and seeing the view that looks towards the sea, and watching people going by and coming into the home. People have the choice to use any of the six bathrooms and there are two showers. Hydraulic bath seats are provided to make it easier for people to get in and out of the baths. There is a well equipped laundry room, and we saw that there are good procedures in place to control the spread of infection. There are plentiful supplies of protective clothing for staff to use and liquid soap and paper towels. The laundry room has a large stainless steel sink, but there is no separate hand wash basin for staff use. We discussed with the manager that this is considered good practice, as is referred to in the Kent and Medway Community Infection Control Guidelines. The manager said he would discuss this with the provider for future consideration. Care Homes for Older People Page 20 of 27 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 can be confident that they will be supported by competent and qualified staff, knowing that there will be enough staff on duty, at all times, to meet their needs. They can be assured that the homes recruitment practices will protect them. Evidence: We looked at the numbers of staff on duty and saw that staffing levels have been set to take account of peoples needs and the various cooking, cleaning and management tasks. On the morning of the visit there was seven staff on duty, including five care staff, one cook and one cleaner. In the afternoon, there were three carers and the cook, who was on duty until after the evening meal. The manager, or deputy manager are on duty in addition to this. The rotas indicate that this is the usual care staffing complement throughout the week, with two staff on waking duty at night. There is also an additional supper time assistant on duty every day for 2 hours to take the tea trays round and help clean the dining room. People say they like the staff and they are confident that the staff know what they are doing. Their comments included: Staff are very kind and friendly; They look after you well here. Care Homes for Older People Page 21 of 27 Evidence: Staff spoke enthusiastically about their work, saying they like working at the home and that there is a good team spirit, with staff working together well. The providers support staff to achieve their National Vocational Qualification (NVQ) in care, or equivalent, and to date, eleven of the seventeen care staff employed have achieved this at level 2 or above. A number of security checks are carried out on new staff before they start work at the home. We looked at two staff files and saw that all the checks specified in the National Minimum Standards and legislation had been done. These include: past employment history, written references, checking identity and criminal records bureau checks. This is important to make sure that new staff are trustworthy and safe to be around the people living in the home. We saw training records that show a wide variety of courses completed by staff. A staff training matrix has been introduced since the last inspection and the manager is currently working on introducing staff training profiles for all staff. The home uses the Skills for Care induction training programme recommended by the Department of Health. We spoke to two staff and they confirmed the training provided. They have a good knowledge of relevant things, for example, medical conditions such as Parkinsons disease. All the things we looked at confirm the judgement made at the last inspection that people experience good outcomes because there are enough staff on duty that are well trained. Care Homes for Older People Page 22 of 27 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. The home is well managed, in a way that safeguards the best interests of the people living there, promoting and protecting their health, safety and welfare. People benefit from the quality monitoring processes that the management have developed to make sure they act as a result of listening not only to people who live in the home, but to a range of other interested parties as well. Evidence: The manager has been in post for two years and was registered in February 2007. This means that we think he has the necessary skills to manage the home. The Annual Quality Assurance Assessment (AQAA) was well completed and had all the things in it that we asked for. It was therefore helpful in the planning of the visit and the things that we tested out were confirmed as being correct. They have developed the way that they monitor the quality of care and overall service Care Homes for Older People Page 23 of 27 Evidence: provided within the home. They have listened to what the people living at Highfield say they want and have made changes as a result of this. For example one thing people said could be improved is the way meals are served. As a result they have made sure they do not dish up the meals too soon so that they do not become too dry. Another example is how they have increased the level of activities offered and provided more outings. People say they can make suggestions and take part in residents meetings. The provider holds resident representative meetings and the manager holds residents meetings and staff meetings. A variety of different people are surveyed by giving out questionnaires to people living in the home, their relatives, health care professionals and staff. The results are analysed and published in the service users guide. The home also uses two other external organisations to inspect it for quality and we saw their reports displayed in the entrance hall and on the residents notice board. Views of all of these people support the statement in the AQAA that they have strengthened their quality assurance procedures and have made excellent progress on their last development plan. The AQAA indicates that the home does not have any involvement in the handling of monies for the people living in the home. If people ask the management to make any purchases on their behalf, they are invoiced monthly and records are kept. The management hold monthly Health and Safety at Work meetings, which are documented. These show that any incidents of falls are monitored and action is taken to reduce this risk. Since the last inspection, a number of improvements have been made including one to reduce the risk of flooding in the cellar and work on the electrical installation. We saw that staff training on areas such as fire safety, first aid, food hygiene and moving and handling is given a high priority and sufficient staff are trained in these things so they can keep people safe. The AQAA indicates that the homes equipment is regularly serviced and no safety hazards were observed. Care Homes for Older People Page 24 of 27 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 25 of 27 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 Care Homes for Older People Page 26 of 27 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. 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