Inspection on 29/09/08 for Hythe Nursing Home

This inspection was carried out on 29th September 2008.

CSCI found this care home to be providing an Good 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

Hythe Nursing Home 14/11/06

Hythe Nursing Home 28/02/06

Hythe Nursing Home 24/08/05

Hythe Nursing Home 19/10/04

Hythe Nursing Home 22/07/04

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: Hythe Nursing Home 91 North Road Hythe Kent CT21 5ET     The quality rating for this care home is:   two star good 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: Mark Hemmings     Date: 2 9 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 29 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 29 Information about the care home Name of care home: Address: Hythe Nursing Home 91 North Road Hythe Kent CT21 5ET 01303265441 01303230329 premiumhythe@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Barbara Hazrati Type of registration: Number of places registered: Premium Healthcare Limited care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 35. The registered person may provide the following category/ies of service only: Care home with nursing to service users of the following gender Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category -OP Date of last inspection Brief description of the care home Hythe Nursing Home (the Service) is registered to provide accommodation and nursing care and personal care for 27 older people. Two people who are under 65 years of age can be included within this number. The premises are a large three storey detached property. The accommodation is arranged on each floor. There is a passenger lift between the floors. The people who live in the Service can get around to everywhere they need to without having to use stairs. When full, there is provision for three of the bedrooms to be shared by two people each. All of the other bedrooms are single Care Homes for Older People Page 4 of 29 Over 65 35 0 Brief description of the care home occupancy. Each bedroom has a private wash hand basin and two of them also have a private toilet and bath. The bedrooms have a call point. This is there to help people ask for assistance should they need it. The bedrooms also have a television point. People can have their own phone installed if they want to pay for it. There is a main lounge and dining room. The back of the property looks out over Hythe and to the sea. There is a small patio area in the back garden. There is an adequate number of bathrooms and toilets. There are sensible things such as banister rails to help people get about. The Registered Provider is a private company. The Directors of the company have their office in the Service. Details of the fees charged for each person to live in the Service can be obtained from the Manager. The fees include all accommodation, meals, personal care, laundry and in-house entertainment. They do not cover things such as personal toiletries 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: two star good 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: We arrived at the Service at 9 Oclock in the morning and were in the Service for about eight hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, it considered any information that we have received about the Service since the last inspection. During the inspection we spoke with both of the Directors. We spoke with three of the people who live in the Service. We also spoke with the Manager, the deputy manager, one of the nurses, three health care assistants, one housekeeper, the laundry manager, the office administrator and with the cook. We looked in the lounge, several of the bathrooms and toilets, the kitchen and the laundry. We saw four of the bedrooms. We looked at a selection of key records and documents. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 29 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 3 and 6. People who are about to move in are asked about what support they need and how they want this to be done. People who want to stay for shorter periods are helped to go back home. Evidence: The Manager asks people who are considering moving in about what support they need and want. This is done so that everyone can be confident that moving into the Service is the right thing for them. The Annual Quality Assurance Assessment recognises the importance of this process. We looked at the sorts of things that are usually considered. These are practical and relevant. They include a clear account of what nursing care support they need. They also include things like the help that may be needed for the person to use the bathroom in safety and comfort. The Manager then Care Homes for Older People Page 11 of 29 Evidence: tells the nurses and health care assistants about what she has learnt so that they know what to do from the start. We asked one of the nurses and one of the health care assistants about how this all works out in practice. They say that the system works well and that they know about the nursing care and the general support they will need to provide as soon as someone comes in. Some people stay for shorter periods of time. These shorter stays are usually because they have been in hospital and are not yet ready to go home. The Manager says that careful attention is given to helping people to go back home so that their stays do not last longer than is necessary. This is important because sometimes admissions to residential settings can drag on and become longer than is necessary. We looked at the circumstances of one such person. There are clear plans in place to help the person go back home if they want to and if their health allows. 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. Standards 7, 8, 9 and 10. People are provided with the nursing and personal care they need. Medicines are dispensed in the correct manner. People are treated with respect. Evidence: The people who live in the Service say that the nurses and the health care assistants give them all the help they need. There is a written individual plan of care for each person. These are important because they are one of the ways that people can say what assistance they want to have and how they want it to be done. Also, the plans give information to staff so that they know what to do. We looked at four of these plans. They give a clear account of who needs to do what and why. There is important information about nursing matters. There is also information about things such as helping people in the bathroom, what people like to do each day and about keeping people safe. We asked one of the nurses and two of the health care assistants about some of these requirements. We did this to see if they know what the plans say. They Care Homes for Older People Page 13 of 29 Evidence: have a good knowledge. For example, they know about one person who has been in hospital and who needs to rest before trying to be up and about again. They also know about another person who needs to be given extra help to say what they want. The plans are kept up to date so that they are accurate. This includes a monthly review. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, some people have bed rails fitted so that they don’t roll out of bed. The Manager considers this carefully before fitting the rails. This is because bed rails can sometimes make a problem worse if they are used at the wrong time. People are helped to keep healthy. Nurses and health care assistants keep a tactful eye open so that medical assistance can be sought if someone is becoming unwell. Since our last inspection a number of people have seen their doctors, some on more than one occasion. There have also been consultations with professionals such as speech therapists, community psychiatric nurses and chiropodists. None of the people manage their own medication. The Manager says that people will be assisted to do this if this is their wish. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines that is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is dispensed. We examined three sets of these records. They are correctly completed. We looked at three medicines in more detail. We did this to see if the remaining stock matches what should have been there. Again, we found things to be in order. We asked three people what they think of the nurses and the health care assistants. They praise them saying that they are courteous and attentive. One person summarises the general mood when they say, they (the staff) have been really wonderful to me since Ive been here. All the staff are so kind and helpful. I really could not have been better cared for. We saw nurses and health care assistants around the place. They are indeed kind and respectful in their manner. Little things count. We noticed how when serving tea in the lounge one of the health care assistants took time to speak with one person who was puzzled about our presence in the Service and wanted to know all that was going on. She gently spoke with the person and didnt leave until she was satisfied that the person was quite happy about how things were going. It would have been very easy for her just to get on with serving the teas. Care Homes for Older People Page 14 of 29 Evidence: We also noted how people are assisted to use the bathroom in a private manner. They are quietly helped to leave their armchairs. Once in the bathroom the door is closed to give them privacy. People are helped to wear neat and clean clothes so that they can present themselves as they wish. People are given their post promptly. If someone has difficulty with small print a member of staff offers to read things for them in private. There is a pay telephone that people can use. 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. Standards 12, 13, 14 and 15. There are social things for people to do. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is an activities coordinator who is around most week days. Unfortunately we didnt have the chance to speak with her. However, we asked about what she does and we looked at her records. She does a number of small groups that people can join in. For example, some people like to play bingo and others like to have a chat. She also spends time with people on an individual basis. In addition to the activities coordinator, there is someone who calls to the Service to do music for health sessions. We asked three people if they have enough to do and none said that they want to do more. However, we think that its a good idea for the Manager to keep this matter under careful review. This is so that she can be sure that everyone is having the opportunities they want. People are helped to keep in touch with members of their Care Homes for Older People Page 16 of 29 Evidence: families, if this is necessary and if it is their wish. The Assessment says that family members and friends are welcome to call to the Service at any reasonable time. The Manager keeps in touch with family members so that they know how things are going. The Annual Quality Assurance Assessment says that people are encouraged to make their bedrooms their own. For example, they can bring personal things in with them like small items of furniture, ornaments and photographs. We saw examples of all these in the bedrooms we looked at. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant affair. There is a choice of dish at each meal. Arrangements are flexible. For example one person had an outpatient appointment when we were there. The cook knew about this and she made special arrangements so that the person could have something to eat as soon as she came back. We looked at the menu and we think that it provides a range of meals that most people would want to have. People can dine in their bedroom if they want to. Special diets can be met. As we have already said, little things count. When we were in the kitchen we noticed that the cook has written a list of things that individual people dont like. This is a good idea because it means that alternatives can be given without the person having to repeat themselves. 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. Standards 16 and 18. There is a system for sorting out complaints. The wellbeing of the people who live in the Service is safeguarded. Evidence: There is a written complaints procedure. This explains how the people who live in the Service and other people can go about raising a concern. Most concerns can be sorted out locally without things being too formal. However, people can always speak to us first if they dont feel comfortable about talking with a member of staff. The procedure does not explain this option and it does not give our correct contact details. The Registered Provider is going to put this right by 1 November 2008. We asked two people about how free they feel to raise a concern with the Registered Provider or with other members of staff. They say that they are confident to approach them. They also say that there was no need to do so at the moment, because they do not have any concerns. Since our last inspection the Registered Provider received a complaint about the conduct of a member of staff. The Registered Provider responded appropriately to the matter. This included suspending the person until an investigation Care Homes for Older People Page 18 of 29 Evidence: could be completed. This was done by Kent County Council under its duty to safeguard vulnerable people. There was no information to support the complaint. The Registered Provider has looked into some other less serious complaints. We checked to see what has been done to sort them out. The actions taken are sensible and helpful. For example, one person who was concerned about sharing their bedroom now has one to themselves. There is a written statement of the Registered Providers commitment to making sure that the people who live in the Service are safeguarded from being abused in any way. For example, this might involve being bullied or taken advantage of in some way. We asked one of the health care assistants about this matter. They have a good knowledge of things to look out for that might be a cause for concern. None of the members of staff we spoke with have any concerns about how things are going. The people who live in the Service say that they feel safe in Hythe Nursing Home. 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. Standards 19, 22, 25 and 26. The accommodation in general is homely and comfortable. However, bathrooms and toilets are rather bare. Evidence: At the moment there is quite a lot of work going on with the outside of the building. New windows have been fitted at quite a few places and these are waiting to be painted and for the render to be made good. Also, some of the drive way has been taken up and is in the process of being re-laid. On the inside, the accommodation including the bedrooms is homely. The decoration and the furnishings are of a good standard. There are one or two locations in the hallways where paintwork has become chipped. However, even these areas have more of a lived in feeling to them rather than being tatty. The bathrooms and the toilets are clean but rather bare. More could be done to make them into welcoming spaces. The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. It is understood that the Kent Fire and Rescue Service Care Homes for Older People Page 20 of 29 Evidence: says that the system meets the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to make sure that there is nothing that might reduce the level of protection in place. The assessment recommended that a number of improvements be made. The Manager says that all of them have been done. We checked out one of these and we found it to have been completed. The local Department of Environmental Health inspected the kitchen last year. It said that everything is in order. We understand that the Registered Providers intend to refurbish the kitchen once the new extension has been completed. We looked in the kitchen. It is adequately equipped, clean and well organised. The cook does sensible things to ensure good food hygiene. For example, once food is opened it is covered. Then a date is written on it to make sure that things are not allowed to hang around too long. Also, she regularly checks the fridges and the freezers to make sure that they are cold enough. People who need it are helped to get about. There are banister rails in corridors. At key places there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. Help is also given in the bathroom. There is a special rise and fall bath. Another bath has a fixed hoist and there is also a walk-in wet room that has a shower. We asked people how warm the accommodation is kept. They say that they are always comfortable even during the coldest weather. The radiators are fitted with guards. This has been done so that there are no heated surfaces that might burn someone. The hot water taps are fitted with thermostatic valves. These are designed to reduce the temperature to a level that is not likely to scald someone. The laundry has commercial grade washing machines. These have an extra cycle for items that need an especially hot wash. There is also a large dryer. The laundry is clean. The laundry manager keeps things organised. This helps to ensure that things dont get shrunk by being washed in the wrong way. Also, she checks to see that clothes dont get returned to the wrong person. The Registered Provider is going to check that the laundry complies with new regulations about preventing used water from leaking back into the main pipe-work. This will be done by 1 November 2008. 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. Standards 27, 28, 29 and 30. There are enough staff around. There are limited gaps in the recruitment system. Nurses and health care assistants know what they are doing. Evidence: There is always a qualified nurse on duty. She is in charge whenever the Manager and the Deputy Manager are not around. From early in the morning until the early afternoon there are five or six health care assistants on duty. This number reduces to three health care assistants in the afternoon and evening when things are usually quieter. There is a waking staff presence at night. During the day there are also other members of staff who do things such as housework and the laundry. There is a cook on duty for most of the day. We looked at the written roster for several days before our visit. All of the shifts described to us had been filled. The Registered Providers complete a number of security checks on new members of staff. These include things such as confirming their identity and doing a police check. This is done to make sure that they are trustworthy people who are suitable to have unsupervised access to the people who live in the Service. We looked at the records for two recently appointed health care assistants. Most of the checks have been Care Homes for Older People Page 22 of 29 Evidence: completed. However, for both of them there are minor gaps. The Registered Providers are going to get this sorted out by 1 November 2008. New care workers receive introductory training before they work on their own. We asked a health care assistant about their introductory training. They say that it was very useful. They say that they were introduced to the people who live in the Service and that they were told about each persons needs for support. We looked at the records of the subjects covered. They include important things such as how best to support people who are having difficulties managing their continence. After their introduction, nurses and health care assistants are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. We looked at some of the records of this extended training provided for health care assistants. These show that people are doing quite a lot of training. However, there are some gaps. For example, six of them have not yet done training on basic first aid and five people have not done a course of how to help people who can get sore skin. The Manager says that she is going to get these gaps filled by the end of the year. In addition to this, the Manager is going to double check the knowledge and skills each of the health care assistants. She is going to do this using a nationally recognised system. We think that this is a very good idea because it helps everyone to keep up to date. The Manager is going to do this exercise by 1 January 2009. There is a total of 14 health care assistants. Of this number, five have completed a National Vocational Qualification at Level 2 in health and personal care. This qualification is important because it helps health care assistants to deliver high quality residential care services. The Assessment says that more people will be encouraged to study for the qualification in the future. We spoke with three health care assistants to find out about their knowledge and skills. They know a lot about how each of the people who use the Service like to be supported. They also know about important points of detail. For example, they know about helping older people to take care of their skin and about the important contribution good hygiene makes to health and safety. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 31, 33, 35, 36 and 38. Things are well managed. People are asked what they think, but this needs to be a little more organised. People are helped to but what they want. A part of the fire safety regime needs to be strengthened. Evidence: The Registered Providers have their office in the Service. They are around quite a lot of the time and so they know whats going on. The Manager and the Deputy Manager are both qualified nurses and they have many years of experience. The Manager has a recognised management qualification. Nurses and health care assistants say that there is good team work in the Service. One health care assistant summarises the general mood when they say, There is no us and them between us and the nurses because everyone works with each other. The Care Homes for Older People Page 24 of 29 Evidence: nurses are in charge but they work alongside us and so were all one team. Another person says,its a really happy place, not at all like some places Ive been to where you cant have a laugh and be yourself. There are handover meetings at the beginning and end of each shift. These are held so that nurses and helath care assistants can keep up to date with developments. Also, there are team meetings every now and then, where people can raise any issues they want to. Several things are done to ask people what they think about their home. These include informal discussions as part of daily life. The people who live in the Service or their relatives are invited to complete questionnaires about once a year. We looked at the most recent questionnaires. There were 14 of these and they show that people are quite happy with how things are going in the Service. There are some shortfalls in the consultation arrangements. Members of staff are not included. Also, there is no organised system to tell contributors what is going to be done to respond to any improvements that they may have suggested. The Manager says that the system will now be strengthened to sort out these gaps. This will be done in time for us to be told about it when the Registered Providers send us their next Annual Quality Assurance Assessment in 2009. The Registered Providers help some of the people to manage their personal spending monies. They have been asked to do this by the people concerned. It involves them paying for things such as seeing the hairdresser and buying newspapers and then billing relatives every now and then. We looked at one set of records to see if there is a receipt to cover several of the items included in the bill sent to the relative concerned. We found the receipts to be there and the bill to be correct. Checks are done to ensure that the Services fire safety equipment remains in good working order. This should include a weekly test of the fire alarm bells. Some of these have not been done over the past fews months. The Manager is going to make sure that they are all completed on time in the future. More detailed periodic checks are completed by a contractor. All members of staff are expected to attend a fire safety lecture once a year. The Manager says that this can be difficult to achieve in practice if someone is not able to attend. This might be because they are on leave at the time or off sick. We looked at the records to see who has not attended a fire safety lecture in the last 12 months and we identified nine members of staff. The Manager is going to introduce a new system to make sure that these people receive fire training by 1 November 2008. After this has been done, all members of staff will have fire training at least once every six months. This is important because the level of fire safety protection in the Service largely depends whether or not members of staff do the right Care Homes for Older People Page 25 of 29 Evidence: things at the right time. There are up to date reports from engineers about things such as gas appliances, the passenger lift and the electrical wiring. These say that they are in good order and are safe to use. We looked at the record of accidents that have occurred in the Service since the last inspection. There is nothing in the frequency or in the nature of the accidents that causes us concern. The maintenance man checks the premises and the accommodation to ensure that there are no hazards that might cause someone to have an accident. We looked at the records of the most recent check. These were completed in March this year. They show that he looks at sensible things. For example, he checks that the wardrobes in the bedrooms arent wobbly and likely to topple over. He says that there are no obvious hazards. We didn’t notice any either. 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 Care Homes for Older People Page 28 of 29 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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