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Inspection on 23/09/08 for Little Brook House

Also see our care home review for Little Brook House for more information

This inspection was carried out on 23rd 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a well maintained and tastefully decorated environment for service users to live, which is homely, is kept clean and hygeinic. The house is surrounded with beautiful gardens and grounds to which all service users have access to. The care plans are well documented and demonstrate a thorough assessment and risk assessments with care plans to describe how to meet the service user`s needs. The healthcare needs of service users are met by accessibility to a multidisciplinary primary care team that visit the home when requested. Service users told us they are treated with respect and their privacy upheld and that they have choices in all their activities of daily living. The menus demonstrate a health wholesome diet and service users say that food is very good with a good variety of meals. The management team supports staff to develop their skills and experience by providing an ongoing training programme. This provides a well trained and motivated staff team.

What has improved since the last inspection?

The garden has been re designed with a paving and patio area put down for service users to access the garden. The care plans demonstrate residents` involvement with the process and their review.

What the care home could do better:

Handwashing facilities of a soap dispenser and disposable towels should be made available to service users and staff in all toilets and bathrooms to promote the prevention of cross infection. Staffing levels must be kept under review and must reflect the dependency of the service users, taking into account the number of residents admitted with a dementia or mental disorder. The recruitment files must demonstrate that two written referneces are in place before the staff member commences employment.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Little Brook House 101 Brook Lane Warsash Hampshire SO31 6FE     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: Janette Everitt     Date: 2 3 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 30 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 30 Information about the care home Name of care home: Address: Little Brook House 101 Brook Lane Warsash Hampshire SO31 6FE 01489582821 Telephone number: Fax number: Email address: Provider web address: jan@littlebrookhouse.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Cooper Type of registration: Number of places registered: Little Brook House Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia, service users who are over 65 years of age but do not fall within the category of old age DE(E) Mental disorder, service users who are over 65 years of age but do not fall within the category of old age MD(E). Date of last inspection 20 20 0 Over 65 0 0 20 Care Homes for Older People Page 4 of 30 Brief description of the care home Little Brook House is a registered care home that provides personal care and accommodation to 20 older people. The home can also accommodate older people with dementia. The home is located in the rural area of Warsash, Hampshire, with Southampton as the nearest large city. The name of the house derives from the brook, which runs through the garden area of the property. The 300 year old home was formerly a farmhouse, the original building having been modernised and extended to include further accommodation. The building is well maintained, tastefully decorated and furnished and has extensive well-kept grounds. Two conservatories to the rear of the property overlook the gardens. The current fees were quoted as being 550 to 570 pound sterling. The fees do not include hairdressing, chiropody, newspapers and personal items. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The site inspection visit to Little Brook House, which was unannounced, took place over a one day period on the 23rd September 2008 and was attended by one inspector. The deputy manager and proprietor assisted the inspector throughout the visit. The visit to the home formed part of the process of the inspection of the service to measure the service against the key national minimum standards. The manager had returned the Annual Quality Assurance Assessment (AQAA) to the CSCI for the current year and an Annual Service Review (ASR) had been completed in May 2008. The focus of this visit to the home was to support the information stated in the AQAA and other information received by the CSCI since the last fieldwork visit, which was an key inspection, made to the home in September 2006. Care Homes for Older People Page 6 of 30 Documents and records were examined and staff working practices were observed where this was possible without being intrusive. The inspector spoke to most of the residents, staff and visiting relatives in order to obtain their perceptions of the service the home provides. Those spoken to were very happy and complimentary about the care and services that are provided. Surveys had been distributed to service users, GPs and staff. Eight service user survey, one relative, and ten staff surveys were returned to the CSCI. The outcome of the surveys indicated that there was a high level of satisfaction with the service and that generally residents and relatives were pleased with the care and the environment the home provides. There were 18 residents accommodated in the home, most of whom could communicate effectively with us to give their views. There were no residents from an ethnic minority group. 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. 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 Care Homes for Older People Page 8 of 30 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have sufficient information to enable them to make an informed choice about whether to move into the home. Detailed pre admission assessments ensure residents may be confident they will only be offered a place if their needs can be met. Evidence: The previous inspection identified that the Statement of Purpose did not make clear that potential service users who were in need of a wheelchair could not be admitted owing to the geographical layout of the home. The Statement of Purpose has now been reviewed to reflect this and copies of this is sent to potential service users along with the brochure. Two service users admission assessments were viewed. The pre-admission assessment covers all aspects of care needs of service users and is reviewed regularly. The deputy manager said that she or the manager undertake the assessments of Care Homes for Older People Page 11 of 30 Evidence: service users prior to them moving into the home to ensure the service can meet their needs. A newly admitted resident was spoken with and he told us that the deputy manager visited him in his house to undertake an assessment and tell him about the home. He said he also came to the home for a visit prior to his admission. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of residents are met. Policy and procedures are in place to manage the residents medication safely and effectively. The home promotes staff working practice to ensure that residents privacy and dignity is respected Evidence: The majority of service users in residence at the time of the visit were well able to verbally express their needs and said that staff enabled them to manage their own personal care. They only offered assistance when it was required. The sample of care plans viewed demonstrated that risk assessments and care plans were in place covering all the care needs and of how to manage identified risks. There was evidence that the care plans were reviewed on a monthly basis, using an assessment tool to identify changes in dependency levels. The service users are involved in the care planning and reviewing process, if they wish to be, and some had signed the care plans to evidence this. The AQAA says the weakest point is expressing the amount of choice and level of Care Homes for Older People Page 13 of 30 Evidence: encouragement and control each client has over their lives and it is difficult to put in care plans how to express this. The home wish to improve their care plans in the future using clients own words and encourage the client to be fully involved and or their families with writing the care plan. Daily notes are maintained for all service users evaluating the outcomes of the care delivered and how the service users have spent their day. The home monitors residents nutritional needs and regularly checks their weight. Weight charts were evidenced in the care plans. Staff spoken to said that the care plans are working documents that inform their day to day practice but most staff are familiar with the residents needs. The AQAA states that the home gives the residents that freedom and support to choose which doctor, dentist, hairdresser and chiropodist they wish. Residents said they were able to see their doctor when they wished and staff supported them if necessary. The deputy reported that a GP calls most days to the home. It was observed that care plans include records of all visiting professionals which include GPs, dentist, Community Psychiatric Nurses (CPN), Occupational Therapist (OT) and other members of the multidisciplinary primary health team (MDT). Outcomes of these visits are documented. Service users spoken to and those who returned the surveys to CSCI confirm that their medical needs are met fully. The local pharmacist supplies the medication in a monitored dosage system. The pharmacist also supplies some training for staff along with an outside training organisation that delivers medication training to staff. The deputy manager told us that only staff that have received the training are able to administer medication. The AQAA states the home supports service users to manage their own medication if they wish within a risk assessment framework. Four residents did look after their own medication and risk assessments were seen to be completed to ensure they were supported to do this safely. The home had a procedure for staff to follow to ensure medication is managed safely. A record is kept of medication received into the home and any returned to the pharmacy. Medication administration records were signed whenever the member of staff has administered medication to a resident. The deputy manager coordinates the ordering of medication and told us that she does see the prescriptions before they are dispensed to ensure the home does not receive medication that is not needed. There Care Homes for Older People Page 14 of 30 Evidence: was no evidence of over stocking of medications that are prescribed on the as needed basis. The AQAA states that all staff are trained at the onset of their employ to respect all clients and provide dignity and privacy to clients. This was supported by the observations of the good interaction between staff and service users throughout the day. Service users spoken to and surveys returned to CSCI say that staff are very kind and they are well cared for and happy with their home. Service users told us that they are able to go where they like and stay in their rooms if they wish. One lady was observed to be enjoying a pre-lunch drink and the deputy told us that the residents live their lives as they wish and make their own decisions. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of activities for service users, which meets their expectations and preferences. Service users are able to maintain contact with family and friends and visitors are welcome at any time. Service users are supported to exercise choice and control over their lives and are provided with a wholesome and balanced diet in pleasant surroundings at a time convenient to them. Evidence: The manager organises the social activities in the home. There is no set programme of activities. The AQAA states that outside agencies come to the home for activities and the residents are left to make a decision if they want them to return. Activities do take place although one relative described them as spasmodic, pointing out that although there are a few keen people to participate, a lot of the residents chose not to take part and would rather make their own entertainment with cross word groups, sherry mornings and the use of the lovely gardens. Surveys returned from service users say that they are mostly satisfied with the activities supplied but a number of residents are apathetic about joining in the activities and that on one occasion an outing had to be cancelled due to lack of Care Homes for Older People Page 16 of 30 Evidence: interest, which was disappointing for the manager who had organised this. Social profiles are recorded for all residents and the home will support and encourage the resident to continue with hobbies. Some of the residents continue to go out independently into the community and one service user has their own car that is used every day to take him on outings. The clergy do visit the home and other residents go to the local church to allow them to practice their faith. The AQAA states that the home will accommodate special needs of service users with specific religious or cultural needs. Relatives spoken with say that they are made very welcome to the home at any time and felt that the layout of the home afforded them privacy to see their relative if they wished. Residents said they felt the daily routines of the home were organised around their needs and that they were able to make choices about all aspects of their daily lives. They are able to bring to the home their personal belongings and personal furniture if they so wish. All rooms are very individual and reflect the residents personal preferences. Residents told us the food they were given was very good. Staff were observed asking people which of two choices they would like for their main meal. The menu plan showed a well balanced diet was provided and residents said the choices offered were very good. Staff serve the meal at the dinner table, so that residents may choose the portion sizes and vegetables they have. They said there was always a good supply of fruit and home made, old fashioned puddings such as steamed sponge and bread and butter pudding. Residents said drinks and snacks were routinely offered. This was supported in the surveys from service users and relative who said the food was good and we observed the lunchtime meal that was well presented in a very pleasant dining area. Service user can choose to eat in their rooms and some do so. The residents meeting minutes identified that food was discussed and suggested that the supper menu was repetitive which was addressed by a new supper menu being created with suggestions from the residents. The kitchen was visited and was clean and tidy. The cook told us that service users can have what they like to eat and she talks to them in the morning to find out their preferences for that day. The cook told us that she does not have to prepare any special diets currently but could do so if requested. Care Homes for Older People Page 17 of 30 Evidence: Carers prepare and serve the evening meal and this was discussed with the proprietor as to the staffing levels during this period. Discussion took place with the proprietor with regards to a complaint made to CSCI about staffing levels at this time of the day and the proprietor stated that she would monitor the staffing levels to ensure sufficient staff were on duty. All staff have received training in Food Handling and Hygiene. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure in place and service users and their relatives are confident that their complaints will be listened to and acted upon.The policies, procedures and training of staff ensure that service users are protected. Evidence: The home has a complaints procedure that is part of the Statement of Purpose. Service users spoken with and surveys returned to CSCI said they had no complaints, but felt they knew how to do so if they felt the need and were confident any issues raised would be addressed. They said issues were often discussed at resident meetings, which took place every month. The registered manager always gave them written feedback about any action taken following these meetings. The AQAA identifies no complaints have been received and there were no complaints recorded in the log. The commission had received one verbal complaint in recent weeks with reference to the staffing levels at certain times of the day and this was discussed at the time of this visit. The home had a policy and procedure for the protection of vulnerable adults. Some staff had attended a training course, or had covered aspects of adult protection as part of their National Vocational Qualification (NVQ). Surveys returned from the staff and Care Homes for Older People Page 19 of 30 Evidence: speaking to staff, would suggest that they are aware of the procedures to take should they witness or suspect any kind of abuse to service users or if they have concerns. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities. The home is clean, pleasant and hygienic and free from offensive odours. Evidence: We looked around the home and viewed bedrooms and communal areas. The home provides a clean, comfortable environment for residents, who told us how much they liked their rooms and they were very comfortable in their environment. The bedrooms viewed were well decorated and service users had personalised them with their own belongings. The proprietor told us that there is an improvement plan in place to continually maintain the old building. She goes around the home regularly to trouble shoot any faults or identify any repairs and the manager will let her know if anything needs repair. Bedrooms are decorated as they become vacant and if possible service users are involved with choice of colours. The AQAA told us that the garden has been redesigned and a new patio area put down with paving around the garden to enable service users better access. The gardens are well maintained and provide a pleasant outlook from all rooms. The lounge area has been redecorated and new furniture purchased within the last year. Care Homes for Older People Page 21 of 30 Evidence: The home is a listed building that has a lot of steps throughout. Residents can access all parts by using stair lifts, but the home cannot accommodate anyone who needs to use a wheelchair, as there is no shaft lift and some corridors are narrow. The home employs domestic staff throughout the week to clean the home and from observation, speaking to residents and comment on surveys returned to CSCI indicate that the home is generally kept very clean. One relative commented that at one stage her mothers room was not cleaned properly but this issue has been dealt with following a discussion with the management. Training records showed that staff had recently completed infection control training and the home had policies and procedures to provide further guidance. It was observed that staff have access to disposable gloves and aprons when they need them. The home had a contract for the disposal of clinical waste. It was observed that there were no soap dispenser and paper towels provided for hand washing in the bathrooms and toilets and this was discussed with the proprietor who told us that she will ensure these are provided immediately. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sufficient staffing numbers with a mix and range of staff skills on duty to meet the needs of service users in residence at the time. However, there are indicators that staffing levels need regular review to ensure all service user needs are met appropriately. Service users benefit from a staff team that has had sufficient training to meet the needs of service users. The homes recruitment policy and practice supports and protects service users. Evidence: The homes rota showed that the normal staffing levels were two care staff on duty throughout the day and evening. The registered managers hours are in addition to this. Residents are supported at night by one waking, one sleeping night staff. Care staff undertake the laundry and also prepare and serve the evening meal and breakfast. The majority of residents require minimal assistance with personal care, moving and handling or help with eating. However, the category of admission to the home has been granted to admit people with dementia and mental health related illness, and therefore the dependency and care of the service users may be different. This was discussed with the proprietor and the deputy manager, in relation to the care needs being greater. The proprietor said Care Homes for Older People Page 23 of 30 Evidence: she will monitor the situation and discuss this with staff. A staff survey commented that the level of support needed by service users has increased but has not been reflected in the staffing level. The commission has recently received one complaint in relation to staffing levels and what appeared to the complainant as lack of staff available to answer bells promptly. Service users spoken with and surveys returned indicate that generally they consider that staff are available when they are needed but comments on the surveys say that staff are stretched to the limit with increase needs of dementia residents. Sometimes there is not the prompt response from a request and this gets forgotten. The staff try hard and work hard to be available when they are needed. Nearly all of the staff have achieved the National Vocational Qualification to at least level 2 with some staff having achieved level 3. The proprietor and manager encourage staff to undertake training and staff are motivated to undertake training that is available. Three recruitment files were viewed for the latest recruits to the home. All information required to be maintained to include Criminal Bureau Checks (CRB) and Protection of Vulnerable Adults (POVA) checks with two references were in two of the three files viewed. The third file having only one reference. This was discussed with the deputy manager, who acknowledged that one reference was missing and that she would endeavour to obtain this promptly. The home has an induction programme based on the Skills for Care induction standards and this can take up to one year for a staff member to complete. When completed, staff are then required to go on to complete their NVQ level 2. The staff files demonstrated that supervision takes place every six weeks and appraisals annually. This is used to identify individual training needs. The home has a training matrix to identify what training has taken place. The matrix needs to state the date the training takes place to ensure mandatory updates are recorded. Training is supplied through a training organisation. This is done by staff working through a workbook and completing a knowledge paper on the completion of this and a certificate is then issued by the training organisation. These were evidenced in the staff files that training for food hygiene, health and safety, fire, moving and handling, risk assessment, dementia and diet and nutrition had been completed. Staff spoken with and surveys returned say that staff feel well supported by the management team to develop their skills and knowledge. All staff surveys returned to Care Homes for Older People Page 24 of 30 Evidence: CSCI indicate that when you start work at the home the induction programme covered everything that is needed to do the job and that on going training is provided that is relevant and up to date. Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good 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 and there are systems in place that enable residents to give feedback about the service they receive. There are systems in place that make sure health and safety issues are addressed and that staff and residents are protected.The home accounting and financial procedures safeguard service users financial interests. Evidence: The registered manager was not at the home at the time of this visit. The deputy told us that the manager has been in post of four years and has achieved her registered managers award and has previous experience in managing care services. The deputy manager has the NVQ level 4 as so has the senior carer. Speaking to staff and surveys returned to CSCI from staff generally indicate that they feel well supported by the management team. There was comment on one survey to say staff did not see enough of the manager and did not receive regular supervision. Care Homes for Older People Page 26 of 30 Evidence: The staff files viewed evidenced that supervision was being recorded two monthly. Service users spoken with, felt their voice is heard through the residents meetings which take place monthly and are recorded. The home distributes an annual questionnaire to relatives to gain feedback from them. The results of this questionnaire is collated into a report. The AQAA states that in the coming year, the manager will listen to what service users are saying and use the information in quality assurance questionnaires to improve the performance of the home. Staff meetings take place regularly and are recorded. The management team hold a weekly meeting to discuss any issues and the general management of the home. The manager checks weekly on the Medication Administration Records (MAR) sheets to ensure they are being completed appropriately. The home does hold small amounts of money for some service users. An individual record is kept of the amount held and any expenditure, together with receipts. The staff training files demonstrated that staff receive the mandatory training for moving and handling, first aid, health and safety and food hygiene. A sample of servicing contracts were seen that evidenced that equipment has been regularly serviced and these included the stair lift, hoist, portable appliances test and fire equipment. The fire log demonstrated that equipment and the system is tested at appropriate intervals and in accordance with the requirements of fire safety legislation. The home has a fire risk assessment for each individual resident. The accident book showed that all injuries are recorded appropriately and the commission notified if any resident has a serious injury so that these can be monitored. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!