Inspection on 02/10/08 for Moorland House

This inspection was carried out on 2nd October 2008.

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

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

Other inspections for this house

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moorland House 20 Barton Court Avenue Barton on Sea New Milton Hampshire BH25 7HF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joyce Bingham     Date: 0 2 1 0 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: Moorland House 20 Barton Court Avenue Barton on Sea New Milton Hampshire BH25 7HF 01425614006 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Moorland House Ltd. Type of registration: Number of places registered: 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) Mental disorder, excluding learning disability or dementia (MD) Dementia (DE) Date of last inspection Brief description of the care home Moorland House is set on the outskirts of the town of New Milton, in Barton-on- Sea, with access to local amenities. It provides residential care for up to 20 elderly Care Homes for Older People Page 4 of 29 Over 65 0 0 20 20 20 0 Brief description of the care home residents, including those who have dementia. The home is on both ground and first floors and there is a lift between these. There are a variety of aids and adaptations to allow residents to move about more independently. All of the bedrooms are single, and all have en-suite facilities. There is a communal toilet, and a bathroom with toilet on the ground floor, and one bathroom with a toilet on the first floor. There is a large garden around the building. The current fees are between £413 to £462 per week excluding personal toiletries, chiropody 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The purpose of the inspection was to find out how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included the Annual Quality Assurance Assessment (AQAA) completed by the home, and comments from residents, family members, stakeholders and staff. An unannounced visit to the home was carried out on 2 October, lasting a total of 8 hours 30 minutes. During this time we were able to have a partial tour of the premises, including ensuite bedrooms on both floors, the lounge, kitchen, dining room, laundry, bathrooms and toilets. We had private Care Homes for Older People Page 6 of 29 discussions with the manager and two staff, three visitors, and contact with a large number of the residents of the home. We sampled staff and care records, and policies and procedures that relate to the running of the home. All regulatory activity since the home changed hands was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection (CSCI). 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 240 7535. Care Homes for Older People Page 8 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 9 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents and their families/advocates are supported to make an informed choice about the home by adequate information they are given. The information needs to be further developed to be fully comprehensive and meet the legal requirements. The residents needs are assessed and their wishes are identified prior to admission to ensure these will be met by the home. Evidence: We were informed through surveys conducted about the home that Care Managers felt pre-admission assessments were thorough; accurate information was gathered by the home to enable appropriate planning of the care service to the individual. One said the home caters to the individual and they will try anything to help the person settle in. All four of the residents who completed the surveys said they had sufficient information about this home before they moved in so they could decide if it was the right place for them. Care Homes for Older People Page 10 of 29 Evidence: We looked at four of the files of people who had been admitted recently and they contained pre-admission assessments demonstrating that the manager or senior member of staff had conducted assessments and afforded them opportunity to visit the home prior to admission. Where relevant there were Care Management assessments from Social Services. The home was displaying a statement of purpose and a service user guide in the lounge and in the entrance hallway, and there was evidence of them in bedrooms. We were told that the home would shortly be producing a brochure with updated information about the new ownership and management arrangements. We advised the manager to ensure that the information issued to potential residents meets the content requirement of the regulations. Some of the current paperwork is a compilation of documents produced at various times by different people, and in places is needlessly repetitious. We noted that a couple of people visited the home with a view to placement during the inspection but they were not given anything in writing to take away and had not been referred to the service user guide which details what the home offers. The home does not admit people for intermediate care. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are protected by access to health care services as needed. The staff demonstrate awareness of the residents needs but the current written care plans and risk assessments are limited in scope, so some needs may go unrecognised. The training arrangements and written procedure for drug administration and recording are satisfactory but regular monitoring of staff adherence to good practice is needed to avoid mistakes. Life histories and personal profiles could be further developed to assist in defining, understanding and applying consistent guidelines to meet the individual needs of the residents with dementia. Evidence: From the four service users surveys returned there was an almost complete satisfaction with the care and support they receive, and two Care Managers said that health care needs were properly monitored and attended to. We saw that the assessment tool led into a detailed plan of care that had been drawn Care Homes for Older People Page 12 of 29 Evidence: up for each of the residents that we randomly sampled. In some areas the paperwork was thorough and detailed but not easily accessible as a working document for care staff. The manager was rightly redrawing these plans into a format for easy reference by the care staff. She was still in process of reproducing these when the inspection took place, and this was acknowledged. We drew to her attention the absence, in the care plans created so far, of guidance in the important area of behavioural patterns with those experiencing dementia. This applied to references about short term memory, triggers and prompts for those who lacked recall, whether people were tactile or communicative, able to articulate thoughts and feelings etc. Feedback from the staff was that their training in the care plans was not complete, and that some important information was left out of the care plans. This is particularly significant where the home is frequently engaging agency staff and also recruiting new staff who will need to familiarise with the residents individual personalities and needs. Care plans had been reviewed and the reviews were dated and recorded. There was evidence of people accessing health care services, and of monitoring their nutritional needs. A regular audit is conducted by the manager on residents weights and significant incidents such as falls. We spent some time walking around the home, sitting in the lounge and observing some of the interactions between the residents and the staff. People were smiling and responsive to staff inspite of some memory loss and evident confusion and we noted examples of very positive, supportive responses by the carers, particularly avoiding aggressive reactions by their gentle tone and affirmation. The drug trolley and medication records were seen and found to be in good order and up-to-date. The administration of medicines was partly observed. We noted that carers did not remain always long enough to observe the residents take/swallow the medication before the staff left the room. This presents a risk for the resident themselves and also other confused residents who might wrongly pick up the tablets. Care Homes for Older People Page 13 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. The residents are supported to exercise choice and some control over their lives, and are encouraged to maintain contact with family and friends as they wish. The home is successfully developing its range of activities and opportunities for trips out. Sustaining that on-going improvement is necessary. The residents are provided with a variety of home-cooked, nicely presented meals with more focus to be given to the feeding strategy for the residents with higher needs. Evidence: The AQAA informed us that the home asks residents for their choices and preferences on how they spend their day and what they would like to do, e.g. rising and retiring times and activity preferences. Residents are able to have breakfast anytime they choose between 7am and 9.30am. The residents are asked by the care staff their choices of food from the menu for lunch and supper for the next day. The survey from the residents scored 100 for the activities arranged by the home that they can take part in, and meals scored 75 . A care manager said nothing is too much trouble. The home is always open to new ideas. A member of staff said this is a very happy home. We try to give all our residents as much choice as possible Care Homes for Older People Page 14 of 29 Evidence: everyday..............drinks, food, clothes they wear...music..tv programmes...videos in their own rooms or in the lounge, joining in activities, who they sit with where possible etc. One member of staff said they felt more activities could be organised. Several of the residents expressed the desire to go out more, saying that they had walked the garden and knew every inch, but wanted to go out further and have more of a change. The manager acknowledged that some are supported by their family to go out more than others. The provider confirmed that he is looking into the possibility of purchasing a larger vehicle to facilitate trips out for small groups of residents. A family member of a resident commented that the activities have improved very much under the new owners/staff. The home has recently joined NAPA (the National Association for Providers of activities for older people). The manager confirmed that the new provider has had so much to do to bring the home up to standard that there is a long list of improvements still waiting to be actioned and more activities feature as a part of that, including linking with local voluntary groups and church links when requested by the residents. Outside musical entertainment is provided each week on a Friday if residents wish to attend. On the day of the inspection a lady came with a quiz and some music to engage folk in the lounge. The home told us that they have an open visiting policy to enable residents to maintain close contact with their families and friends. The AQAA states, We provide ‘protected mealtimes’ to ensure the residents are not disturbed as far as possible from enjoying meals as a social event. Several visitors came during the day and confirmed they are always made welcome and offered a cup of tea. One said, In my view it is brilliant here. Ive never heard a cross word. Another said, I come every other day and we come up to the room and we can come and go as we want to. Its very nice. It was acknowledged that the home is in process of creating a quiet lounge and an activities/TV lounge that will provide people with freedom of movement and alternative locations to spend their time. The serving of lunch was observed. Unusually, cups of tea were provided at the start of the meal. A staff member said this was to help with taking the medication. Meals were nicely presented, at place settings that were domestic in nature and served on nicely warmed plates. One or two residents complained about the wait at the table but this was partly due to the home using a different room because of the decorators. Comments were mostly positive about the meals. We noted that the four weekly menu plan had been changed by the cook, and that there were some meals that did not reflect real choice, e.g. having an alternative but both were fish dishes, or two beef meals, packaged slightly differently. Meals for those requiring a softened diet had each item pureed separately, so the colour and taste were nicely preserved. We noted that the three residents with higher support needs were left on this day in the lounge to feed themselves and one in particular managed this very badly, using a cup to scoop Care Homes for Older People Page 15 of 29 Evidence: their meal and eventually spilling food on their knee and the floor. They consumed very little of the meal and the staff member who came later had to distract them in order to remove the plate and use a supplement drink to ensure they had received some nourishment. We discussed with the manager the need for a feeding strategy for the residents with higher needs. (This resident was later seen in the main dining room being fed by a carer at tea time.) The family member of one confused resident said, I am unable to determine if XXX really like the meals, but they have a good appetite when I sometimes have tea in the home with them, and they always clear their plates. Care Homes for Older People Page 16 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. The residents are protected from abusive practice by policies, procedures and staff awareness. The residents and their families express confidence that their concerns/complaints are heeded and acted on. Evidence: Each of the surveys from the residents said they always, or usually, knew who to speak with if they were unhappy about anything. Three out of four knew how to make a formal complaint if they needed to. The care managers said the home always responded appropriately if concerns were raised. We saw that the complaints procedure was included within the service user guide. No complaints have been received by the CSCI. We spoke with the manager about one complaint that had been raised directly with her and she was able to confirm it had been dealt with within the set timescales and brought to conclusion. Further defined guidance for the staff had resulted from the complaint and a protocol for supporting residents to hospital and informing family in an emergency. The home has a policy on dealing with suspected abuse and had at one point recently activated the safeguarding procedure following an incident between two residents. Notification to the CSCI had been overlooked on that occasion and this was brought to Care Homes for Older People Page 17 of 29 Evidence: the managers attention. The staff spoken with were aware of the potential for abusive practice in a residential setting and spoke of their readiness and historic experience, under the previous homes management, of whistle blowing in relation to the protection of the service users. The homes records indicated potential staff are suitably screened in relation to criminal history and any referral to the POVA register (Protection of Vulnerable Adults). The manager confirmed that the home does not hold or manage cash/money on behalf of the residents. Monthly invoices of relevant fees and expenditure are made to the residents representatives. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are experiencing change and improvement to the physical facilities of Moorland House, which impacts them currently on a daily basis. The home is generally clean, but with poor odour in some bedrooms and a poor standard of cleanliness in the kitchen and food stores. Evidence: The AQAA states that the home has twenty bedrooms and they each have en-suite facilities which ensures the residents privacy and convenience. Residents are able to bring in their own furniture and personal affects to personalise their rooms as they wish. This was found to be the case on the day of the inspection. The residents spoken with said they like their room and they can return to it when they want to during the day. There was evidence of people meeting their visitors in their own rooms. Moorland House has a large, pretty garden at the rear which has been made safe for residents and families to use. The manager stated that the home has a maintenance book noting any maintenance required such as new bath plugs, light bulbs, curtain rail broken etc. This is looked at daily and repairs are dealt with quickly. Care Homes for Older People Page 19 of 29 Evidence: The managers admin/reception office is sited on the ground floor where the home has an open door policy for residents enabling them to come in for a chat knowing there will be someone there. Each of the five surveys from the residents commented that the home is fresh and clean. One said, My relatives room is always spotless, with clean towels and face cloth. We saw and agreed with the manager that on the day of the inspection the kitchen and food store was in urgent need of a thorough clean across the surfaces and some of the equipment. Very old and worn food containers are in need of replacement. The AQAA states that the home lacks a policy on the control of infection and the need for this was pointed out. The provider agreed to give priority to arranging a thorough industrial clean of the kitchen and food storage areas. The new owner of Moorland House has made significant improvements to the laundry facility with new commercial washing machines and tumble dryer, which provide and reliable and efficent service. There was significant redecorative work happening on the day of the inspection with workmen stripping down the wallpaper in the entrance hall, corridor and stairwell, and a new floor being fitted in a ground floor lounge. Two new windows will give attractive patio door access from the lounge so that residents can go directly into the rear garden. We discussed that a strategy to enable residents to independently manage the height differential is needed if they are to enjoy the freedom of the garden during the summertime, without the need for staff support. The noise of the workmen hammering loudly was disruptive and disturbing. A number of the residents were wincing at the noise levels and asking how long it would go on. They acknowledged the alteration work was time limited, and agreed the new decoration will be a great improvement. We noted that in some areas of the home there was a poor odour. The Manager confirmed that carpets are being changed and rooms redecorated. The carpet in the entrance and hallway is very soiled, and again we were told this will shortly be changed to new and brightly coloured carpet. We were told of the plans to improve the communal bathrooms. One staff survey indicated a shower room for residents would be appreciated. The home has not been visited by the Environmental health Officer since its new registration. Care Homes for Older People Page 20 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported by kind and caring staff who are well trained and well motivated, but who at times find themselves in insufficient numbers to fulfil a totally holistic role. The homes recruitment, induction and training procedure provides support and protection for the residents. Evidence: The four service user surveys agreed unanimously that the staff always listen and act on what they say, very much so. Their responses about staff availability when they wanted them scored 88 . A care manager said their view was that the homes staff have appropriate skills and experience to support the residents social and health care needs. The staff return of surveys (x5) was limited but they expressed positive views about the recruitment and induction processes, being supplied with adequate information and relevant training to fulfil their job roles. Management support and guidance is also of a high order, The manager is very good at checking to see we have the right training and support we need. If we ask she is always there for us with help and advice with any problem we may face. Care Homes for Older People Page 22 of 29 Evidence: We saw very kind interactions betwen the staff and the residents, and assisting with moving and handling. We inspected the staff duty roster and spoke privately with the manager and two staff. We sampled three sets of staff records. The home employs dedicated cleaning and catering staff but laundry and the kitchen assistant role is fulfilled by the carers. We noted that there had been a turnover of staff around the time of the change of ownership, with a number of newly recruited carers waiting to start when all their checks are completed. Duty rosters indicated a period of staff shortage had been experienced and this was confirmed by the carers themselves. We identified two issues of concern: -a recent shift when two male agency staff had been on duty with a newly recruited female carer who had been only four weeks in post. This raised the question of the residents choice of cross gender care, and whether two agency staff would be in a position to understand the assessed needs and appropriately support the residents. The manager informed us that one of the agency staff was engaged on a regular basis. -one senior carer was going off duty at 2pm on the day of the inspection having worked an 8am to 2pm shift. They were returning at 8pm again to work a twelve hour night shift on awake duty. Staff comments and surveys indicated a concern about staff shortages, short staffed at present, and need more staff on shift, some staff working long hours to cover shifts. Even in a very positive staff survey the comment came this is an area we have a problem, but the manager always helps when needed. These points were brought to the attention of the manager and the owner as an important issue to be resolved. Athough not yet to standard it was acknowledged that real progress is being made with recruitment and training. Inspite of the pressure the staff still indicated that morale was good, between 8 and 9 out of 10, and that the home is happy and caring. Staff suggestions for improvement include, the recruiting of a kitchen/laundry assistant, regular monthly staff meetings, handover meetings, more opportunities to do activities with the residents, a keyworker system for consistency of care, and a better rate of pay. Records indicated that induction training and foundational training are well organised. Staff also said, Yes, we get loads of training. 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. The home is run in a responsible way with identifiable improvements taking place and further planned developments to the premises and systems of working being progressed. The residents financial interests are safeguarded within the home, and their health, safety and welfare are promoted by applying practical and reasonable policies, procedures and training. Evidence: Moorland House changed ownership in April 2008, and a new manager was recruited with years of experience in the care services. An application has been made to the CSCI for registration and this is currently being processed. We evidenced a mutual respect and a supportive relationship between the provider, who is present at the home several days a week, and the manager. Clear lines of accountability for their respective roles have been defined. Care Homes for Older People Page 24 of 29 Evidence: A local care manager has commented that since the change of ownership in April this year there have been improvements and that the home has been eager to work jointly with Social Services. They commented that in their view the new owner and manager have established good relationships together and between the home and Adult services. Another care manager said that the home has an excellent manager who is willing to try anything to help the residents settle in and feel at home. A member of staff said, there has been a huge improvement since the new owner and manager took over. The manager is very good for the residents and staff. She gets on well with everyone, they can always talk to her and she will always give you time and support when you ask. We are all backing her to be the best we can to have a happy home with happy well looked after residents. The home provided an annual plan detailing the developments and improvements for the home, many of which have already been progressed. Quality monitoring systems have been put in place and the results summary were available. Very holistic personal care that is most impressive, was a comment from a local doctor, and have looked after my patient well, who can be quite challenging at times, from a specialist in dementia care. The manager confirmed that the home does not hold or manage cash/money on behalf of the residents. Invoices of relevant fees and expenditure are raised monthly and billed to the residents representatives. The AQAA confirms that policies are in place ensuring the health and safety of residents and staff. Manuals were in evidence at inspection, and the file of servicing equipment and maintenance testing was sampled. An item not available for inspection was the recording of fridge temperatures. We were told this had been taken home by the cook. The manager was reminded to ensure that all notification of incidents are reported to the CSCI, including safeguarding and falls resulting in a hospital visit. Care Homes for Older People Page 25 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 26 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 1 1 5 The provider must produce and provide an up-to-date service user guide in accordance with the regulations to enable prospective residents to have all the information they should have to make an informed choice about living at the home. 30/01/2009 2 7 15 Care plans must include guidance for staff on the behavioural apects of dementia care, and include relevant risk assessments to enable the staff to have clarity in all aspects of need and provide holistic care. 30/01/2009 3 9 13 Monitoring of staff practice in administering medication in line with procedures must be provided to ensure medicines are administered safely. 30/01/2009 Care Homes for Older People Page 27 of 29 4 27 18 The provider must ensure 30/12/2008 that at all times there are sufficient competent persons employed to fulfil an acceptable pattern of duty roster, with staff working appropriate hours to function in a competent way and effectively meet the assessed needs of the residents. 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. 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. 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