Inspection on 14/04/09 for Mountbatten Lodge

This inspection was carried out on 14th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mountbatten Lodge 17/04/08

Mountbatten Lodge 23/10/07

Mountbatten Lodge 19/02/07

Mountbatten Lodge 20/01/06

Mountbatten Lodge 25/06/05

Mountbatten Lodge 14/01/05

Mountbatten Lodge 17/08/04

Mountbatten Lodge 26/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX     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: Jeffrey Orange     Date: 1 4 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Mountbatten Lodge Old Crabtree Lane Hemel Hempstead Hertfordshire HP2 4EX 01442244188 01442282546 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Quantum Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 60 60 60 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 Mountbatten Lodge is situated in the Jarman Park Area of Hemel Hempstead, close to the town centre with its local shops and facilities and adjacent to a large supermarket and leisure park. Mountbatten Lodge is a purpose built home for up to sixty older people. The home is on two floors and divided into four individual units with single en-suite bedrooms, a lounge, dining room and assisted bath and shower rooms. Two units cater for people with dementia and these are on the ground floor with access to an enclosed garden area. Parking for cars is available. Care Homes for Older People Page 4 of 27 Brief description of the care home Fees range from £438 to £615 per week (as at 01/04/09). Additional charges apply for personal toiletries, newspapers, hairdressing and dental and chiropody services. Information about the home, the services it offers and the fees payable are contained in its Personal Guide A copy of this and the most recent CQC inspection report are available on request in the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: We last inspected this service on 17th April 2008. This unannounced inspection was carried out by one inspector, where the report refers to we it recognises that it is written on behalf of the Care Quality Commission (CQC). The inspection started early in the morning, which provided an opportunity for us to observe the routine in the home as people were getting up and ready for the day ahead. We spoke to people who live in Mountbatten Lodge and to visitors to the home, including health care professionals. We spoke to members of the care staff team and to support and administrative staff. We also had very open and useful discussions with the acting manager and the wider management team. Where we have received comments from people who live in the home from surveys returned to us, these have been taken into account in drawing up this report. We have also made use of the Care Homes for Older People Page 6 of 27 information provided to us by the home in their annual quality assurance assessment or AQAA. The AQAA is a self assessment document that says how well care outcomes are being achieved for people who live in Mountbatten Lodge and also includes some useful statistical information, for example about staff training and complaints. We also looked at some key records, including those for staff recruitment and training, care plans and medication administration. During the inspection we spent a period on one unit, observing the breakfast routine to determine how well it met the needs of people living in the home and how staff interacted with them. This report also draws on any information received about Mountbatten Lodge since the last inspection. This could be in the form of notifications by the home of significant events affecting people who live there or from health and social care professionals associated with the home or from relatives and other people who visit the home. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering Mountbatten Lodge as a home for themselves or someone they are responsible for can be confident that they will only be admitted once a rigorous and thorough assessment has been carried out to ensure that their care needs are fully understood and can be appropriately met. Evidence: When we asked people living in the home if they had been able to visit before they moved in, to see if they felt they would be happy there, they told us that they or quite often their families or carers had done so on their behalf. One relative told us that they had looked at several other homes before deciding that Mountbatten Lodge was The right one. When we looked at pre-admission assessments for some people who had only recently been admitted to the home we found that they contained the amount and detail of information that should mean that their care needs were well-understood, so that care Care Homes for Older People Page 10 of 27 Evidence: staff could meet them appropriately. The positive comments that we received from people living in the home, such as I like it here, they look after me very well suggests that this is the case. The Quantum Care Personal Guide for the home has previously been found to include exceptionally comprehensive information about the home, including details of what is offered and the terms and conditions that apply in a very clear and accessible format. This infomation is also available on-line and this should mean that anyone considering Mountbatten lodge as a home for themselves or someone they are responsible for have ready access to the information they need in order to make a well-informed judgement and decision about the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mountbatten Lodge can be assured that they will receive the personal and health care support they need to maintain their health and well-being and that the system of care planning in place provides care staff with the information they need to ensure that their needs are met appropriately. People living in the home who require assistance with their medication can now be confident that this will be done safely and accurately. On occasions people living in the home may feel that care staff do not have the time or insight to provide care in a way that recognises their need for respect and patient encouragement. Evidence: When we talked to a community nurse visiting the home they informed us that in general their relationship with the home was very positive, with referrals to the community health service being made appropriately.They indicated that there were occasions when staff didnt appear to have the time to help them as much as they would like. We spoke to a wheelchair specialist occupational therapist who was very positive about Care Homes for Older People Page 12 of 27 Evidence: the referrals made to that service by the home. When we asked people who live in the home if their health care needs were met, they all replied that they were and when we looked at care plans we found that they included details of the involvement of a range of community and acute health services with people living in the home. The acting manager informed us of meetings held with the surgery providing a GP service to the home. These were to improve communication and to build mutual understanding of processes, policies and procedures and the implications these have for all parties. This liaison process is to continue and the acting manager assured the inspector that the health and welfare of people living in the home had not and would not be compromised in any way at any time. All of the above demonstrates that people living in Mountbatten Lodge have ready access to the medical services they require in the home and in the community. When we looked at care plans we found that they contained the information care staff require in order to identify the needs of people living in the home and how they are to be met. There was evidence of a regular review process in most cases, with only a few of those seen not having an up to date monthly review sheet completed. One for example had records only up to January. In some instances the care plans had not been fully completed although in others the standard was very good, including some good examples of personal history, which provides care staff with an insight into the life history, background and interests of the people they are providing care for. In their AQAA the home told us that their care plans have a person centred approach, and if that is to be a reality, the social history part of the care plan is a crucial element. We discussed with the management team how significant information recorded in one part of the care plan is picked up and used to influence specific individual care, for example where the personal history indicates that memories of particularly traumatic events in the life of a person may be triggered by activities in the home celebrating historical anniversaries.When we talked to one of the homes management team about care plans, they indicated that they did routine audits of care plans in order to monitor the standard of them and to link into care plan training workshops, which we were informed had already taken place and that would be continued. This should ensure that the improvements noted in care plans at this inspection can be maintained and taken forward, which will in turn, improve the way that people living in the home experience care. When we looked at the minutes of one units team meeting it recorded in February that; medication mistakes are still being made, with gaps and codes not being used. This openness and open monitoring of medication in the home is actually very positive and means that any medication errors that occur are noted early and appropriate action taken. The homes AQAA and training records indicate that staff have received training in medication and the home have recently received positive feedback from an audit of their records carried out by the homes pharmacist. When we checked records Care Homes for Older People Page 13 of 27 Evidence: we found a good standard of recording and practice, which represents a significant improvement on the position at the previous inspection and suggests that people living in the home are now being better protected by the homes policies and procedures. During the inspection we observed some care staff interaction with people living in the home that raised some concern insofar as it was brusque and task driven. We were also told by some of the people who live in the home that I dont like the young carers, they dont have time for you and They are sharp with you and They dont talk to you.To balance theses views we were also told that;They look after us very well and I am very happy here and we also saw some very good and appropriate staff interaction with people living in the home including one young member of the staff team who was outstandingly enthusiastic and positive and who made time to talk to almost everybody they came across, so it would be wrong to make a generalised judgement about care staff based simply on their age.In their AQAA the home told us that During training all staff are made aware of the importance of treating our residents with respect and dignity. We promote this within the home by working alongside staff and during discussions held in meetings and supervisions. What we saw and were told during this inspection suggests that this process needs to be continued so that people living in the home experience care consistently provided in a way that shows respect and recognises their need for encouragement and patience. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mountbatten Lodge can be confident that they will be given opportunities to take part in activities appropriate to their needs and inclinations. They can be assured that they will be able to develop, build and maintain relationships with families and friends and that they will have a choice of what where and when they eat their meals. Evidence: One person living in the home who we spoke to told us that; Its all go in here! and we saw sufficient evidence during the day to suggest that there are activities available for people to take part in if they choose, for example at 10 am we observed a music and exercise session attended by seven people and later in the day there was a service of Holy Communion for those who wanted to attend. When we looked at the activities programme and spoke to the activities coordinator we found that there was a mixture of regular activities such as the mens club with an old time pub, sherry mornings and cheese and wine events, together with specials for example making Easter bonnets and celebrating the Queens birthday. It was explained that further enhancement to the homes garden is planned, which it is hoped will include a sensory and herb area and which may enable more activities to be Care Homes for Older People Page 15 of 27 Evidence: centred there, weather permitting! Activities staff are looking forward to the possible recruitment of an additional volunteer and we were also able to check training for activities staff including specific dementia care training and an activities workshop. Insofar as the homes activities rely to any extent upon care staff having the time to assist in between their care duties, comments received from staff would suggest that this is likely to be restricted. We simply do not have the time one care worker remarked. The activities coordinator that we spoke to said that many activities are mixed for all and that Everyone is treated the same. We were also told that the activities team includes some dementia champions and this means that the need should be recognised for sometimes providing separate activities for those who are living with dementia and those who are not, in order to appropriately meet both sets of peoples needs. We were told by the activities coordinator that each person living in the home has their own activities record, this should mean that it is possible to monitor if people are taking part in activities and if they are not whether this is because they choose not too, or because they feel unable or unwilling to do so. We observed the breakfast routine on one unit and the lunch routine on another. The experience was mixed, with the breakfast experience seeming a sociable occasion, with cooked breakfasts being offered, a pleasant atmosphere with soft music playing and comments from people having their breakfast being very positive; Tell them its very good and The food is not at all bad. The staff interaction seen was good and provided a pleasant start to the day. The lunchtime experience we observed was much less positive with some people living in the home seeming to be ignored by staff for long periods,with very little positive interaction seen and generally being very task orientated with little effort to make it a sociable event. One person on asking can I have a cup of coffee? was told not now, I will make it later as the care worker went past. In general the comments made about the food were quite positive, it was certainly not a major source of adverse comments made during this inspection process. One relative spoken to confirmed that they felt care staff were co-operative and that they as a family were welcomed and involved. The home have started a Friends of Mountbatten meeting which has been well received and which will build upon the good will that was evident in conversations with the relatives of people living in the home. During our visit we saw one person who lives in the home helping staff by taking a trolley around the home. They were provided with appropriate protective clothing and this was a positive experience for the person concerned as they were making a practical contribution and were engaged in a meaningful activity. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mountbatten Lodge and those who are responsible for them can be assured that they are protected from abuse by staff training and the application of it in practice and that any complaints made are listened to, taken seriously and dealt with appropriately. Evidence: Mountbatten Lodge has a complaints policy and procedure that is clearly written and easy to understand. It is available in a number of formats and this means that anyone living in the home or responsible for them can complain or make comments about the care experience and outcomes in the home. People living in Mountbatten Lodge told us that they knew how to make a complaint if they needed to. In their AQAA the home informed us that they had received 10 complaints in the previous 12 months, that they had all been resolved within 28 days and that all 10 had been upheld. The home also informed us that 1 safeguarding referral had been made to Hertfordshire County Council under their safeguarding vulnerable adults policy and procedure. The Commission are aware of a number of safeguarding referrals since the last inspection as well a series of concerns brought to our attention. We have seen copies of correspondence to complainants and action plans drawn up to address issues raised. Throughout this period Quantum Care have co-operated fully with the respective authorities and have taken active steps to address any shortcomings in performance identified. This suggests that people living in Care Homes for Older People Page 17 of 27 Evidence: Mountbatten Lodge or those responsible for them can be confident that any complaints will be dealt with promptly and apropriately. When we talked to care staff they all had a good understanding of issues around abuse and what to do if it is seen or suspected. When we looked at staff training files we saw evidence that care staff had received appropriate training, that should enable them to identify abuse and know what to do if it were seen or suspected. We have also received information directly from care staff in the past, which demonstrates that they are aware of routes to raise concerns outside of their immediate organisation. This should provide confidence to all those living in the home or responsible for them, that information about concerns will be shared appropriately, so that any issues can be investigated and dealt with. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mountbatten Lodge provides a generally comfortable and safe environment for those people who live and work there and people who live in the home can be assured that they will be able to make their own rooms reflect their tastes and interests if they wish to do so. Evidence: When we walked around the home early in the day, we found that the home was generally free from any obvious areas of unpleasant odour and as the day progressed we were able to observe cleaning staff working throughout the home. When we spoke to cleaning staff they took justifiable pride in the way they kept the home clean and free from odour and showed a very real sense of ownership in maintaining a pleasant environment for people who live and work in the home and visitors to it.When we spoke to visitors and people who live in the home, they all told us that they felt that the home was either always or usually kept very clean and tidy. When we spoke to cleaning staff they did express some concern about the effectiveness of some of the cleaning products provided by Quantum Care, although it has to be said that the outcomes they achieve with them are good. During this inspection there was a fire alarm test and automatic doors were seen to operate effectively.There were also monthly window checks being carried out to ensure they operated safely and effectively. Care Homes for Older People Page 19 of 27 Evidence: In discussions with the acting manager we were told of plans in the current years budget for enhancement to the garden of the home in order to make it more userfriendly. The grounds and garden were seen to be well-kept and included places where people who live in the home could safely walk around or sit and enjoy being outside. When, with their permission we saw the rooms of people who live in the home we found that they were personalised with pictures, ornaments and in some cases items of their own furniture, which enables them to put their personal stamp on their own living area. The only negative observations made about the environment whilst we were in the home were concerned with the excessive temperature in many parts of the building, which at times made it feel quite stuffy. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people living in the home can be confident that the staff providing care for them have been subject to a robust recruitment process and are provided with a high level of training and support, there are times when care outcomes for them are compromised by pressures on care staff time. Evidence: When we looked at staff recruitment records we found that there is a robust and thorough process being followed which should provide people who live in the home with confidence that they are being protected from the employment in the home of unsuitable people. When we spoke to the member of the management team responsible for maintaining training records and when we spoke to staff and saw records of training undertaken, we found that there is a good level of training provided for staff to ensure that people who live in the home benefit from receiving care from a well-trained and skilled staff team and that staff feel supported and valued from having opportunity to gain new skills and to maintain existing ones. We were told that Staff are far more enthusiastic and that They enjoy training. Care staff told us that they valued the opportunities for personal development that the home provided. Throughout this inspection we were told by people who live in the home that whilst they received a generally very good standard of care, there were occasions when care outcomes for them were compromised by pressures on care staff. One example seen Care Homes for Older People Page 21 of 27 Evidence: during the inspection was when someone asked Can I have a cup of coffee? and were told by care staff Not now, I will make it later This view was supported by relatives visiting the home and by comments made by visiting health care professionals, who again whilst paying tribute to the support they received, felt that at times the staff were not able to help them as much as they might like. When we spoke to care staff they told us that the were often under pressure. We are desperately short of staff was one comment made. It is acknowledged that people living in the home are generally very appreciative and supportive of care staff and the care that they provide and we were also told by some care staff that they felt there was just about enough staff at most times. However, the number of comments about times when staffing is not adequate to provide a consistently high standard, made by a range of people, suggests that this does need to be looked at. During the inspection call bell response times did appear to be excessive sometimes and the inspector did have to draw care staffs attention to people calling out on two occasions. Throughout this inspection we observed a range of staff interaction with people living in the home from very good to quite poor in a very few cases. Whilst some people living in the home told us that it was the younger care staff who had less time for them, we would not agree, from what we saw, that you could fairly make that general comment. In staff meeting minutes seen, it noted; Cannot give one to one care to residents and They are missing out because the unit is hectic.In their AQAA the home tell us that they have recently held a recruitment drive and are about to appoint several new care workers, which should reduce the amount of agency staff used. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working in Mountbatten Lodge have benefited from the exceptional quality and quantity of management support provided to the home over recent months. The current assessment of this outcome area reflects the fact that the longer term, permanent management team for the home is yet to be finalised. Evidence: The home currently does not have a registered manager following the resignation of the previous post-holder. It is understood that the process of appointing a new manager is either underway or will soon be underway. This will provide people living in the home, staff and relatives with confidence about the stability of the future management of the home. The consistent theme of this inspection was that there has been significant improvement in staff morale.Things are much better, Things have improved were comments from two care staff. The home has been through a period of uncertainty about its management and this has been a difficult time for all concerned. Throughout Care Homes for Older People Page 23 of 27 Evidence: the period since the last inspection Quantum Care have put considerable effort and additional management support into the home that has led to significant improvement, as noted throughout this report. This interim management team has included at least three ex- registered managers with a wealth of experience and expertise who have been able to concentrate for example on medication practice and staff training to bring about the improvements noted. When we looked at supervision records and spoke to care staff, we found that although there have been times since the last inspection when supervisions were not being carried out as frequently as they should,a schedule is now operating to address this. In their AQAA the home acknowledged; Due to a vacancy in the management team and long term sickness absence, staff supervision has not been as regular as it should. When we looked at financial records for monies held by the home on behalf of people living there, we found that they were accurate and that there was a satisfactory system of checks and audit in place to protect them from financial abuse. When we asked what the home did to ensure that the views of people who use the service are promoted and used as the basis for decisions about the operation and routine of the home, they told us that they hold regular resident unit meetings, that resident reviews are carried out, involving people who live in the home, that their are resident committee meetings, annual questionnaires to residents, relatives and clinicians, that there is a home forum and that a Friends of Mountbatten group has been established. The manager told us that so far this had been very positive. All of this, which is supported by records seen and comments made by those concerned, suggests that the views of people living in the home and those responsible for them are taken fully into account and are central to how the home is run. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 18 The manager must review the staffing level of the home to ensure that sufficient staff are available at all times to meet the needs of people living in the home appropriately and effectively in a timely manner. At times people living in the home, care staff and visiting health professionals have said that care outcomes for people living in the home are being compromised by the pressure on care staff. 29/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!