Inspection on 19/01/09 for NewDay Nursing Home

This inspection was carried out on 19th January 2009.

CSCI 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

NewDay Nursing Home 06/12/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: NewDay Nursing Home 45 Wynford Road Acocks Green Birmingham B27 6JH     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: Lisa Evitts     Date: 1 9 0 1 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. 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 © (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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: NewDay Nursing Home 45 Wynford Road Acocks Green Birmingham B27 6JH 01217060427 01217060427 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Ruth Tickey Malesa Type of registration: Number of places registered: Huskards Care Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 37. The registered person may provide the following categories of service only: Care Home with Nursing - Code N 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) 37 Physical disability aged 60 and above (PD) 37 Dementia (DE) 37 Date of last inspection Brief description of the care home NewDay is a thirty-seven bedded nursing home situated in Acocks Green. It is registered to care for older adults who may have physical disabilities and/or dementia. The home has a choice of lounges, dining rooms and a separate smoking room. Bedrooms are a combination of double and single rooms of which thirteen have enCare Homes for Older People Page 4 of 29 Over 65 0 37 0 37 0 37 Brief description of the care home suite facilities. The home has assisted bathing facilities and equipment for moving and handling people with limited mobility. The corridors in the extension are wide and have handrails suitable for people with mobility problems, so that they can move around the home freely. Access to the front of the property is via a ramp. The home is within a short walking distance of shops, bus routes and train services. There is a garden to the rear of the home with a patio area, which has a water feature and seating for use by people when the weather permits, however there are some steps to negotiate. Limited off road parking is available to the front of the home. The last inspection report is available at the home on request. Other information of interest is on display. Fee rates are not included in the service users guide but are available from the home. 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 focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Two inspectors undertook this visit to the home, over seven hours and the registered manager assisted us throughout. There were thirty-four people living at the home and two of these were receiving hospital treatment. The home did not know that we were visiting that day. Information was gathered from speaking to and observing people who lived at the Care Homes for Older People Page 6 of 29 home. Three people were case tracked and this involves discovering their experiences of living at the home by meeting or observing them, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. One other file was partly reviewed. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were reviewed. Prior to our visit we sent out random questionnaires to ten people who live at the home and five staff. Ten people who live at the home and four staff returned questionnaires, which provided us with positive feedback about the home. The comments are included in the report. During the visit we spoke to four people who live at the home and two staff. It was not possible to speak to a number of people who live at the home due to their dementia. The registered manager and provider also completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gives us information about how well the home think they are performing, it tells us how they have improved and about plans for further developments. It also gives us some numerical information about the people living at the home and the staff. Reports that the home has sent us about accidents and incidents, which have happened, were reviewed in the planning of this visit. No immediate requirements were made at the time of this visit which means that there was nothing urgent for the home to do to ensure the safety of the people living there. What the care home does well: Pre admission assessments are completed so that people know their needs can be met before they move in. People have access to a range of Health and Social Care Professionals and this ensures that health care needs are met. Advice is sought from professionals by the home proactively to ensure that peoples needs are addressed. People are offered a range of activities they can participate in so that they lead an interesting and stimulating lifestyle. People are provided with a varied menu, which meets any dietary needs, cultural or personal preferences. There is an open visiting policy so that people can receive their visitors as they choose and maintain relationships that are important to them. Staff receive training to provide them with knowledge and skills to meet the assessed needs of the people living at the home individually and collectively. People are involved in meetings about the home and are involved in care planning. This gives them the opportunity to voice their opinions. Small amounts of personal money can be held by the home and this should ensure that people’s money is safe. People told us: My husband receives the care and attention he needs whilst in the home The nurse gives us our medications, we were asked if we wanted to do them but I didnt fancy that I went to see Mamma Mia at the cinema twice We go to Asda in taxi with a nurse in case we fall, to get our own clothes The menus are set but there is a choice of two things The meals are always different every day and the staff always keep my mother fed because she cant do it herself We go to our key worker if we are not happy, or the manager or resource manager The staff come and help me when I need help and when I feel sad, they are my best friends All the staff are first class people and I cannot speak highly enough of them Care Homes for Older People Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have sufficient information about the home to enable them to make an informed decision about whether they would like to live there. Pre admission assessments ensure that people know their needs can be met prior to moving in. Evidence: The home has a statement of purpose, which is also available in large print so that people with visual impairments can access the information. There is a service users guide which gives information about the home but this does not include fee rates. This is recommended so that people know how much they will need to pay to live at the home. The certificate of registration and public liability insurance are displayed. A notice informing people they can get a copy of the last inspection report is displayed so that people have access to this information should they choose to see it. Care Homes for Older People Page 11 of 29 Evidence: Comprehensive pre admission assessments are completed and confirmation letters are sent out so that people know that their needs can be met prior to moving in. The home does not offer intermediate care facilities. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with guidance about how to assist people to meet their needs in a way they prefer. People receive their medication as prescribed. Access arrangements for some areas of the home may compromise peoples privacy and dignity. Evidence: Each person has a care plan written. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order for the person to meet their needs. Three care files were reviewed and one file was partly reviewed. The care plans had improved since our last visit and provided good details of peoples likes and needs so that staff know how to assist people to meet their needs in a way that they prefer. A summary of information had been written which provided good details about the person, their likes and how they liked to spend their days. Care plans were updated when changes occurred so that staff had current information about how Care Homes for Older People Page 13 of 29 Evidence: to meet peoples needs. Care plans for difficult behaviour gave staff guidance about how they could minimise this for example Stroke her hair, arm as this tends to calm her down. This should help to reduce peoples anxieties. Risk assessments are completed each month for nutrition and risk of skin soreness. Moving and handling assessments are completed and provided details of equipment to be used and this means that staff know what equipment they should use for individual people to move them safely. Falls risk assessments are completed and staff have a falls protocol to follow to ensure people are safe if they have a fall. Wound assessments and care plans are completed if people have any sore areas of skin and this ensure that staff can monitor any changes in these and take action. When dressings are changed this was recorded in daily reports rather than on care plan evaluation. It is recommended that dressing changes are recorded on the care plans so that staff can evaluate wound changes effectively. Some care plans had been signed by people living at the home and this shows that people are involved in making decisions about their care. There is evidence that external healthcare professionals such as the GP, optician, social workers, tissue viability nurse and dentists see people. This ensures that people receive specialist care where required. One person told us My husband receives the care and attention he needs whilst in the home. Nine of the ten of the surveys received from people living at the home said they received the care and support they needed. The management of medication was reviewed. The audits on medications were correct and this means that people receive their medication as prescribed. There were no gaps on Medication Administration Records (MAR) and eye drops were dated when opened to ensure they would be discarded at the correct time to minimise risk of cross infection. Some of the records did not have identity photographs and this is recommended so that staff can identify people when giving their medications. One person living at the home told us The nurse gives us our medications, we were asked if we wanted to do them but I didnt fancy that. This shows that people are involved in decisions. Although a new fridge had been installed, temperatures were still too high to ensure that medication was stored within its product licence and this should be reviewed. Care Homes for Older People Page 14 of 29 Evidence: People were well presented and had been assisted to wear clothing to meet their individual choices. Hair care was reflective of personal choices, one persons plan said that the person likes their hair plaited each week by staff and this person was observed to have plaits in her hair. One shared room did not have dividing curtains that were wide enough to ensure that the other person in the room had their privacy and dignity maintained and the manager addressed this at the time of the visit. The manager told us that they had some difficulties with people entering other peoples rooms and removing things. One room had had all of the photographs removed from the wall by someone else living in the home and a photograph frame broken. Two people who live at the home said Other people come into our rooms, they either pinch our things or use it as a toilet. This does not ensure that peoples privacy is maintained and this must be reviewed. People are able to hold keys to their rooms and two people we spoke to confirmed they had keys to their rooms. One person said I have a key for my door and keep it locked. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to choose the activities that they participate in which promotes their individuality and independence. People are offered a choice of meals to meet their dietary, cultural needs or preferences. Evidence: The activity coordinator is on leave and the home has recruited another person into this role. This person is completing a distance-learning course regarding activities, which will assist in their knowledge of how to meet peoples social needs. There is a weekly activities programme, which consists of newspaper discussions, games, quizzes, music, nail care, movies, tactile activities, shopping and one to one time. A forthcoming events programme detailed trips to McDonalds, pet therapy, cinema trips, a pub lunch or Asian restaurant, a clothes show, indoor music and karaoke. There were photographs around the home of celebrations such as Eid and trips out to the safari park. Progressive mobility visit the home each week to assist people to exercise to music. Some people go out to a craft centre and others attend a lunch club and this helps them to maintain links with the local community. A hairdresser visits each week so that people can have their hair dressed in a way they prefer. Care Homes for Older People Page 16 of 29 Evidence: People told us: I went to see Mamma Mia at the cinema twice We go to Asda in taxi with a nurse in case we fall, to get our own clothes People are able to have newspapers delivered so that they can continue to read articles of interest to them, and we observed staff taking newspapers to people in their rooms. There is an open visiting policy, which means that people can see their visitors as they choose and maintain relationships that are important to them. The home has a four-week rolling menu. There are two choices of hot meal at lunchtime and a hot meal or sandwiches and soup in the evening. Breakfast is a choice of cereals and an option of a cooked breakfast on a Saturday. There was evidence on the menus that they had been changed to meet individual peoples requests and this means that people receive food that they like. Dining tables were presented with cloths, placemats, cutlery and serviettes. Staff were observed to sit down to assist people who needed assistance to eat their meals and meals were well presented. A number of people were seen to have a curry, which met their cultural requirements or personal preferences. Other people had minced beef pies or sausages. The home are able to cater for meals for reasons of personal taste, religious and medical needs. The cook had a good knowledge of individual peoples dietary needs. People told us: The menus are set but there is a choice of two things I enjoyed my curry The meals are always different every day and the staff always keep my mother fed because she cant do it herself Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is comprehensive and is accessible to people should they need to make a complaint. The home has policies, procedures and staff training, which should safeguard people from harm. Evidence: The complaints procedure is displayed in the home and is included in the statement of purpose and service user guide so that people know how to make a complaint if they need to. This procedure is also available in Urdu and Hindi so that people who speak a language other than English can access the information. Since the last inspection at the home we had received one anonymous complaint about the home, which we had responded to directly. This was regarding the management and standards of care at the home. The home have not received any formal complaints since our last visit but the manager said any issues raised had been resolved at the time. It is recommended that a grumbles book is implemented to record these low level complaints so that we can see how the home have dealt with them and also so the manager can audit these and monitor any trends. There is a suggestions box in the reception area and a comments book so that people can voice their opinions about the home. This contained one complimentary comment about the service provided. Care Homes for Older People Page 18 of 29 Evidence: Eight of the surveys completed by people living at the home told us that they always knew who to speak to if they were unhappy. Two people we spoke to said We go to our key worker if we are not happy, or the manager or resource manager People at the home have access to advocacy services and Independent Mental Capacity Advocates so that they can be involved in decisions about their care. The home has an adult protection policy and a copy of Birmingham Multi Agency Guidelines so that staff have guidelines to follow in the event of an allegation of abuse. This should safeguard people from harm. There have been three adult protection cases opened and closed since our last visit. The home have reported incidents to the required people in order to safeguard people from harm. The majority of staff have undertaken adult protection training so that they should have the knowledge to safeguard people in the event of an allegation being made. One member of staff was able to tell us the correct procedure to follow if an allegation was made but a second member of staff was not aware of local guidelines. This person had not received any training in protection of vulnerable adults since starting work at the home recently. This was brought to the attention of the manager at the time of the visit and training was planned. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a homely and comfortable communal environment in which to live. Bedrooms do not always reflect the personal choices of people living there. Evidence: Access to the home is via a ramp, which enables people in wheelchairs to gain entrance to the home. There is also a ramp inside the home so that people in wheelchairs can are able to access the main part of the building. There is a passenger lift to the first floor. On the day of the visit, a partial tour of the building was undertaken and the home was found to be odour free. There are two lounge areas that are adjoining the dining room/conservatory in the extension plus a further dining room that is adjacent to the kitchen in the original building. There is a quiet lounge which is equipped with sensory lights and a smoking room if people choose to use these. This means that people have the choice about where to spend their time. There was a pleasant atmosphere in the home and people were seen to move around the home as they choose. The corridors are wide and have handrails to enable people to move around the home independently and with aids, as they require. One of these handrails was loose and was brought to the attention of the manager as may cause an injury. Care Homes for Older People Page 20 of 29 Evidence: There is a rolling programme of decoration in place and a number of bedrooms had been redecorated and had new flooring laid to enhance the living environment. The dining area was in the process of being decorated on the day of our visit and people living at the home were pleased with this, one person said We like the new decoration but we didnt choose the colours. New beds and mattresses had been purchased and a large flat screen TV had been purchased for one of the lounges so that people could see the TV and watch programmes they chose to. Bedrooms seen had some personal items, however it was of concern that people told us that things went missing from their rooms as people wandered into them. We were told that other people at the home had taken down pictures in one persons room and this does not provide people with a room where their privacy and dignity can be maintained. Each room has a lock so that people can lock their rooms as they choose, however this must be reviewed so that peoples rooms are safe if they are unable to lock the door independently. We were concerned about some gates that had been placed on some peoples bedroom doors to prevent people wandering in. There were no risk assessments on file and we were concerned about peoples safety. The manager must review this and explore how this can be managed in a safer way. If the gates are required then risk assessments must be in place so that peoples safety is maintained. We asked the West Midlands Fire Service for advice about the gates and they visited the home. The gates had been removed following our visit and the manager is looking for alternative gates which she will need to agree use of with the fire officers before they are installed. The home was generally clean with the exception of dividing curtains in one of the rooms were soiled and one room had a cushion that was dirty. On the staircase there was some dried spilt food on the skirting board, the manager addressed all of this at the time of our visit. People told us: Its clean here It is the cleanest nursing home I have ever been in. There is always a cleaner on hand to mop up the mess Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who receive training to ensure they have the knowledge to meet people needs. The recruitment process ensures that people are safeguarded from harm. Evidence: There are five care staff and two trained nurses on duty throughout the day and three care staff and one trained nurse during the night. In addition to nursing and care staff the home also employs domestic, maintenance, kitchen and activity staff to meet all the needs of the people living at the home. There was one carer vacancy at the time of our visit and the home maintains a stable staff group. This means that people know who will be assisting them to meet their needs. 94 of the care staff have completed a National Vocational Qualification (NVQ) in care. This should ensure that staff have the knowledge and skills to meet peoples needs individually and collectively. People told us: The staff come and help me when I need help and when I feel sad, they are my best Care Homes for Older People Page 22 of 29 Evidence: friends All the staff are first class people and I cannot speak highly enough of them There is always somebody around when you need them and they are always willing to help Three staff files were reviewed and these contained all the required checks to ensure that people are protected from harm. It was recommended that the reference request form is further developed, as the current one does not provide much information about the candidate. There is a rolling programme of training in place to ensure that staff receive annual updates and have current knowledge. There had been an improvement in the training and staff had received training in moving and handling, infection control, health and safety, first aid, food safety, fire safety, protection of vulnerable adults, venepuncture and pump feeding. Some staff had received training in the Mental Capacity Act and further training was planned for remaining staff to receive this training. There is an induction programme in place, which covers the skills for care to ensure that people have a basic induction into their role. There was evidence that people receive this training and one new member of staff said my induction workbook is almost finished 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 adequate 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 the best interests of the people who live here. Health and safety procedures do not always protect people. Evidence: The manager is a registered nurse who has worked at the home for approximately seven years. Since our last visit she has become the registered manager and has made a number of improvements for the benefit of the people living and working there. She has also completed the Registered Managers Award which will assist her knowledge in the effective leadership of the team. The manager has completed study days for venepuncture, deprivation of liberty and mental capacity act. In addition to this she also completes the in house training alongside staff so that she has the knowledge to guide the staff team. One person told us she is a really good team leader and makes you feel you are part of a team Staff and people at the home hold meetings so that they can discuss any ideas or Care Homes for Older People Page 24 of 29 Evidence: concerns about the home. Minutes of these were seen however are not made available for people to see. It is recommended that the minutes are displayed so that people know what has been discussed. The Registered Provider continues to show a commitment to making improvements at the home and visits the home once or twice a week. A monthly report is written regarding the quality of the service provided. The manager undertakes a number of audits and service users satisfaction forms are sent out to people living at the home twice a year. From these findings an annual report should be written so that people are given information about the quality of the service. Individual records are maintained for people where the home holds personal monies. The balance of money was found to be correct and audits are undertaken. This should ensure that peoples money is held safely. Accident records were reviewed and were in line with data protection. Audits are now completed so that any trends can be monitored and acted upon. Health and safety and maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks are completed on the fire system and equipment and staff receive fire training and drills so that people should be safe in the event of a fire occurring. The exception to this was that the emergency lighting had not been checked since October 2008, this was brought to the managers attention. We were concerned about fire safety and people being injured by the half gates, which were on some bedroom doors. We asked West Midlands Fire Service for advice about these and they visited the home. The gates had been removed following our visit and the manager is looking for alternative gates which she will need to agree use of with the fire officers before they are installed. The manager told us that an external electrician checks water temperatures twice a year but there was no evidence of the most recent check. The water in one of the hand basins in a communal toilet was cold and the manager requested a visit from the electrician so that these could be checked. It is recommended that random rooms are tested each month to ensure that the water is maintained at a safe temperature. 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 10 12 Systems must be in place so that peoples privacy and dignity is maintained. 23/02/2009 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 1 1 Fee rates should be included in information about the home so that people know how much they will have to pay if they live at the home. Care records should demonstrate an audit trail of wound care so that peoples wounds are monitored and correct treatment is provided. Medication should be stored at a correct temperature so that it is stored within its product licence. Low level complaints should be recorded so that any trends can be monitored and acted upon. Reference request forms should be reviewed so that they provide sufficient information about potential staff so that people are safeguarded. Minutes of meetings held with people using the service should be available in a format accessible to them so that they are kept informed of the issues discussed. An annual report should be written about the quality of the 2 7 3 4 5 9 16 29 6 32 7 33 Care Homes for Older People Page 27 of 29 service and be available so that people can access this information. 8 38 Systems should be in place to ensure that all equipment is in safe working order so that people are safeguarded. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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