Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 12/06/09 for Nightingale Nursing Home

Also see our care home review for Nightingale Nursing Home for more information

This inspection was carried out on 12th June 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

Nightingale Home provides good quality personal and health care support to meet the individually assessed needs of each service user. The home is effectively managed and staff are well trained and supported to enable them to provide a very good service within a safe and homely environment. The home retains a stable group of staff whose numbers are adequate to meet the needs of the residents and to ensure the smooth running of the service. Recruitment procedures for new staff are thorough with evidence of all the required checks having been made before new staff commence duties. Without exception the residents consulted confirmed that they are well cared for with comments such as `Nightingale provides a very caring environment where everybody works hard to continually offer us good quality care in every aspect`. The environment is well maintained and the home provides a spacious individual and communal spaces with appropriate facilities provided according to individually assessed needs.

What has improved since the last inspection?

Since the last inspection additional Activity Organizer hours have been employed and the range of activities greatly increased. The care plans have been reviewed and now contain detail of each service users assessed needs presented in a more person centered format. Works of redecoration and renovation have been completed throughout the home and these and the addition of new carpeting and soft furnishings in some areas provide an attractive and homely environment.

What the care home could do better:

The home is very well managed and there were no issues of concern at the time of this inspection. The management must ensure that all the management procedures and checks that they carry out are fully recorded so as to fully evidence these to ensure the safety of the service users.

Key inspection report Care homes for older people Name: Address: Nightingale Nursing Home 85 New Road Ware Hertfordshire SG12 7BY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jan Sheppard     Date: 1 2 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 26 Information about the care home Name of care home: Address: Nightingale Nursing Home 85 New Road Ware Hertfordshire SG12 7BY 01920463123 01920463013 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Greenswan Consultants Limited Name of registered manager (if applicable) Mr Jose Poulo Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: This home may accommodate 3 older people with terminal illness who require nursing care. This home may accommodate 34 older people who require nursing care. This home may accommodate 34 older people who require respite nursing care. Date of last inspection Brief description of the care home Nightingale Nursing Home, provided by Greenswan Consultants Limited, is registered for 34 older people, who may require nursing or respite nursing care. It also provides nursing care for people who may be terminally ill. The home is a five-storey period building. It is situated in a residential area, close to Ware town centre. Care Homes for Older People Page 4 of 26 Over 65 34 0 0 3 Brief description of the care home The home has 24 single bedrooms and 5 shared bedrooms, 3 lounges and one dining room. There are 2 bathrooms with over-bath hoists and an assisted shower room. All floors are serviced by a lift. There are parking facilities at the front and to the rear of the building. The back garden has a small patio with seating. It is accessible to residents and wheelchair users. The home charges £533 - £650 per week. Further information can be obtained from the homes Statement of Purpose and the Service User Guide. A copy of the CQC Care Quality Commission Inspection Report is available in the home. Care Homes for Older People Page 5 of 26 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: three star excellent 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: This inspection was unannounced and took place over eight hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Older People. The report is written using accumulated evidence gathered prior to the inspection including information contained in the AQAA ( Annual Quality Assurance Assessment ) completed by the Manager, information given in the seventeen pre-inspection questionnaires returned to the Commission from service users, relatives, staff and other professionals and also takes account of statutory notifications sent periodically to us by the Manager. We made a tour of the building had in depth discussions with the home owner, an area manager and the deputy manager on duty. We were able to speak with many of the staff who were on duty throughout the day and with a number of service users and their visitors. Spot checks were made on a number of the homes records and care plans. Care Homes for Older People Page 6 of 26 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 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 7 of 26 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 8 of 26 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 who use this service can expect to have an assessment of need prior to entering the home and to have the opportunity to assess the service offered. The home does not offer intermediate care. Evidence: The home explained that there had been no changes to their procedures for assessment of prospective new residents since the last inspection. All applicants have an assessment of their care needs made by one of the homes management team who will visit them in their own home or in hospital. Information from medical and social care services is also gathered so that the home can be fully informed about all aspects of the applicants needs. All prospective service users are invited to visit the home and to spend some time with existing residents and thereby have the opportunity to gain some understanding of the life style of the home. Their relatives are also encouraged to visit if they wish. Care Homes for Older People Page 9 of 26 Evidence: The home has a brochure which provides clear information and a visual insight into life in the home.The homes Statement of Purpose was up to date and informative containing all the required elements. Pre admission assessment documents were seen on all the care plans examined during this visit and residents and relatives spoken with all said that they had had the opportunity to visit the home and assess the service before making the decision to move in. One said I have always found everybody so friendly and helpful and they helped me to settle in at a pace that suited me and I remain very happy here. Care Homes for Older People Page 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their health and personal needs met in a dignified and respectful manner by staff who have a good knowledge of their care needs and how these should be met. The homes medication policy, procedures and practice protect the service users from risk from any medication error. Evidence: The care plans were found to be well maintained and to contain a good level of detail about the action required by staff to support the service user and to meet their assessed needs. Some plans were seen to be signed by the service user there by evidencing their involvement with its compiling and all plans seen had up to date risk assessments. All care plan files contained clear records of contact with a range of health care professionals including mental health services and general practitioners. Service users spoken with all confirmed that they have prompt access to what ever medical service may be needed. Since the last inspection the home has had no incidents of falls or pressure sores amongst the service users. This is the second inspection where this has been the case and all members of staff are to be Care Homes for Older People Page 11 of 26 Evidence: congratulated for contributing to this excellent result. All the residents spoken with confirmed that they were always treated with respect by the staff and their dignity was upheld at all times. During this visit staff were seen to be knocking on bedroom and bathroom doors and to be addressing service users using the name that they preferred. Spot checks found that the home was following its stated policy and procedures concerning medication storage and administration thereby ensuring safety for the residents. The home has a medication room where medication is safely stored, the medication trolley is attached to the wall when it is not in use. The administration records examined were found to be correctly maintained and staff receive regular training from a local pharmacist. Information concerning new medications and the treatment of conditions (illnesses) not previously encountered by the home were seen to be explained verbally and in written format to all staff by the assistant manager. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are encouraged to exercise choice and have control over their lifestyle.The home offers good facilities to meet their recreational and social needs and enables residents to maintain close links with their family and friends. People who use this service are offered a choice of nutritionally balanced home cooked meals. Evidence: Since the last inspection the home has increased its provision of activities and has employed extra activity organizers who work along the homes staff in delivering the activities programme. All the service users have an assessment of their activity needs and interests and records are kept of which activities and classes are attended and whether or not the service user enjoyed these. Preferences for individual or group activities were also noted. Posters advertising the planned activities were seen to be displayed around the home and residents spoken with were aware of these. Photographic evidence could be seen of recent outings and parties held at the home. Life History forms were seen to be completed for most residents these give staff knowledge of peoples previous life interests and gives ideas as to what activities they might like to be involved with now. Staff explained that they also consulted with Care Homes for Older People Page 13 of 26 Evidence: relatives about this aspect and that this had given them new ideas as to what activities might be appreciated. Relatives reported that they had been consulted and several comments saying that the provision of activities had improved were made. Service users who are able are encouraged to maintain social links outside of the home one attends a local club and another regularly goes out to visit Friends. On the day of this visit one service user was seen to take herself out for a walk to the nearby postbox. She said, I am lucky I can still get out a little way and sometimes see the local shops. Appropriate risk assessments are completed for these activities. Several service users and their visitors were seen to be enjoying sitting in the gardens and it was noted that tea was served to them and that they were given space and privacy which they all said they appreciated. The serving of lunch was observed the food was seen to be attractively presented and service users confirmed that they have good choices variable portion sizes to meet their individual preferences and that generally the food is served at the correct temperature. All the comments from service users and relatives concerning their food were positive. The cook confirmed that she regularly visits and speaks with the residents concerning their food preferences and makes a special point of doing so for new residents. Special diets are accommodated and birthday and celebration cakes are always provided. Renovation works to the kitchen walls have recently been completed following a recommendation made at an environmental health inspection. The kitchen is of a good size has appropriate modern equipment and on the day of this visit was found to be well organized and clean. The nutritional needs of some of the more frail service users were seen to be carefully monitored and recorded and staff confirmed that they (the nurses and the cook) work closely together about this aspect. It was seen that two sittings were held at lunch time so that staff had plenty of time to give to service users who required help with feeding. It was also noted that the home owner shared lunch with residents during the second sitting and that a free and easy rapport existed between them. He told us of his plans to extend the dining area by the provision of a conservatory overlooking the garden work that was to start shortly. Care Homes for Older People Page 14 of 26 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. Practices in this home ensure that people who use the service can be confident that they are listened to and are protected from abuse. Evidence: The home has a robust and effective complaints procedure and all the service users asked said that they knew who to talk to if they were not happy about any aspect. Service users spoken with during this visit said that they would raise any concerns with the manager directly or with the owner who spends several days each week in the home. Several service users commented that the manager was always very approachable having an open office door and always seemed to welcome chats with residents. The homes Statement of Purpose and Service Users Guide gives information about the homes complaints procedure and the expected time frame for any issues to be dealt with. Information about how to access Advocacy services is also given. The Care Quality Commission has not received any complaints about the home since the last inspection. Information given to us on the AQAA ( Annual Quality Assurance Assessment ) compiled by the manager tells us that the home has received no formal complaints but that a number of comments and suggestions from service users and relatives have been dealt with promptly and that these have led to improvements to the homes service delivery for example the improved and extended activities programme. The home keeps records of any Compliments received and a number were shown to us during this visit. These were without exception all very complimentary about the services received and the manner in which they were Care Homes for Older People Page 15 of 26 Evidence: delivered. One said All the staff are brilliant welcoming and very helpful. A relative wrote I always feel that this is a friendly happy home where I enjoy visiting. The home has a copy of the guidelines issued by Hertfordshire concerning the safeguarding of vulnerable adults and has a comprehensive whistle blowing policy to protect staff and residents. Staff spoken with confirmed that they were aware of these policies and of the steps that they should take if they suspected that any abusive practice was occurring. The homes training records evidenced that training covering these subjects was undertaken by all staff,was up to date and that further training courses had been arranged. One non care member of staff member told us of their recent attendance on a safeguarding course and how this had made them realize all the various aspects of abusive behaviour . No incidents concerning the Safeguarding of Adults has arisen in the home since the last inspection. The Manager has undertaken training about the implications of the Mental Capacity Act and further training for other staff is to be arranged. Care Homes for Older People Page 16 of 26 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. People who use this service live in a safe, comfortable and well maintained environment.The accommodation is comfortable clean and hygienic and is well appointed with the appropriate facilities to meet their assessed needs. Evidence: The home which was rebuilt about fifteen years ago provides spacious communal accommodation and single bedrooms with ensuite facilities. There is good access to the large rear garden. On the day of this unannounced visit the home was found to be very clean and tidy and to be free of any mal- odours. People living there told us that the home is always kept in this way and that some of the house keeping staff have worked there for many years and take great pride in keeping it so. House keeping staff spoken with had good knowledge of safe infection control procedures and were following these. The overall interior appearance is homely and comfortable and bedrooms were seen to be personalized and individually furnished to suit the residents tastes and requirements. Each floor is accessible by lift and a small communal space with comfortable seating is provided on each floor in addition to the main lounge and dining room on the ground floor. Residents are there for provided with comfortable seating spaces close to their bedrooms where they can choose to sit quietly or can use to have private time with visitors and relatives. Care Homes for Older People Page 17 of 26 Evidence: The home provides a number of hoists a variety of wheelchairs ,several special wheel able arm chairs and has a number of profiling beds. This equipment was seen to be subject to regular servicing and to be maintained in good working order. Care Homes for Older People Page 18 of 26 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 who use this service can be confident that they will be supported by appropriate numbers of skilled and fully trained staff who have been robustly recruited to protect them and to ensure the smooth running of the service. Evidence: Since the last inspection the staffing levels have been consistently maintained and the numbers of staff found to be on duty on the day of this unannounced visit were found to tally with what was planned on the duty rota. We were told that the home was fully staffed and that they do not have to use agency staff to cover any unexpected shortfall. Staff were seen to be working well together as a team and to be providing support for the service users in a kindly and unhurried manner allowing them to do as much for themselves as it is safely possible for them to so do. The home operates a key worker system so that there is continuity of personalized care for each service user. The retention of long standing staff is given good priority and many staff have worked at the home for many years. Several told us that it was a happy place to work and that they were well supported by the managers and had good training opportunities. Information given to us on the AQAA ( Annual Quality Assurance Assessment ) completed by the manager confirmed that of the Carers over 87 held NVQ qualifications at either levels 2 or 3. The qualified nurses all attend refresher training courses and recently these have included topics such as the Liverpool Care Pathways and End of life Care given by the Isobel Hospice. Introductory information Care Homes for Older People Page 19 of 26 Evidence: concerning the care needs of people with Huntingdons Disease has recently been accessed by the home. The recruitment files of two recently appointed staff evidenced that all the required checks had been made this to ensure the safety of the service users. New staff commence duties only after results of a full CRB check have been received and then they all undertake an induction period and work initially alongside trained and experienced staff until they are familiar with the routines of the home and with the residents assessed needs. The home gives good priority to staff training and each member of staff has an annual training needs and development profile from which the homes annual training programme is compiled. Care Homes for Older People Page 20 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service benefit from the sound management of the home and the homes person centered ethos ensures that it is run in their best interests. Administration practices in the home protect service users and promote a safe environment. Evidence: Since the last inspection the registered manager has left and a new manager who had for the past four years worked as the deputy manager in the home has been appointed. He is a qualified nurse ( RGN ) and holds the NVQ level 4 management award and has worked in the field of elderly care for many years. He has made application to the Commission for manager registration. Since the time of this inspection visit and the completion of this report the manager has been interviewed by the Commission and has been accepted as the Registered manager for the service. On the day of this visit but acting Manager was not on duty Care Homes for Older People Page 21 of 26 Evidence: but a senior nurse who has also worked at the home for several years was in-charge and explained that until a new deputy manager was appointed she was taking a managerial role to assist the manager. The home therefore continues to benefit from a stable and familiar management team and residents relatives and staff consulted all confirmed that the recent changes had gone smoothly had been well managed and they said that they continued to have confidence in the management team. The home gives good priority to promoting the health safety and welfare of the residents and staff through the regular maintenance of safety checks, training and record keeping. The records of the weekly testing of the fire bells evidenced that these are regularly carried out as were the regular checks made of water temperatures. The home carries out an annual Fire Evacuation practice and the Fire prevention service gave a lecture in the home for all staff on the 5th of March this year. The home has arranged an Emergency Evacuation plan where by all residents could be safely accommodated in the premises of a nearby church. The records kept by the caretaker evidenced that he makes weekly checks of the emergency lighting system,the condition of wheelchairs and footplates and makes an assessment of the condition of carpets and of any other general repairs needed around the home. He explained that he and the owner make regular inspections of the state of the buildings and grounds to ensure their good upkeep and the safety for the residents and staff. All the service users have locked drawers or other secure facilities in their rooms for the safe keeping of valuables and money.Whilst the home does not generally keep residents monies small amounts of cash held on behalf of residents at their request to ensure its good safety were found to be being kept so that individual amounts held and spent could be properly accounted for and tracked. Individual receipts are kept for services such as chiropody and hairdressing. The home has appropriate systems in place to enable good communication between the various groups of staff. Records of staff meetings , nurse meetings and meetings with residents and relatives are kept. The manager told us in information given on the AQAA that this is an aspect which he wishes to strengthen further so as to ensure that good participation from all groups of staff covers all aspects of care delivery and personal development. All the staff were found to be very positive about their work and in promoting the quality of service given at Nightingale Lodge. The home sends residents relatives staff and external stakeholders annual quality assurance questionnaires and the results in the replies are studied to enable the home to continually improve its service delivery. It would be beneficial if an annual report of the information on these surveys was compiled and we discussed with the owner how this could perhaps be linked to the homes annual business plan. The owner spends three or four days each week working in the home working on administration talking with staff residents and relatives and sharing in the life of the home especially at lunch times. The comfortable rapport that the residents and all Care Homes for Older People Page 22 of 26 Evidence: groups of staff had with him was evident throughout and several residents commented positively on this during our visit. All the staff spoken with confirmed that they have regular supervision and an annual appraisal. Management meetings between the manager and owner are held regularly but no records of specifically designated Regulation 26 meetings are being maintained.The owner agreed to address this aspect. The management must ensure that all aspects of their management work can be fully evidenced with the appropriate records. Staff confirmed that they were always well supported by the manager and by the owner . Staff said that they have regular supervision meetings and an annual appraisal but that they are able to discuss problems at any time. The ethos of the home is clearly to put the needs of the service users first and to support all the staff to do this also. The home has an effective quality assurance and monitoring system. Feedback is regularly sought from residents , relatives and other professional visitors to the home. The Commission received seventeen replies to the pre inspection questionnaires it sent out and these were entirely positive with comments such as The homes meets all the criteria for caring for people. All the staff from the managers to the cleaners are involved in the care and provide a happy and homely environment for residents and staff. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 37 Records of all regulation 26 management meetings must be maintained. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!