Inspection on 30/03/09 for Parklands

This inspection was carried out on 30th March 2009.

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

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

Other inspections for this house

Parklands 27/03/08

Parklands 08/11/06

Parklands 29/11/05

Parklands 08/06/05

Parklands 22/12/04

Parklands 22/06/04

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Poldhu

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Hunters Care Centre

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Key inspection report Care homes for older people Name: Address: Parklands Kensham Avenue Bradninch Exeter Devon EX5 4RD     The quality rating for this care home is:   two star good 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: Vivien Stephens     Date: 3 0 0 3 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 30 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 30 Information about the care home Name of care home: Address: Parklands Kensham Avenue Bradninch Exeter Devon EX5 4RD 01392881375 01392882089 parklandsreshome@btconnect.com www.parklandsresidentialhome.co.uk Mrs Heather Baker,Mr Roy Baker care home 27 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Parklands is a large detached home in grounds with views over the surrounding countryside. The home is registered to provide accommodation and personal care for up to twenty-seven older people who may also have dementia. There are ten rooms within the home that are registered for double occupancy. However, all bedrooms are currently used for single occupancy only. Eleven bedrooms have en-suite facilities. There is a passenger lift to the first floor and ramps fitted around the home to provide access for people using wheelchairs. An extension has been built to the side of the home and contains seven bedrooms and a shower room. All new bedrooms are over twelve square metres with en-suite facilities. CSCI inspection reports are displayed on the hall table. Care Homes for Older People Page 4 of 30 Over 65 27 27 0 0 Brief description of the care home Fees for the home are 425 pounds per week, which includes newspapers and toiletries. Hairdressing, phone calls and chiropody are not included in this price. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Several weeks before this inspection took place we sent an Annual Quality Assurance Assessment form (AQAA) to the home. The completed form gave us useful information about the home and the services they provide. We also send survey forms to the home and asked them to distribute them to a random sample of people living in the home, to the staff team, and to health and social care professionals who visit the home. We received 11 surveys from people living in the home, 8 from staff, and 1 from a GP. Their responses have helped us to form the judgements we reached in this report. This inspection began at approximately 10am am and finished at approximately 7 pm. On the day there were 22 people living in the home. During this inspection we looked at the care plan files for four people chosen at random and we looked at all of the records relating to those 4 people including the assessment documents from their initial admission, care plans, daily reports, medication records, Care Homes for Older People Page 6 of 30 and any risk assessments relating to their care. We looked at other records the home is required to keep including staff recruitment, induction and training records, activities provided by the home, and health and safety records including the fire log book. We carried out a tour of the home during which we looked at a random sample of bedrooms, the toilets and bathrooms, the kitchen, laundry and the communal areas. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: We talked to the owners about how the care plans could be further improved to give Care Homes for Older People Page 8 of 30 greater detail about daily routines. This should include such tasks as dressing, washing, cleaning teeth, and eating. This will help the staff to work in a consistent manner. People should be asked to sign their care plan to agree it is correct. The home should approach Social Services to request advice and support to one person who wants to return to their own home. The information in the medicines administration records could be improved to ensure the care staff have all of the information they need when administering medicines. The home should also consider improving the information in the care plans about the medications people receive, what they are for, and any special instructions, for example, how to recognise when a person may be in pain and when pain relief should be administered. Where care staff complete medication administration recording sheets by hand the details should be checked by a second person who should sign to confirm the instructions are correct. The homes medication administration policy should be updated to ensure care staff have all of the information they need on all aspects of the receipt, storage, administration and disposal of medications. The home should keep a written record of all complaints, any investigations carried out, and the outcome of the complaint. At least two satisfactory references should be obtained before any prospective new member of staff is offered a job. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident they will be given enough information and opportunity to visit and get to know the home before they make a decision to move in permanently. The home has followed good assessment procedures that ensure they can be certain they will be able to meet the persons care needs. Evidence: The home told us in their AQAA When a potential resident first enquires we have a very informative brochure which is sent. The potential resident and relatives and friends are welcome to visit to inspect the quality of the home, facilities and suitability. We will then arrange for a home visit to assess whether or not we can effectively meet their needs. If we can then the potential resident will be invited to stay at the home for a day or night free of charge to see how they get on. At the last inspection we asked the home to make sure their statement of purpose was correct and contained all of the information they are legally required to include. Since Care Homes for Older People Page 11 of 30 Evidence: then they have updated the statement of purpose and brochure and we were given a copy on the day of this inspection. We found the brochure contained a good range of information and was easy to read. At the last inspection we told the home they must improve the way they assess peoples needs before they move in. We looked at the way the home had assessed the needs of people who had moved in since the last inspection. We found that the home had gathered a good range of information covering their health and personal care needs, and important information about family and friends and health professionals involved in their care and well being. We also saw useful information provided by health or social care professionals. The people we contacted during this inspection told us they were happy with the help and information they had received before they moved in. Comments included Very happy and satisfied. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent improvements to the care planning systems and training for care staff means that care staff now have better information about each persons individual needs, although more work is needed to improve the level of detail about all daily routines. While medicines are generally stored and administered safely there are some areas where changes need to be made to provide even greater security and safety. Evidence: At the last inspection we found that the care plans needed to be improved to provide better continuity of care and guidance to staff. At this inspection we looked at four care plan files and other documents such as medication administration to find out how they planned and monitored each persons care needs. Since our last inspection a new care planning system has been introduced. They have used a commercial care planning system from a company who specialise in care services. The home had clearly spent a great deal of time completing the care plans, and we found they contained some good information about the care needs of each Care Homes for Older People Page 13 of 30 Evidence: person. While the overall level of detail in the plans were satisfactory there were a few areas where the detail could be further improved, including greater detail about the personal care tasks such as washing, bathing and dressing and how the person wanted the care staff to assist them. We talked to the providers and Care Team Leader about how the plans should explain clearly each persons normal daily routine, and they should provide sufficient detail so that a new member of staff can pick up the care plan and know immediately how the person wanted to be assisted. At the last inspection we advised the home that they should as each person to sign their care plan to confirm the plan is correct. During this inspection the providers told us that they had not managed to obtain signatures yet, but they planned to do so in the near future. The staff team have completed daily reports completed and we found these provided good information about the care provided. We talked to each of the four people whose care plans we looked at. Each person told us they were happy at the home and felt the staff gave them all the help and support they needed. One person we talked to said they wanted to return to live in their own home and we agreed with the providers that they will help the person contact Social Services to obtain the support they needed. We looked at the way the care home helps people who have skin conditions, or who are at risk of developing pressure sores. No one had been prescribed creams to be administered by the care staff, although one person had creams in their room that had been left by the District Nursing team to be used when they visited. The nurses had visited this person regularly and monitored their nursing needs, including skin care and risk of pressure sores. A GP who completed a survey form before this inspection told us that they were satisfied with the care provided by the home and said the home provides Good holistic care. At our last inspection we told the home they must improve the way they administered medicines to ensure people are protected from harm. The people who live at Parklands have GPs from Silverton, Bradninch and Cullompton areas and each surgery has its own pharmacy. This has resulted in the home have three separate medication systems. Care Homes for Older People Page 14 of 30 Evidence: Since that inspection the providers have discussed the problems with a pharmacist and a new monitored dosage system has been introduced. The home now has three different monitored dosage systems which is an improvement on the situation we found at the last inspection where there were 2 different monitored dosage systems and some medications supplied in bottles and packets. No medicines were being now potted up by the home (this is known as double dispensing) and this has reduced the level of risk of error. The home also has 2 different types of administration records. The level of detail in one set of administration sheets was very good, and provided care staff with important information relating to the administration or the effect of the medication. The other administration sheets provided very basic details about the name, dose, and basic administration instructions. We recommended that the home returned to the pharmacy to ask if the level of information could be improved. Alternatively the home could consider adding this information to the care plans or by providing information sheets in the folder that holds the administration records. We saw some gaps in the medicine administration records. This suggested that the care staff may have failed to give those medications to the correct person at the correct time. We could not see and records to show the actions care staff had followed when they saw the gaps. We looked at the medication policy to find out what instructions the care staff had been given and we found that the policy was not detailed enough. We talked to the providers about the information they could obtain to help them update their policy. Some medicine administration recording sheets had been completed by the care staff. We advised that these records should be checked by a second member of staff and signed or initialled by that person to confirm that the details are correct. We found that medicines were stored securely in metal cabinets firmly fixed to the wall. All unwanted medicines have been returned to the pharmacy and the home only held medicines that were currently in use. At the last inspection we asked the home to speak to each person to ask them if they wanted a lock on their bedroom door. We were told that this has been carried out and those people who wanted a lock on their door have been given one. We also recommended that the home should improve the level of confidentiality for the records they hold. The room used as the main office was also used by people to reach the dining room. The providers told us that they were planning to partition the office area Care Homes for Older People Page 15 of 30 Evidence: in the next few weeks and this will provide better security and confidentiality. Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a good choice and range of activities to suit most peoples interests. People are offered a good range and quality of meals to suit all preferences and dietary needs. Evidence: At the last inspection we found that the level of activities provided by the home was good but we suggested some improvements, including a greater focus on those people who did not want, or could not, join in with group activities. At this inspection we found that the home had kept a record of the activities they had provided and the people who participated. The records helped them identify those people who had not joined in and who might benefit from more time on a one to one basis. Two staff have been given specific responsibility for organising activities. These staff have received specific training on this topic. One member of staff commented in the survey form they completed before this inspection I think the home provides a good range of activities for the residents to participate in, if and when they wish to, and always tries to include all residents. Care Homes for Older People Page 17 of 30 Evidence: In the entrance hallway we saw notices about forthcoming activities planned for the week. These included a trip out or music and instruments, a visit by the Baptist Minister, visiting musicians, and an arts and crafts session. We were also given a list of some of the activities regularly provided by the home. These included various musical activities including visits by entertainers, quizzes, bingo, exercises, hand and foot massage, visits from the local donkey sanctuary, a person who keeps birds of prey, and Pets as Therapy. Several people told us how much they enjoyed the regular minibus outings provided by the home. There are also visits from leaders of two different denominations of local churches. The home told us they will arrange visits from other denominations if requested. Regular Residents Committee meetings are held in the home. These meetings have given people an opportunity to have their say about daily life and activities in the home. The people we talked to told us the staff give them choices in all aspects of their daily lives. The home told us they cater for all diets including cultural requests. All of the people we spoke to during our visit, and those who completed a survey form, said they always enjoy the meals. Comments included Yes, they are very good. Lots of fresh veg. and X chooses alternative meals when the menu is not to his taste. A member of staff said Lovely, home cooked meals, with choices, or alternatives to the main meal for the residents. The dining room has been attractively decorated and furnished and tables were laid with co-ordinating tablecloths, making the room appear welcoming and a pleasant place to have a meal. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the home has taken good measures to ensure people are protected from the risk of harm or abuse. Evidence: Since the last inspection no complaints have been received by the Commission. The home told us in their AQAA that they had received two complaints but these had been resolved. We asked Mr Baker to show us the records of these complaints but he told us that both complaint had been minor in nature and had been quickly resolved and therefore he had not made a record. We advised him that the home must keep a record of each complaint so that we could check that they had been properly investigated and action had been taken where necessary. People have been given a copy of the complaints procedure in the homes brochure. It has also been displayed on notice boards around the home. People who live in the home and their relatives have also been given a questionnaire that incorporates the complaints procedure. In this way the home has invited people to speak out if they had any concerns or complaints. Each person has also been given a detailed contract of residence containing their legal rights. All of the people who completed a survey before this inspection, and those people we talked to, told us that they knew how to make a complaint. Some people told us they would speak to the providers. One person told us they had Nothing to complain Care Homes for Older People Page 19 of 30 Evidence: about. The home told us that all of the staff have received training on the protection of vulnerable adults and prevention of abuse. They have policies and procedures in place covering all aspects of abuse. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and comfortable home that has been well maintained. Evidence: During this inspection we carried out a tour of the home. We looked at most of the bedrooms and all of the communal areas, bathrooms and toilets. We also looked in the kitchen and laundry. At the time of this inspection each person had their own single occupancy bedroom. We were told that people were encouraged to bring items of furniture and personal effects to make their rooms feel as homely as possible. Many of the rooms we saw were highly personalised with pictures, plants, ornaments and items of furniture people had brought with them. Around the home we saw vases with fresh flowers making the home appear welcoming and comfortable. All of the bedrooms were in good decorative order. The providers told us that when a person leaves the home the room is redecorated and a new carpet laid. Modern nursing beds had been provided in many of the rooms - these were domestic in appearance but could easily be adjusted by staff if the person needed assistance to help them move. Specialist mattresses have been provided where necessary to reduce the risk of people developing pressure sores. Care Homes for Older People Page 21 of 30 Evidence: 23 bedrooms have en suite toilet facilities. The bathrooms appeared bright, modern and were equipped with specialist baths. On the day of this inspection there were 2 cleaning staff on duty. All areas of the home were bright, fresh and clean. There were no unpleasant odours. In the entrance hallway there was a dispenser for anti-bacterial hand gel and people were invited to use this on entering the home. Wash hand basins were equipped with soap dispensers and paper towels. All of the people who completed a survey form before this inspection, and those people we talked to during our visit told us the home was always kept clean. They also said they were happy with their rooms. The gardens were well tended with colourful displays of spring flowers. The providers told us they have re-surfaced many of the paths to make them safer. There was a decked area at the back of the house where people could sit outside and enjoy the gardens and the lovely views of the surrounding countryside. We looked in the laundry and found the room large, well equipped and in good order. A laundry assistant was employed and she explained how the washing was sorted, washed, and returned to the correct owner. People have been encouraged to mark all items of clothing, and problems with missing items of clothing have been kept to a minimum. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that there are sufficient staff employed who have the necessary skills and knowledge to meet their care needs. The home has followed safe recruitment procedures. Evidence: At the time of this inspection there were 22 people living at Parklands. Information provided by the home before this inspection showed that there were 15 care staff and 5 domestic, catering and maintenance staff employed. On the day of this inspection there were 2 providers (including the registered manager) and 1 Care Team Leader, 3 care assistants, 1 cook, 1 laundry assistant and 2 cleaners on duty in the home. Most of the people who completed a survey form before this inspection, and the people we talked to on the day of this inspection said that there were always sufficient staff on duty to meet peoples needs. The staff who completed a survey form before this inspection told us they thought there was always or usually enough staff on duty. We looked at the recruitment records for 3 staff recruited since the last inspection. The files were in good order, neatly filed, and showed that all required references and checks had been taken up before each person had begun work with the exception of one person who worked just a few hours each week and did not work directly with the Care Homes for Older People Page 23 of 30 Evidence: people living in the home. We advised the providers that it is good practice to take up at least two satisfactory references on all staff, regardless of the number of hours they will be working, and regardless of the nature of the job, before they begin work. We saw evidence to show that new staff have received induction training during the first 3 months of their work following a nationally recognised induction programme. Information provided by the home before this inspection showed that over half of the care staff team already hold a nationally recognised qualification known as NVQ. 4 more staff were in the process of obtaining this qualification, or working towards a higher level. This demonstrated that the home recognised the importance of having a well trained and qualified staff team. We looked at the employment files for many of the staff team and saw copies of the training they have received on health and safety related topics and on subjects relevant to the care needs of the people who live at Parklands. Training in the last year has included basic first aid, protection of vulnerable adults, health and safety, fire safety, infection control, food hygiene, safe administration of medicine and moving and handling. The providers have kept records of the training each member of staff has received and were aware of the dates each member of staff was due to receive updates on each topic. The home told us they have also planned to provide training on the Deprivation of Liberty and the Mental Capacity Act in the next year. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and safe. Evidence: The providers have owned the home for a number of years. Mr Baker holds a relevant qualification known as NVQ level 4 and the Registered Managers Award. Mrs Baker previously worked as a State Registered Nurse. The people and staff who completed a survey form before this inspection told us they felt the home was well managed. We received many positive comments from the staff including, A warm, homely atmosphere where staff and management are very approachable, I feel. I am given the support I need. Although the home isnt perfect our aim is to keep it homely and we pride ourselves in achieving this. We looked at the records the home is required to keep, including care plans, daily reports, staff handover notes, and staff supervision records. We also looked at records relating to health and safety, including the fire log book. We found these had generally been well maintained. Care Homes for Older People Page 25 of 30 Evidence: The providers have consulted with the people who live in the home in various ways, including the use of questionnaires, Residents Meetings, and by being available and by talking to people on a daily basis. The home does not hold any money on behalf of any person living there. The providers told us that if people do not want to, or are unable to handle their own money the home will pay for any items such as hairdressing or toiletries and will invoice people once a month Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans should be improved to give greater detail about daily routines - times of rising/going to bed, what personal care tasks the person can do for themselves and a detailed explanation of how the staff should help the person with those tasks they could no longer do for themselves. This should include such tasks as dressing, washing, cleaning teeth, and eating. This will ensure staff are working in a consistent manner. People should be asked to sign their care plan to agree it is correct. 2 8 The home should approach Social Services to request advice and support to one person who wants to return to their own home. The home should seek advice from a pharmacist on how the level of information about each medicine could be improved to ensure the care staff have all of the information they need when administering medicines. The home should also consider improving the information in the care plans about the medications people receive, what they are for, and any special instructions, for example, how to Page 28 of 30 3 9 Care Homes for Older People 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 recognise when a person may be in pain and when pain relief should be administered. Where care staff complete medication administration recording sheets by hand the details should be checked by a second person who should sign to confirm the instructions are correct. The homes medication administration policy should be updated to ensure care staff have all of the information they need on all aspects of the receipt, storage, administration and disposal of medications. 4 10 Confidentiality should be maintained at all times. All records relating to the care of individuals should be stored in a room that can be secured to ensure complete privacy. The home should keep a written record of all complaints, any investigations carried out, and the outcome of the complaint. At least two satisfactory references should be obtained before any prospective new member of staff is offered a job. 5 16 6 29 Care Homes for Older People Page 29 of 30 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). 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