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Inspection on 02/12/08 for Riverside Rest Home

Also see our care home review for Riverside Rest Home for more information

This inspection was carried out on 2nd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Riverside has built up and maintained an excellent reputation regarding the trips and activities provided for those living at the home. The people who come for short stays regard the trips as an enjoyable part of their ` holiday` experience and the activities are also appreciated by those living permanently at the home. Staff provide a homely and responsive service, with daily routines being kept flexible. People are able to choose how they spend their time. The people spoken to felt that they received a high standard of care and that the staff team were very good. The home is well managed, with good training provided for staff and a high proportion of the team are now qualified. This means that people are supported by staff who have had their work practice assessed and are deemed to be competent workers.

What has improved since the last inspection?

Since the last key inspection certain improvements have been made. A new boiler has been installed and new flooring has been fitted in the porch area. The hot water is being tested, with records being kept, which helps to ensure that water is of a safe temperature. Improvements have also been made to the storage of cleaning and decorating materials, which are now safely stored. Improvements to the system for recruiting new staff have been made. The records viewed showed that appropriate references had been gained, which helps to ensure that only suitable people are employed at the home.

What the care home could do better:

The main aspect of the home requiring improvement is the actual physical environment. Some areas are looking unkempt and shabby and require attention. This will help to ensure that the home is an attractive and pleasant place to live. There are still some water outlets in resident areas that do not have thermostats fitted. This must be addressed in order to protect people from the potential dangers of the water being too hot.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Riverside Rest Home 17 West Beach Lytham Lancashire FY8 5QH     The quality rating for this care home is:   two star good 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: Lesley Plant     Date: 0 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 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 28 Information about the care home Name of care home: Address: Riverside Rest Home 17 West Beach Lytham Lancashire FY8 5QH 01253737317 01253737317 riversideresthome@daisybroadband.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carron Lesley Cayley Type of registration: Number of places registered: Mr Peter Fenton Warwick care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Learning disability - Code LD The maximum number of service users who can be accommodated is: 26 Date of last inspection Brief description of the care home Riverside is a family run home for older people registered to accommodate up to 26 residents of both sexes. The registration also allows for people with a learning disability to be accomodated. Mr and Mrs Warwick are the registered providers and their son and two daughters run the home on a daily basis, with the eldest daughter being the registered manager. The home offers accommodation in 3 double and 20 single bedrooms, most of which have en-suite toilet facilities. There are 2 lounges on Care Homes for Older People Page 4 of 28 Over 65 0 26 3 0 Brief description of the care home the ground floor and a dining room on the lower ground floor. All floors are serviced by a passenger lift. The home continues to provide permanent care and short stay holiday care, with a free transport service collecting and returning residents to and from home. The home has now earned a reputation for providing holiday type care and prides itself on the variety of activities, entertainment, outings and trips they provide. Details of the current fees and what is included in the fees is available from the home. Care Homes for Older People Page 5 of 28 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: This key inspection focused on the outcomes for the people living at the home and involved gathering information about the service from a wide range of sources over a period of time. The visit to the home was unannounced and looked at all of the key national minimum standards plus the standard relating to supervision arrangements for staff. At the time of the visit there were 18 people resident at the home. The inspector spoke to the registered manager, two care staff and five people living at the home. Information was also gained from the annual quality assurance assessment completed by the registered manager. This is a self assessment that focuses on how well positive Care Homes for Older People Page 6 of 28 outcomes are being achieved for people who use the service. It also provided some numerical information. CSCI surveys inviting feedback about Riverside were received from seven staff and eight people living at the home. Some relatives also added their comments on these surveys. Records were viewed and a tour of the building took place.Time was also spent observing staff and the people living at the home as they went about the days activities. The last key inspection was in December 2006, with a service review in January 2008.The report relating to the service review is held at the CSCI office and would be made available if requested. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 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. The assessment process helps to ensure that people are only admitted to the home if their needs can be met. Evidence: Full assessments are carried out prior to an individual moving into the home. The records for two people were viewed and showed that relatives are involved in the assessment process as appropriate to the individual. Risk assessments are also carried out. Risk assessments were seen in relation to medication and mobility. The information gathered is then used to inform the care plan for each person. Riverside also provides short term and respite care, with some people coming to stay for a week or two, perhaps when their main carer or family member is on holiday. The people who come for short periods see their visit as a holiday and a break from their usual surroundings. Assessments are also in place for those who come for short Care Homes for Older People Page 10 of 28 Evidence: breaks. Some individuals who have visited for a holiday break have then moved into the home on a permanent basis when their circumstances have changed. Feedback from surveys completed by those living at the home confirms that good information is provided about the home and that pre admission visits take place. Comments included; On our very first visit we were immediately impressed by the caring and helpful attitude of all the staff. The atmosphere was clearly friendly and relaxed and the clients were happy to speak to strangers about their home. Another person had written Came for several breaks over a three year period and when I had to become a resident I chose Riverside because I was well looked after in that period. An individual who was spoken to during this inspection visit explained that his daughter had taken him to see a number of homes in the area but that as soon as he visited Riverside he knew it was where he wanted to be as it felt very relaxed. The home does not provide intermediate care. Care Homes for Older People Page 11 of 28 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. Health and personal care needs are met and privacy and dignity is promoted. Staff training and good practice help to ensure that medication is handled appropriately. Evidence: The care planning information for two people was viewed. Care plans are in place and these are regularly reviewed. For one person who was poorly in bed, the care plan showed the changes regarding nutritional needs and the need for staff to now provide all personal care. During the lunchtime period staff were observed supporting this person with her meal, as outlined in the plan of care. Care plans show the preferred times for getting up and going to bed and where possible are signed by the individual concerned. Staff keep good daily records of how each person has spent their time. Risk assessments are also in place and address potential risks regarding mobility. Risk assessments give very good detail regarding how support is to be provided in order to minimise potential risks from falling. Care Homes for Older People Page 12 of 28 Evidence: CSCI surveys completed by staff confirm that up to date information about the support needs of the people in the home is made available to staff. Comments included; Every month the needs are updated by key workers, daily report to advise staff to read care plans when there has been a change and information is updated monthly/when required and is easily accessible to those requiring the information. Records are kept of each persons weight, with any significant changes being responded to. Good records are kept of any health care visits such as by district nurses or doctors. This means that any health issues can be monitored and tracked. For one person who is poorly and being cared for in bed, additional records of food and fluid intake and pressure care are being kept. The people spoken to all stated that their health care needs were being met. One person explained how the pain relief medication she was taking was making her feel sick. Staff had informed her GP who visited that day and prescribed pain relief patches to alleviate this problem. A stair lift had been installed to help one person access their bedroom which was reached by a few steps. This shows that the home are responsive to individual needs, although this person had later chosen to move to another bedroom. Medication is dispensed into blister packs by the pharmacist and is safely stored. Staff who administer medication have all received appropriate training in this area. The medication administration records for two people were viewed. These had been completed correctly and have a photograph of the person attached, which is good practice and helps to prevent mistakes being made. Staff use correct codes to indicate if medication has not been given for any reason. Following risk assessment people are able to look after their own medication if this is deemed to be safe. At present one person does so and has been provided with a lockable container to keep her medication in. Some people keep their own inhalers and creams in their bedrooms ready for using when needed. Privacy and dignity are promoted at Riverside. Most of the bedrooms have en suite facilities, meaning that individuals can be supported with their personal care in the comfort and privacy of their own bedroom. One person spoken to explained that staff give him support when he needs it but leave him alone when he wants to be alone. He explained that he liked to have someone with him when he took a bath just in case and that staff would provide this oversight discreetly. This persons mail was brought up to his bedroom and politely left for him to open. He explained that staff provided help with any official mail as his eyesight was poor and that staff would later help him Care Homes for Older People Page 13 of 28 Evidence: with this. Staff were observed as they went about their tasks and responded to people in a polite manner. During lunch staff provided support to people who needed help cutting up food and this was done quietly and discreetly so as not to cause embarrassment. Several people have a telephone in their bedroom and there is also a pay phone in the entrance hall for anyone to use. Care Homes for Older People Page 14 of 28 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. The excellent range of activities and trips out are highly valued by those living at the home. The service is flexible and responsive to the needs and preferences of individuals. Evidence: Details of preferred times for getting up and going to bed are recorded on individual files. Daily routines are flexible and take into account individual preferences. Some people choose to have meals in their bedroom and this is supported. An excellent range of activities and trips out are provided at Riverside. Details of planned events are displayed on the noticeboard. Events planned for this month included a pub lunch, brass band concert at the nearby theatre, a birthday buffet for a resident, a clothes party, a party at a nearby hotel and a concert performed by staff. The people living at the home who completed CSCI surveys responded positively when asked about activities at the home. Comments included; Very good. Bingo, shopping, theatre, I try my best to go on all the trips and Plenty throughout the year. The last inspection highlighted the excellent range of activities provided at Riverside. Care Homes for Older People Page 15 of 28 Evidence: This high standard has been maintained and continues to be a strength of the service. There is one person at the home who has a learning disability. Staff have developed close links with a well established learning disability provider organisation in the area and some of the team have undertaken specialist training. The individual has been to sample some day time activities, such as dancing, provided by this organisation and arrangements are being made for her to access this resource on certain days each week. This person also likes to wash crockery and this is built into her care plan. After tea, when the oven and hob are not in use, she is able to go into the kitchen and wash some dishes. This helps her to maintain her skills and to continue activities which are enjoyable and meaningful to her. Visitors are made welcome and people are supported to keep in touch with relatives. One person has a relative who lives some distance away and he is able to stay overnight at the home when he visits. The registered manager explained that this is offered if there is a room available. Two people who met at the home and formed a close relationship have moved into a double room. This move being supported by each persons family. This flexibility and responsiveness is a very positive aspect of the service. People are supported and encouraged to exercise choice and maintain control of their lives. Advocacy information is available. Some people are able to manage their own finances and for others a relative takes on this responsibility. Individuals are supported to look after certain elements of their medication such as creams and inhalers. People are able to bring their own possessions into the home and so personalise their bedrooms. The people spoken to said that they were happy with the meals provided. The main meal is at lunch time and tea is a choice of snack meals. People are asked to choose what they would like for tea as happened during this visit. Drinks and snacks are provided during the day, with cakes being served on the afternoon of this visit. Some people prefer to eat in their bedroom or in the lounge and this is supported. The main meal served on the day of this visit was nutritious and tasty. Certain cutlery and crockery is provided for some people, to help them to maintain independence when eating. At present a small number of people require their food to be blended. The registered manager is aware of good practice in this area and has attended training regarding the nutritional needs of elderly frail people. At present these people prefer to have the elements of their meal blended together. The registered manager is aware that the elements of the meal would usually be blended separately as this allows for more Care Homes for Older People Page 16 of 28 Evidence: accurate recording of what has been eaten and allows for different flavours to be appreciated. The preferences of the individuals involved are being respected in this matter. Care Homes for Older People Page 17 of 28 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. Staff training, written policies and good practice promote the protection of those living at the home and help to ensure that any concerns are responded to. Evidence: There is a formal complaints procedure in place. Responses from surveys completed by people living at the home confirm that individuals know how to raise any concern that they may have. During the visit it was clear that people living at the home have formed good relationships with the staff and managers, meaning that any issues can be raised and dealt with informally as part of day to day life at the home. Management staff and most of the care staff have completed training regarding protection and abuse and refresher training is being planned. Care staff also receive guidance as part of their induction period and abuse is covered within NVQ (national vocational qualification) programmes. Some staff have also undertaken training regarding challenging behaviour. Written policies regarding protection help to guide staff in their work. There are good arrangements in place regarding the safekeeping of money. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is warm and cosy, however some parts of the building require refurbishment and redecoration . Evidence: Riverside is situated on the sea front and is close to both the town and the Lowther pavilion theatre and park. Most of the bedrooms are single and most have en suite facilities. Since the last key inspection a new boiler has been installed, new flooring laid in the entrance porch, a smoking shelter erected at the rear of the home and a stair lift installed to improve access to some bedrooms which are reached by a short flight of stairs. Decoration and refurbishment of the home is ongoing, with bedrooms decorated as they become vacant. There are some parts of the home which need attention. A number of the bathrooms and toilets need updating and require new flooring and fittings. One of the bedrooms viewed was in need of decoration as was the landing. This area was stripped and ready to be decorated. Another bedroom had a problem with a window leaking. The carpet in the dining room is in need of attention or replacement. This room is on the lower ground floor and can seem rather gloomy, which is not helped by the tired looking Care Homes for Older People Page 19 of 28 Evidence: carpet. Maintenance records are maintained and these were viewed. The registered manager is aware of the areas which require attention and there is a planned programme of renewal and decoration in place. The areas highlighted must be attended to. The home was warm and appeared clean and odour free. Domestic staff are employed. Care staff carry out laundry tasks, with the night staff doing the ironing. Staff undertake infection control training as part of the core training programme at the home. A disposal contract is in place regarding soiled waste. Feedback from the people living at the home who completed CSCI surveys confirmed that the home is always kept clean. Care Homes for Older People Page 20 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a well organised programme of staff training and excellent opportunities for staff to gain relevant qualifications, helping to ensure that people are supported by skilled and competent workers. Evidence: On the day of this inspection visit there were three care staff on duty plus cleaning and kitchen staff. The registered manager explained that there are always three care staff available from 8 am to 9 pm, with two night staff on duty throughout the night. Staffing levels are increased if trips are arranged and at other times when it is required. Rotas were viewed, which showed that these levels are being maintained and that management staff are on duty in addition to this basic cover. The people spoken to confirmed that staff are available when they need them and that this includes assistance during the night. The staff team has remained stable and no agency staff are used. Team members work extra hours to cover for holidays and sickness. This means that people know who is going to be helping them and helps to ensure consistency of care. The excellent commitment to qualification training for staff has continued, with 13 of the 17 care staff on the team having gained NVQ (national vocational qualification) at Care Homes for Older People Page 21 of 28 Evidence: level 2 or above. This means that staff have had their work practice assessed and helps to ensure that people are supported by skilled and competent staff. The recruitment records for a recently appointed member of care staff were seen. Records include an application form, two references, including one from their last employer, a criminal records bureau disclosure and a record of the check against the nationally held list of people who have been deemed unsuitable to work with vulnerable people. Copies of certificates relating to training completed with their previous employer were also available. Training and induction records were viewed. The training matrix for the team shows that most staff have completed training regarding fire safety, health and safety, food hygiene, first aid, moving and handling and infection control. This training helps to ensure that staff are working in a safe manner. Two members of staff were spoken to and confirmed that good training opportunities are provided and that this includes refresher training of areas already covered. Following a period of induction, staff are encouraged to register for NVQ training. The home is also able to accommodate a small number of people with a learning disability and some staff have undertaken specific training in this area. Riverside has developed good links with a well established learning disability service in the area and use this service as the training provider for most courses for the staff team. This helps to ensure that any specialist needs can be addressed and equips staff to work with older people and with people with a learning disability. Care Homes for Older People Page 22 of 28 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. Staff are supported in their work and quality monitoring systems are in place, helping to ensure that good standards are maintained. Evidence: Riverside is a family run home. Mr and Mrs Warwick are the registered providers and their son and two daughters run the home, one being the registered manager. Both the registered manager and her sister have gained NVQ level 4 and the registered managers award. Each family member has specific management responsibilities and all have many years experience in the field of social care. The two assistant managers, the deputy assistant manager and senior care assistants also carry out certain management tasks at the home. Senior staff have good opportunities to update their knowledge and skills. Staff who completed CSCI surveys confirmed that they feel well supported in their work. Riverside has achieved the Investors in People award, an external quality management Care Homes for Older People Page 23 of 28 Evidence: award. Internal quality monitoring systems are also in place. There is a suggestion box in the entrance hall, although this is rarely used as the informal and open atmosphere means that issues, ideas and any problems can be easily raised with any of the senior staff. Occasional residents meetings take place and there are plans to hold short meetings following activities such as quizzes, which may encourage more people to attend. Some people prefer to voice their opinions individually and this is encouraged and means that those with hearing problems who may find group discussion difficult are not being disadvantaged. Questionnaires are given to each person who stays for short term or holiday care, inviting feedback about the service provided at Riverside. Some of these were viewed and show a general satisfaction with the care provided. The home has an employee of the month award and the picture of the current months nominated staff member was displayed on the noticeboard. People staying at the home are asked to give feedback or to make a recommendation for this monthly award. Good records are kept of any monies held on behalf of people staying at the home. For some people a record of expenditure, such as hairdressing costs, is kept and then the person or their relative is sent a bill. For others small amounts of money may be held and records of income and expenditure maintained. Some people are able to manage their own money. Records of supervision were viewed in relation to two members of staff. These include a record of observations of work practice such as moving and handling. Appraisals also take place and the appraisal format used includes a useful self appraisal completed by the member of staff plus the comments of the manager. Occasional staff meetings take place, as confirmed by the comments on the CSCI surveys completed by staff. Generally there are good arrangements for maintaining the health and safety of those living at the home. Records were seen of fire equipment and the emergency lighting system being checked and of the fire alarm system being tested. The core training programme for staff includes training regarding first aid, food hygiene, health and safety, fire safety, infection control and moving and handling. These programmes are regularly updated and give staff useful information which is put into practice at the home. The last inspection highlighted the need for water temperatures to be checked and hazardous substances to be safely stored and these have been addressed. However there are still some water outlets in resident areas which do not have thermostatic temperature control and this must be attended to. The registered manager confirmed that these were being installed in wash basins as each bedroom was decorated. Care Homes for Older People Page 24 of 28 Evidence: The overall management of the home is very good, as reflected in the feedback from both staff and residents. The owners and managers of the home need to give the refurbishment and decoration of the home a high priority. Care Homes for Older People Page 25 of 28 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 28 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 19 23 All parts of the home must be furnished and decorated to a reasonable standard. This will mean that the home is an attractive place to live. 31/08/2009 2 38 13 Thermostats must be fitted to all water outlets in areas accessed by those living at the home. This will help to ensure that people are protected form the dangers of water being too hot. 31/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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