Inspection on 19/08/09 for Rushall Care Centre

This inspection was carried out on 19th August 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rushall Care Centre 04/11/08

Rushall Care Centre 05/09/07

Rushall Care Centre 05/07/06

Rushall Care Centre 18/11/05

Rushall Care Centre 23/08/05

Rushall Care Centre 11/10/04

Rushall Care Centre 27/08/04

Rushall Care Centre 17/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Rushall Care Centre 204 Lichfield Road Rushall Walsall West Midlands WS4 1SA     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: Amanda Hennessy     Date: 1 9 0 8 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: Rushall Care Centre 204 Lichfield Road Rushall Walsall West Midlands WS4 1SA 01922635328 01922642393 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.schealthcare.co.uk Exceler Healthcare Services Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 39 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 39 Date of last inspection Brief description of the care home Rushall Care Centre is a care home providing nursing and personal care for up to thirty-nine older people. The home is a purpose built, three storey building. The home has two double bedrooms the remainder of bedrooms are single occupancy. There are two communal lounges and a separate dining room. There is a passenger lift giving access to all three floors. Laundry and catering services are provided within the home. Care Homes for Older People Page 4 of 30 Over 65 39 0 Brief description of the care home A small secure garden is at the rear of the home.The home is located in Rushall, close to all local amenities. There is a main bus route to Walsall town centre; limited car parking is available at the home. As no information is provided in this report in relation to fees the reader is advised to contact the service for this information. 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: This unannounced Key Inspection was carried out by two inspectors on one day from 9.10 a.m. - 4.10 pm, neither the home nor the provider knew that we would be visiting. There were thirty-two people in residence at the time of our visit. The National Minimum Standards for Older People were used as the reference for the inspection. Information for the report was gathered from a number of sources: a questionnaireAnnual Quality Assurance Assessment (AQAA) was completed by the Home Manager and was sent to us before the inspection when we asked for it; We looked around most of the home including peoples rooms, bathrooms, toilets and communal rooms. Records about the safety of equipment and the building were also checked. Twenty-three written surveys were returned directly to us from people living in the Care Homes for Older People Page 6 of 30 home and their relatives. The survey forms are known as have your say about Rushall Care to enable people to tell us about their experiences of life at the home. We had discussions with the Home Manager, Operations Manager, care staff and people who live in the home and their relatives, to gain their views of what it is like to live at the home. We looked at how the service has responded to concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people who live in the home. Four people who live in the home were case tracked. Casetracking involves establishing peoples experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at their care records and focusing on outcomes of the care that they receive. Tracking peoples care helps us to understand the experience of people who use the service. As part of this process we also looked at peoples medicines, how they are ordered and records of their administration. 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 gave the home an immediate requirement that there must be sufficient quantity of and appropriately sized hoist slings available so that frequent laundering can take place whilst ensuring availability for people living at the home. Staff must ensure that people receive the medication that they are prescribed and follow up anything they are unsure of quickly with the persons doctor. We have also advised that staff all have training as soon as possible in the Mental Capacity Act and the Deprivation of Liberty Safeguards and are made aware of their Care Homes for Older People Page 8 of 30 responsibilities within this legislation. 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 have their needs assessed and required information about the home to enable them to make the decision that the home is suitable for them. Evidence: The home has a statement of purpose and service user guide that provides people with information about the home. A copy of the service user guide is available in peoples bedrooms for them to refer to when they need to. People always have an option to visit the home before they make the decision to move in there, if they are not able to take up this opportunity their relatives may visit on their behalf. People have an assessment of their needs before a decision is made that the home may be suitable for them. The assessment of their needs is usually undertaken by the Home Manager. It is also positive that the home also has copies of the social workers Care Homes for Older People Page 11 of 30 Evidence: assessment of their needs. Assessment of peoples needs we saw contained detailed information about the person, their needs, choices and capabilities. It is also positive that a draft care plan is formed following this assessment which then forms the basis of a more detailed plan of care when people move in and staff have a better opportunity to get to know them and their capabilities. The service 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. People who live at the home have their needs identified and met. The management of peoples medicines needs to be improved to ensure that people all have the medicine that they are prescribed. Evidence: Care needs are identified following an assessment of the persons needs. Information is initially included in a draft care plan and as staff get to know them a more detailed plan of care is developed. Care plans we looked at generally provided good information about peoples needs and gave detailed instructions for staff how these needs should be met. When we spoke to staff about the needs of the people we casetracked they told us how they involved a person with limited communication is their care: he has good days and bad days, on a good day he is quite able to make his needs known and will smile and answer, on bad days he lets us know that he cannot understand what we are saying to him, we have to try to interpret what he wants then. The home has a key worker system so their key worker gets to know the person and Care Homes for Older People Page 13 of 30 Evidence: is able to say when they need items such as clothing and toiletries. The persons key worker write a monthly report which informs the monthly review of their care plans. Staff on each shift (usually the trained nurse) makes a record of the persons day and their general health. The service has good systems in place to monitor peoples health. This includes risk assessments for falls, pressure sores and poor nutrition which includes regular weight checks and the use of bedrails with actions in place to minimise any risks. There are also risk assessments for the safe moving and handling of people. These risk assessments need to detail the size of the sling and the type of hoist that staff should use. We have made a requirements about the availability of slings for the hoist within the management and administration section of this report. We were able to see that when there is any changes to the persons health staff ensure that they are seen by their doctor. People told us when we asked what the home does well: looks after people in the home, makes sure they are fed and clothed well and their medical and hygiene needs are well catered for,and I get cared for very well, we couldnt be better looked after. People have access to other health professionals depending on their needs such as opticians, dentists, chiropodists and Speech and Language therapists and we were able to confirm this by records seen. We were able to see that care instructions are proactive to ensure that any concerns are quickly identified and people have the appropriate professional advice, for example one person was identified at risk of pressure sores, care instructions detailed actions that staff needed to reduce the risk of them developing pressure sores and should their skin break down the Tissue Viability Nurse Specialist should be contacted immediately. The management of medicines at the home is undertaken by qualified nurses. Medicines are stored safely within the home in medicine trolleys that are secured to the wall in the large treatment room which is also kept locked. Staff record both the treatment room and medicines fridge temperature to evidence that the medicine is being stored at the correct temperature. Staff sign to confirm when medicines are given and if they are not a code is used to detail the reason why not. We checked some peoples medicines and found that mostly staff had followed the prescribed instructions. We did find however that one person was prescribed eyedrops as directed but had not received these eyedrops although they had been staying in the home for nine days. We spoke to the Manager about this and were told that staff had contacted the persons doctor for instructions about when they should give the eyedrops but had not yet had a response, the Manager did tell us that they would immediately follow up this matter. The same person was also prescribed paracetamol, although the number of staff signatures confirming that they had given the person the paracetamol and the amount of medication remaining were incorrect (six tablets too Care Homes for Older People Page 14 of 30 Evidence: many) and we could not determine if this person had actually received this medication. Staff must ensure that medicines are given as prescribed to ensure that their health and well being is maintained. The homes induction programme includes a section on treating people with respect. We observed staff to knock before entering bedrooms and toilets and interacted in a friendly and open way using peoples preferred name. Care Homes for Older People Page 15 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. People have the opportunity to make choices about their life in the home and maintain relationships with friends and relatives. Evidence: Peoples interests and choices are recorded within their care records. Staff also try to ascertain the persons life history and background to enable them to get to know the person more. Staff also ensure that information in relation to peoples choices such as the time that they go to bed and get up and food and drink that they like and dislike is identified. We were told that people can choose when they get up, go to bed and spend their day, which we also saw during our visit. The home has a new Activity Organiser. Staff and people living in the home were in agreement: She is excellent.A plan of activities for the coming week was displayed on the notice board and included games, singalongs and a pamper session, it is also positive that the home has a mens group. There is an active League of Friends who fund raise for the home and people who live there to enable them to have more social events. Visitors are able to visit the home at any reasonable time. One relative told us: they always give visitors a warm welcome someone else said we have only just got here but they have been very friendly and helpful. We were told that the home offers Care Homes for Older People Page 16 of 30 Evidence: people living at the home the opportunity to take communion if they wish to. The home has a four-week rolling menu. People can have a hot breakfast every day if they choose to and in addition cereals and toast are always available. The main meal of the day is at lunchtime. There is always a choice of meal with a note on the menu to say if people require an alternative such as a salad or jacket potatoes they only need to ask. The food was found to be tasty and was also enjoyed by people living at the home. Drinks are available throughout the day. People living at the home told us: the food is very good. and mealtimes are good. Meals are served either in the dining room or in peoples own bedrooms if they prefer which we saw during the inspection. The home had had an Southern Cross audit just before our inspection which highlighted areas of improvement at meals times, required improvements such as all meals to be given out on trays with the plates covered and dining tables with appropriate cutlery were all addressed at our visit although the same audit did highlight that several people were left to have their meals in the lounge. We did find that eight people remained in the lounge, the majority of whom were fully dependent on staff and needed staff to feed them. When we asked staff why they stayed in the lounge they told us : they seem to prefer to stay here. The main dining room (there is also a small dining area in the upstairs lounge) although very pleasant, is small and would not be able to accommodate all people living in the home but we were unable to ascertain if this was the reason. Care Homes for Older People Page 17 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. There are appropriate procedures in place to listen to people who live in the home and keep them safe. Evidence: The complaints procedure is included in the service user guide and is also displayed in the home. The home have told us that they have had twelve complaints in the last year. We found that there is a log of complaints, letters of acknowledgment are sent, but we saw no information on the investigation and the response to the complainant. We were told this was due to all complaints being responded to by a senior manager within Southern Cross and those records which we did see did have a detailed letter to the complainant on the outcome of their complaint. We have had two complaints about the home (included within the twelve that the home have identified). We visited the home as a result of the concerns raised on 5th September 2008 when we made requirements on the home for improvement. A subsequent visit was undertaken on the 4th November 2008 to assess the homes compliance with our requirements. We found that the requirements were met and although improvements had been made since our previous visit further improvements were needed- copies of the random visit reports for the 5th September 2008 and 4th November 2008 can be requested from us. People we spoke to all said that if they were unhappy would they knew who to speak to people also said the girls are in my room all the time I would tell them if I Care Homes for Older People Page 18 of 30 Evidence: was unhappy, and a relative of a person who had recently come to live in the home said: so far they have bent over backwards to help us, they are much better than the last place we stayed at. The home has had five safeguarding referrals some of which we made following our visit on the 5th September 2008 which related to falls people had sustained some of which may have been preventable. We have found that when requested a senior manager investigates the concerns and produces a comprehensive report which is shared with the safeguarding meeting. Staff at the home all have had or are currently have a place to undertake safeguarding training . We found that staff we spoke to were clear of what may constitute abuse and what actions they should take to keep people safe and minimise any risk to them. They told us I wouldnt hesitate I would go straight to the manager, Its wrong and mustnt go on it has to be stopped. All of the staff said that they had heard of the whistleblowing policy and know of they should report poor practice whilst feeling confident that they would be protected. Staff did not know about the Mental Capacity Act or the Deprivation of Liberty safeguards (this act details what actions should take place if people are unable to make choices such as who they see of when they can go out of the home), however the manager did tell us that training was being organised for the staff in the near future. Care Homes for Older People Page 19 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. The home provides pleasant and safe accommodation for people who live there. Evidence: The home was found to be homely, clean, tidy and free from any offensive odour and decorated and maintained to an acceptable standard. Since our last inspection there have been new carpets throughout the home and the redecoration of the home is ongoing. There is some signage around the home to tell people the location of bathrooms and toilets, although not all bedrooms had names or numbers on to help people find their bedroom. There is one main lounge area on the ground floor and another on the middle floor both lounges were pleasantly redecorated, although people told us they would benefit from new chairs. The dining room is also on the ground floor. There is a small garden area to the rear of the home with decking and garden furniture to enable people to sit out in the warmer weather. The home has two double bedrooms although we were told that they are no longer using them for two people. Peoples bedrooms are pleasant with most adorned with photographs and other treasured belonging making them homely and welcoming. All bedroom furniture is in very good condition and there are comfortable chairs also in Care Homes for Older People Page 20 of 30 Evidence: peoples rooms. Care Homes for Older People Page 21 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. The home has sufficient staff who understand and meet peoples needs. Recruitment and selection processes are good and protect people who live at the home. Evidence: Staffing levels at the home for 32 service users are: 08.00- 14.00 2 trained nurses and 6 care staff (with one carer starting at 07.00hrs) 14.00-20.00 2 trained nurses and 4 care staff 20.00- 08.00 1 trained nurse and 3 care staff. When working the Activities Co-ordinator is additional to care staff and there are adequate numbers of support staff including domestic, catering, laundry maintenance and administration. Staffing levels appear to meet peoples needs, we spoke to one person and asked them how they have to wait for the buzzer to be answered, they told us: not long at all dear they are very quickand staff are very responsive. Staff told us: I think we have enough staff, you could always say you need more but the staff team here are very good and we support each other. The home currently has seventy one percent of its care staff with a minimum of National Vocational level 2 qualification (NVQ) or equivalent. The home therefore Care Homes for Older People Page 22 of 30 Evidence: meets the recommendation that they have at least 50 of care staff with NVQ 2. Staff recruitment and selection is undertaken appropriately and meets the required standard. All required checks such as criminal records checks and references are checked before staff start work at the home and ensure that any risk of unsuitable people working at the home is minimised protecting people who live there. All new staff spend a week being trained before starting work, so that they are equipped to care for people. When they do start they are supported by senior care staff. Staff are supported to undertake further training. All staff we spoke to us told us that they have regular ongoing training. We observed staff interacting positively with people in the living at the home, they were highly dependent and had very limited communication staff were seen to provide reassurance by stroking peoples hands and gave people drinks and assistance where needed. Care Homes for Older People Page 23 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 has effective leadership and good systems in place to ensure that people are safe and their health, welfare and safety is protected. Evidence: The home management has changed several times since our last full inspection. Rebecca Adams was appointed the Home Manager in May. Rebecca was previously working at the home since November as Deputy Manager. Mrs Adams is a qualified nurse and has many years experience within healthcare. Mrs Adams told us that she had just successfully completed her trial period and will now be applying to us to be registered manager. The home manager is currently undertaking recommended management qualifications to manage a care service. The Home Manager has expressed a wish to continue to improve standards at the home. Staff told us: Becky is very approachable you can talk to her about any concerns you have. Other professionals also told us that Mrs Adams is very capable and had confidence in her management skills. In addition the AQAA identifies that: Care Homes for Older People Page 24 of 30 Evidence: The Home Manager on a daily basis speaks to people on a daily walk round which gives people an opportunity to raise any issues they have. The Home Manager holds four managers surgeries a month which are advertised in advance on the Visitor notice board in the foyer. We have identified within the complaints and protection section of this report that staff were not aware of the Mental Capacity Act and the Deprivation of Liberty safeguards or their responsibilities under this legislation. We advise that all staff have training in this legislation so that they are aware of their responsibilities under the legislation The Home Manager completed the homes AQAA which was returned to us when we asked for it. The AQAA gave us adequate information about the service and developments that have been made although more information could have have been included on current developments. The home has an identified quality plan. Until recently the Home Manager has been completing a monthly audit of the care environment, this has included medication, care plans, environment, staffing, kitchen and activities. All reports were completed and sent to head office and issues arising have been dealt with, for example, the kitchen audit identified a faulty dishwasher that has now been repaired. In July this system was replaced by peer review. The manager explained that a visiting manager will come to the home and complete a thorough audit of the service. Suggestions are made and actions points agreed for improvement. The information from the most recent Southern Cross key outcome inspection tool showed the home is performing very well but there were some improvements to be made to care planning, the home scored 86 in this area. Other comments included more activities to be done, tables to be laid for people at meal times, with condiments, better planning for end of life care. We saw the home had taken action to provide more activity for people and taken the time to lay the tables for people at meal times. We were told that the improvements identiied for End of life care planning is still ongoing. People are surveyed about their experiences and quality of service they receive, the last time this was done was November last year, relatives, professionals were also included. The results of this survey were very positive and we saw that an action plan had been developed following the results of the surveys, this included making more domestic hours available to address the cleanliness within the home. The AQAA also states: the views of all residents is taken into account before any changes are made that may affect them in any way. Secure facilities are available for the safe keeping of peoples personal money and Care Homes for Older People Page 25 of 30 Evidence: valuables. Records are available for all transactions which detail the reason for the withdrawal, receipts are available as proof of purchases. All money is kept within a bank system and we were able to see that interest is added monthly to any balances. We did identify one error in the money we checked when hairdressing money had been deducted twice. A senior regional administrator was working at the home on the day of our visit and told us that this mistake would have identified as she checks all financial transactions monthly. The home has computerized records of all training statistics which show that eighty-one percent of staff have received all statutory training and when needed training is booked to address any gaps. The home also has trained trainers to deliver training. We spoke to staff who told us the training is very good I think we get plenty and it keeps us up to date, Ive been trained as a trainer, I take it very seriously and make sure that slings, hoists and other equipment are regularly checked for safety reasons. One person did tell us that the home has a limited amount of slings available and the current one in use was marking people. We checked the slings and found that the home did not have a full range of sizes and we requested immediate action to address this. The AQAA confirms that maintenance contracts for the building is up to date we also found that the home is in a good state of repair and equipment is in working order. Staff also said we dont need anything, if we did they would get it for us. All of the staff we spoke to confirmed they had had fire training, and a recent fire drill. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 31 8 There must be a registered 28/02/2009 manager as identified by the Care Standards Act 2000 Section 11 (1). The home will have a competent manager who has been asessed as being an appropriate and fit person to manage the home. 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 1 38 12 There should be sufficient and appropriately sized slings to ensure frequent laundering can take place and sufficient slings will also be available. This will ensure that the risk of cross infection is minimised and that people will not be injured by the use of inappropriately sized slings. 25/08/2009 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 9 13 People must have the medicines that they are prescribed. To ensure that the people have the medicine they are prescribed for to maintain their health and well being. 16/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The type of hoist and size of sling should be detailed with the person moving and handling risk assessment. Page 28 of 30 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 2 18 Staff should have training in the Mental Capacity Act and the Deprivation of Liberty safeguards and their responsibilities under this legislation. 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). 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 30 of 30 - 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!