Inspection on 03/12/08 for Seagull Rest Home

This inspection was carried out on 3rd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Seagull Rest Home 25/11/09

Seagull Rest Home 11/10/06

Seagull Rest Home 22/11/05

Seagull Rest Home 29/04/05

Seagull Rest Home 12/10/04

Seagull Rest Home 26/05/04

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Seagull Rest Home 131 Stocks Lane Bracklesham Bay Chichester West Sussex PO20 8NY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Annette Campbell-Currie     Date: 0 3 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 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 32 Information about the care home Name of care home: Address: Seagull Rest Home 131 Stocks Lane Bracklesham Bay Chichester West Sussex PO20 8NY 01243670883 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Maniben Odedra care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 23 The registered person may provide the following category(ies) of service only: Care Home only (PC) to users of the following gender:Either Whose primary needs on admission to the home are within the following categories : Dementia (DE ) Mental disorder ,excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Seagull Rest Home is a care home able to provide care and support for up to 23 residents who may have dementia or another related mental disorder. It is situated next to a main road close to the village of Bracklesham Bay near Chichester. Local shops and other community facilities are within walking distance. The accommodation is a single story building with a car park area to the front of the building and paved areas to the rear. Communal areas include a lounge and a dining area. There are twenty one single bedrooms and one double bedroom. Two bedrooms have en suite facilities. Care Homes for Older People Page 4 of 32 23 23 Over 65 0 0 Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The previous key unannounced inspection was carried out on 11th October 2006 and an Annual Service Review (ASR) was carried out on 4th December 2007. The current fees are from 410 to 475 pounds per week. Annette Campbell-Currie carried out the site visit over five and a half hours. The registered manager left in November and since then the deputy manager has been managing the service on a day-to-day basis. The deputy manager assisted with the inspection. Mrs Odedra, the registered provider and a business associate were also available for part of the day. The information and documents required by us (the Commission) were available. There were fourteen people living in the home at the Care Homes for Older People Page 6 of 32 time; one person had been admitted to hospital the previous day. The previous manager completed an annual quality assurance assessment form (AQAA) before the inspection. The AQAA provided information that was used to help plan the site visit. During the site visit everyone staying in the home was seen and three people were spoken with. Time was spent with the deputy manager and the cook. The information gathered has been used to help make an assessment of the service. A tour of the building including communal areas, the kitchen, food storeroom, laundry, bathroom and toilet facilities and a number of bedrooms. The following documents were read: the case records of three people living in the home, the complaints records, recruitment records for three staff, some training records and a sample of medication records. Time was spent in the dining room at lunchtime and the medication round was observed. The outcomes for people living in the home have been assessed in relation to twentythree of the thirty-eight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. Seven requirements and two recommendations have been made following this inspection. What the care home does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments must provide clear guidance to staff so that people receive the care that they need and risks to people living in the home and staff are minimised. A requirement has been made regarding this matter. People must be provided with activities that meet their needs and interests. Including individual time with staff when this is needed. A requirement has been made regarding this matter. The records of complaints must show timescales, actions taken and outcomes so that people know their complaints will be listened to and acted upon. A recommendation has been made regarding this matter. The programme for the development of the service must be in writing with planned timescales for the completion of work and ongoing review. A plan should be developed to minimise the impact for people living in the home. A recommendation has been made regarding this matter The advice of a fire officer must be sought regarding the closure of fire doors and the use of wedges for propping doors open. A requirement has been made regarding this matter. Criminal Record Bureau (CRB) or POVA First checks must be obtained before a new member of staff begins work. Two written references must be obtained and gaps in employment explored before a decision is made about a persons suitability for care work. A requirement has been made regarding this matter. Care staff must have training in working with people who have a dementia. A requirement has been made regarding this matter. A system of quality assurance must be developed in order to make sure that people have some input into the development of the service and the management team keep Care Homes for Older People Page 8 of 32 the quality of the service under review. The registered provider must provide Regulation 26 reports on a monthly basis and any required action should be discussed with the manager. A requirement has been made regarding this matter. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 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 32 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 before a decision is made about them moving to the home. Evidence: The manager said in the annual quality assurance assessment (AQAA) form that a senior member of staff carries out assessments to make sure that the home would be able to meet the persons needs. Relatives are involved in this process when possible. The deputy manager said that she had recently visited someone moving from another care home to carry out an assessment. Copies of care plans used in the previous home were obtained and the person was reassessed after two weeks at Seagulls to make sure her needs were being met. The case records of three people were seen and included assessments that had been carried out before the person moved in. All aspects of health and personal care needs Care Homes for Older People Page 11 of 32 Evidence: were noted including: psychological state, mobility, medical history, nutritional needs, personal hygiene and social activities and spiritual or religious needs and wishes. There was no detail about the persons life history and little information about the persons interests. People have the opportunity to visit the home to make a decision about moving in, although it is usually family members who visit on behalf of their relative. People are able to have a trial period in the home to make sure they are satisfied that the home can meet their needs. There was an admission check list in the case records seen that included information to make sure that everything is in place to help the person when they move in. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care needs set out in a plan of their care. The care plans and risk assessments do not always provide clear guidance to staff. People have their health and personal care needs met. The medication policies and procedures protect people who live in the home. People are treated with respect and their right to privacy is upheld. Evidence: There is a care planning and review process. The case records for three people were seen and none of these included photographs. There were care plans for different aspects of peoples needs including personal and healthcare needs. The care plans included risk assessments that provided some guidance to staff for example: offer X reassurance so she feels safe in her surroundings. Encourage X to express any anxieties she may have. There was guidance about managing continence and personal care needs. There is an emphasis on encouraging people to maintain as much independence as possible, there was a note on one persons file: encourage Care Homes for Older People Page 13 of 32 Evidence: independence, please dont support with feeding X. There was little information about peoples life history or interests to give staff some direction when spending time with people. This is particularly important for people who have a level of confusion and may not be able to verbally recall a lifestyle that may be important to them. There was a note on one persons case notes that said: loves music, daughter will visit daily. Risks had been identified for one person who can display aggressive behaviour at times; for one person there was a note that said: aggressive at times, if X says no he means no. There was no further guidance about possible triggers to these behaviours and how staff should support him if he were to become aggressive. The deputy manager said that she would contact the community psychiatric nurse for guidance about recording and managing these behaviours. It was clear that some other aspects of risk had been noted and that when a change of need occurs a new risk assessment is carried out and action taken to minimise risks. There was an example of this in one persons care plan. There was evidence to show that care plans and risk assessments are kept under review. It was recommended that a risk assessment format should be used where a risk has been identified so that guidance, actions and outcomes are clear. The deputy manager said that some people have annual reviews arranged by staff from the social services department. It was not clear on the care plans seen that an assessment had been made of the persons ability to make an informed choice in line with the Mental Capacity Act. It should be clear when people are not able to make decisions in their lives and if this is the case how decisions should be made on their behalf. Some aspects of peoples health needs were noted and a record kept of contact with healthcare professionals. It was clear that people have access to a general practitioner (GP) when they need to see one and it was clear that people had seen a chiropodist recently. It was noted that one person had had an influenza injection. Some people had problems with oral hygiene and it was recommended that the deputy manager access a local dentist to provide guidance on this issue. It would not be safe for any of the people in the home to administer their own medication. The storage and recording of medication was seen and lunchtime medication administration was observed. The staff who administer medication have all attended training so that they understand their responsibilities. There were photographs on some of the recording sheets and the deputy manager was advised to make sure that all sheets have a photograph of the person to prevent medication Care Homes for Older People Page 14 of 32 Evidence: errors. The deputy manager was advised to access the guidance regarding the storage of controlled medication to make sure that the system complies with legislation. Staff are provided with guidance about how to provide care as part of their induction programme. During the day staff were observed to be treating people with respect and talking to people in a sensitive manner. People were not being rushed and were supported to do things at their own speed. Care Homes for Older People Page 15 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People may not find the lifestyle in the home matches their expectations. People are supported to maintain contact with their relatives. People are able to make some choices in their lives. People are provided with a healthy and nutritious diet. Evidence: There is no programme of activities in the home. There was little information about peoples interests in their case records. During the day people were sitting in the lounge, some were watching television. The deputy manager said that she is planning to introduce some external activities organisers who have specialist knowledge about working with people who have a dementia. She also said that staff try to spend oneto-one time with people when they can and on three days there are three care staff on duty and they sometimes arrange activities. In the summer people sometimes sit in the garden. There were not enough staff on duty during the day to spend time with people on an individual basis and there was no indication in care plans about one-to-one time and when this should take place or what activities the person might enjoy. One person spoken with said she was pleased that no activities were planned, as she does not like Care Homes for Older People Page 16 of 32 Evidence: joining in. The previous manager said in the AQAA that the home keeps a list of peoples interests and that in the past people have been supported to attend local clubs. People are supported in their contact with family and friends. There is no restriction to visiting times in the home and several people have regular visitors. The previous manager said in the AQAA that people would be welcome to have a meal with their relative if they wished to. There is a small lounge with a ramp to the garden that could be used as a visitors lounge where people could meet in private. This room is currently being used as a storeroom. People are able to make some choices in their daily lives although it was not clear in the case records the extent to which people are able to make choices or decisions. The times that people like to get up in the mornings were noted on case records and breakfast can be taken between 7 and 10 in the morning to accommodate peoples choice. One person said that she can get up in her own time and is not rushed. People are provided with a cooked meal at lunchtime and a hot snack or sandwiches at suppertime. The cook compiles the weekly menus with the deputy manager and has different meals each week so that people have a variety. Fresh vegetables are used as much as possible and food is home cooked. Tea and homemade cakes are provided in the afternoon. The cook said that he gets to know people when they come to the home and makes a note of their likes, dislikes, special dietary needs or allergies on a cardex system that is kept in the kitchen for reference. Special diets are catered for; two people have diabetes and he makes sure that they can have a similar meal to others with ingredients that meet their needs. The cook compiles a shopping list of ingredients and the provider buys what is needed on a weekly basis. A local butcher is also used. The lunch was home cooked and appetising with fresh meat, vegetables and stewed apple for dessert. Two people said they enjoy the food and that they always have plenty. There are two dining areas and twelve of the thirteen people in the home at the time ate in the dining room. Lunchtime was unhurried, however there were only two staff to assist people in the dining room. There were three people who needed assistance with eating and one person had to take it in turns to feed two people. People are weighed each month and any fluctuation in weight would be monitored and addressed if necessary. One person is being cared for in her room and the deputy Care Homes for Older People Page 17 of 32 Evidence: manager was advised to seek the advice of the community nurse about recording and monitoring this persons fluid and nutritional intake to make sure she is getting the nutrition that she needs. Care Homes for Older People Page 18 of 32 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 adequate 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 their complaints will be listened to and acted upon although the record of complaints does not always make this clear. There are some measures in place for safeguarding the people who live in the home however the recruitment process does not protect people living in the home. Evidence: The home has a complaints policy that is provided to people living in the home and their relatives. Two complaints have been recorded in the past twelve months. The deputy manager was advised to make sure that a recording system is developed that shows the actions taken following a complaint with the outcomes and timescales so that it is clear that peoples concerns are being investigated and their confidentiality is protected. The commission has recently received an anonymous complaint that has been investigated by staff from the social services department under the safeguarding protocols; they found the allegations unfounded and intend to take no further action. The home follows the West Sussex multi agency policy and procedure regarding safeguarding vulnerable adults. All staff have attended training in recognising and reporting adult abuse. The deputy manager is aware of her responsibilities under the safeguarding protocol and incidents of concern have been appropriately reported. Care Homes for Older People Page 19 of 32 Evidence: The recruitment records for three staff were seen and all had started work before an enhanced Criminal Record Bureau (CRB) or POVA First check had been obtained, this practice could put people at risk of harm or exploitation. A requirement has been made regarding this matter. Care Homes for Older People Page 20 of 32 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 undergoing a programme of refurbishment so that it will provide a safe and well maintained environment for people to live in. The home was clean and hygienic. Evidence: The home is on one level with access to enclosed garden areas that could be used in good weather. The home is in need of redecoration and refurbishment. An extensive programme of improvement has begun and the boiler has been upgraded to make sure that all areas of the home are warm in cold weather. One bedroom has been redecorated with new flooring and furniture. Three bedrooms have been redecorated and new furniture is being purchased. The roof is being repaired, as there have been problems with water penetration. The programme of refurbishment will include all areas of the home: the bathroom and toilet facilities, the kitchen, the laundry and communal areas as well as all bedrooms. We recommended that a development programme should be drawn up with planned timescales so that progress can be monitored and ongoing maintenance reviewed to ensure that the home is maintained in good order when the work is completed. The deputy manager has drawn up a fire risk assessment with the help of the fire Care Homes for Older People Page 21 of 32 Evidence: officer. The guidance of the fire officer should be sought regarding the safe closure of fire doors and the use of wedges to prop bedroom doors open. The proprietor said that these issues would be addressed as a matter of urgency to make sure that people in the home are kept safe. The bedrooms that were seen were comfortable and homely with personal items that people had brought with them. The deputy manager said that new bedding and towels are being purchased to gradually replace those that are worn. Some of the pillows that were seen were in need of being replaced so that people are comfortable; the proprietor said that this would be done. The home was comfortable and the atmosphere was relaxed. There was a discussion with the deputy manager about finding ways to make the environment more accessible to people who have a dementia and memory loss by use of pictures, sensory materials and items that would make people feel more at home. The previous manager in the AQAA indicated that the equipment in the home is serviced as required to make sure that people are kept safe. The proprietor said that someone has been booked to clear the garden so that it will be safe and accessible to people when the weather is good. The laundry facilities are suitable for the home and the sluicing facilities are due to be improved. The care staff are responsible for cleaning duties. The home was clean with no unpleasant odours. Care Homes for Older People Page 22 of 32 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were insufficient staff on duty to meet the specialist needs of people who live in the home. The recruitment procedures do not protect people who live in the home. There is a training programme in place, however staff have not attended specialist dementia training to help them understand the needs of people living in the home. Evidence: The deputy manager is currently responsible for the day-to-day running of the home; she is also on the duty rota to provide care. She said that she has six hours a week for management duties, which does not allow her time to keep up with paperwork and other management issues. During the site visit an additional member of staff was called in to provide cover. The duty rota was seen and showed that there are three care staff on duty between 7 in the morning and 7 in the evening including the deputy manager. There are two members of staff on duty at night. There is one person who needs 24 hour care in bed and another person who spends at least 18 hours in bed. At lunchtime there were three people who needed support with eating. One member of staff was assisting the chef, leaving two people to assist with eating which meant that one member of staff was supporting two people. Care Homes for Older People Page 23 of 32 Evidence: Care staff are responsible for cleaning and laundry duties and three days a week the deputy manager cooks the meals. The staffing levels were not sufficient to provide for the specialist needs of all people in the home. This matter was discussed with the deputy manager. Staff are supported to study for the National Vocational Qualification award (NVQ) and seven of the twelve permanent care staff have achieved the NVQ at level two or above. Three other staff are studying for the award and three people are studying for the level three award. The deputy manager has an NVQ at level three. The home exceeds the target of 50 of care staff achieving an NVQ at level two or above. The recruitment records for three staff were seen. For one person there was no application form on file and a character reference that was not dated. Another persons application form did not have an employment history noted with no referees provided on the application form and only one reference on file. For the third person there was only one reference on file. All three people had started work before a Criminal Record Bureau (CRB) or POVA First check had been received. It was not clear that gaps in employment had been explored during an interview and there were no records of interviews having taken place. These members of staff had been employed while the previous manager was in post and there was a failure to ensure that the required checks had been carried out before each person began work.This matter was discussed with the deputy manager who said that she would be interviewing a prospective member of staff at the end of the week and that she would follow the correct procedures to make sure that people living in the home would be protected. The home must ensure that a robust approach is taken to recruitment to make sure that people are protected. A requirement has been made regarding this matter. A sample of the induction programme was seen. A more experience carer supports newly appointed members of staff when they begin work and go through the induction training topics with them. The deputy manager said she would obtain the Skills for Care guidance regarding staff induction to ensure that the induction programme meets the required standards. There is a programme of training in place and training records were seen. It was clear that sessions in mandatory topics have been arranged to make sure that staff have up to date knowledge and skills. The deputy manager said that none of the care staff have attended training in working with people who have a dementia. Staff should be provided with the knowledge and skills that they need to provide for the specialist needs of people in the home. A requirement has been made regarding this matter. Care Homes for Older People Page 24 of 32 Care Homes for Older People Page 25 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is currently no registered manager in post to ensure the efficient running of the business. There are no clear systems in place for monitoring the quality of the service provided. Peoples finances are protected. There are some measures in place to ensure the health, safety and welfare of people living in the home and of staff; however people are put at risk due to the poor recruitment practices and low staffing levels. Evidence: The registered manager left the home at the beginning of November and the deputy manager has been responsible for the day-to-day running of the home since then. Mrs Odedra, the provider, visits the home on a regular basis. She said that she would be advertising for a new manager within the next week. In order to ensure the business is run efficiently and effectively meets the regulations then good support must be provided to the acting manager and an application submitted for registration when there is a new manager in post. Care Homes for Older People Page 26 of 32 Evidence: In the absence of a registered manager it is the providers responsibility to ensure that the recruitment process is robust so that people living in the home are protected from harm. There was no clear system in place for monitoring the quality of the service provided at Seagulls. There were some questionnaires about the service that had been returned by relatives, however the information was not collated and there was no evidence to show how peoples views had been listened to and acted upon. Mrs Odedra visits the home regularly however there were no Regulation 26 reports to show that the service is being monitored on a monthly basis. This is a requirement to ensure that any shortfalls in the home are noticed and acted upon and to show that there is an ongoing programme of improvement and development of the service. There is a system for supporting people with small amounts of money. Records are kept and receipts obtained where possible. There is only one key holder and the system ensures that peoples money is protected. Relatives or solicitors support people to manage their finances. The previous manager in the AQAA said that equipment in the home is serviced as required. A fire risk assessment has been carried out with the help and guidance of the fire officer. Staff have attended training on health and safety matters. The guidance of the fire officer should be sought with regard to the secure closure of fire doors and the use of wedges to keep doors propped open. The proprietor said that this would be done as a matter of urgency. Incidents and accidents are recorded and reported appropriately and action taken to minimise risks and keep people safe. Care Homes for Older People Page 27 of 32 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 28 of 32 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 7 15 Care plans and risk assessments must provide clear guidance to staff so that people receive the care that they need and risks to people living in the home are minimised. 31/01/2009 2 12 16 The registered provider 31/01/2009 must consult service users about the programme of activities to be arranged and provide facilities for recreation so that people experience a lifestyle of their choice 3 29 19 Staff must not begin work 31/01/2009 until gaps in their employment have been explored and references and Criminal Record Bureau checks have been received in order to protect people living in the home Care Homes for Older People Page 29 of 32 4 30 18 Staff must be provided with 31/01/2009 training in the care of people who have a dementia so that they have the knowledge and skills they need to do their job. 5 31 26 Regulation 26 visits must be 31/01/2009 carried out by the registered provider each month and a written report provided to make sure that the quality of the service is kept under review and improvements made where necessary 6 33 24 A system of quality 31/01/2009 assurance must be developed and reports made of the Regulation 26 visits carried out by the provider so that the quality of the service is kept under review and people who live in the home and their advocates contribute to the development of the service. 7 38 13 The advice of the fire officer 31/01/2009 must be sought regarding the safe closure of fire doors and the use of wedges to prop doors open in order to keep people safe. 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 16 The record of complaints should show timescales, actions Page 30 of 32 Care Homes for Older People taken and outcomes so that people know their complaints will be listened to and acted upon. 2 19 The programme for the development of the service should be in writing with planned timescales for completion of the work and ongoing review to make sure the home provides a safe and well maintained environment for people who live there. Care Homes for Older People Page 31 of 32 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. 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