Inspection on 26/01/09 for Springdale

This inspection was carried out on 26th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Springdale 12/12/06

Springdale 01/02/06

Springdale 05/07/05

Springdale 26/01/05

Springdale 19/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springdale Cucumber Lane Brundall Norwich Norfolk NR13 5QY     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: Jane Craig     Date: 2 6 0 1 2 0 0 9 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 29 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 29 Information about the care home Name of care home: Address: Springdale Cucumber Lane Brundall Norwich Norfolk NR13 5QY 01603712194 01603787363 springdale@norfolk.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Claire Helena Keeble Type of registration: Number of places registered: Norfolk County CouncilCommunity Care care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One (1) Service User, who is named in the Commission`s records and who has dementia, maybe accommodated within the overall number of 35 Service Users Springdale can accommodate service users who require wheelchairs to assist with independent mobility at the point of admission into those rooms which are over 12 sq metres. This means that only rooms numbered 1, 2, 12, 13, 14, 18, 19, 20, 21, 22, 23 and 33 are suitable for wheelchair users. Springdale is registered to offer personal care for up to 35 service users who are aged 65 and over. Date of last inspection 0 0 Over 65 1 35 Care Homes for Older People Page 4 of 29 Brief description of the care home Springdale is a Local Authority home providing care for up to 35 older people. It is situated in the village of Brundall, a few miles east of the city of Norwich. The home is set in sizeable grounds with garden areas to the side and rear and parking space to the front. The home is operated by Norfolk County Council Social Services Department. The weekly fee at the time of the inspection was 387 pounds and 63 pence. Toiletries, hairdressing and newspapers were not included in the fee. People using the service were also asked to make a contribution to some activities. Information about the home, including the last inspection report, is available from the manager. Care Homes for Older People Page 5 of 29 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: The last key inspection on this service was completed on 12th December 2006. This key (main) inspection includes information gathered since the last inspection and an unannounced visit to the home. The visit was carried out on 26th January 2009 by one regulatory inspector. At the time of the visit there were thirty three residents living at the home. We met with some of them and wherever possible asked about their views of Springdale. We spent time observing daily routines in the home and how staff interacted with residents. Three residents were case tracked. This meant that we looked at their care plans and other records and talked to staff about their care needs. Care Homes for Older People Page 6 of 29 We talked to the registered manager, staff and visitors. We looked around the home and viewed a number of documents and records. As part of the key inspection surveys were sent out to people living and working at Springdale. Five residents and five members of staff returned surveys and their responses have been taken into account when making judgements about the service. This report also includes information from the annual quality assurance assessment (AQAA), which is a self-assessment report that the manager has to fill in and send to the Commission every year. What the care home does well: What has improved since the last inspection? The service users guide had been updated. This meant that people who were thinking of moving in to the home had accurate and up to date information about the service and what facilities they could expect. Before anyone moved into the home the manager visited them to assess what care they needed and to make sure that their needs could be properly met at Springdale. The information from these assessment visits was made available to staff to help them to plan care for when the resident moved in. There had been some improvements to the home and the grounds since the last Care Homes for Older People Page 8 of 29 inspection which helped to make the environment more comfortable for residents. 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 9 of 29 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 29 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 thinking of moving into the home were given sufficient information to help them to make a decision and staff received enough information to help them to understand the needs of the new person. Evidence: People thinking about moving into the home were given a service users guide which helped to explain what services and facilities they could expect at Springdale. The manager made sure that people had opportunities to discuss the information with her. As recommended at the last key inspection, it had been updated to include information about the smoking arrangements for people living in the home. Most of the residents who returned surveys indicated that they received enough information about the home. People thinking of moving in were assessed by the manager to make sure that their Care Homes for Older People Page 11 of 29 Evidence: needs were understood and could be met at Springdale. The assessment contained all the essential information about the persons activities of living to enable staff to plan care. However, the assessments we saw during the visit contained very little information about the persons abilities, usual routines and preferences. This could result in staff having difficulty in drawing up person centred care plans, especially if the person was not able to discuss this information with staff. Standard 6 was not applicable. Intermediate care is not provided at Springdale. Care Homes for Older People Page 12 of 29 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. Residents health and personal care needs were being met by a team of staff who respected their privacy and dignity. The lack of up to date information in care plans could result in staff not being clear about what care to provide. Evidence: The annual quality assurance assessment (AQQA) told us that the service was reviewing the care plan documents. The manager said this should make them easier to follow and more useful on a day to day basis. Everyone had a care file which contained a set of assessments and care plans. The standard of information on the plans varied. Some plans contained person centred information. For example, one plan told staff that the resident always liked to wear jewellery, which meant her personal preferences would be taken into account. Others were vague and told staff only that the resident needed assistance but nothing about the way they preferred to be helped. Despite these minor omissions the staff we spoke to were aware of the importance of maintaining independence and knew what Care Homes for Older People Page 13 of 29 Evidence: residents were able to do for themselves. A resident said, They let me do things, but the day that I cant they will come in and do it for me. Another said, They help me to be independent, which is a good thing. In addition to their care file each resident had an action plan in their bedroom, which helped to make information more accessible to staff. In some cases new instructions were not added to both plans, which meant that staff did not always have clear and current directions. For example, the plan in one persons file indicated that staff should chart the amount of drinks they had each day but the action plan in their room did not mention this. Staff whom we asked were not clear whether this instruction had been discontinued or not. Residents had opportunities to be involved in planning their care if they wished. All the care files we looked at had been signed by the manager and the resident. A family carer said they had seen and agreed to the care plans for their relative. Residents had moving and handling assessments and plans on their care files. Throughout the course of the visit we observed staff using the correct equipment and techniques to assist people with their mobility. Residents said that staff looked after their health. One person said that staff had called the doctor when she had a cold. Another said, They look after you very well here, there is nothing at all to grumble about. Everyone who returned a survey indicated that they received the care and medical support they needed. There was evidence, on care files, that residents ongoing health care needs were monitored and records showed that they were referred to outside professionals where necessary. Advice from these consultations was not always entered on the care plan straight away but the staff we spoke to were aware of what care and treatment had been advised during recent visits. Two staff had been nominated as dignity champions. This meant that they took the lead in ensuring that the principles of promoting dignity and other core values were always practiced by staff. Throughout the course of the visit staff were heard speaking to residents politely and respectfully. Residents said that this was always the case. Any procedures, such as use of the hoist, were explained fully and staff provided reassurance throughout. Staff did not leave anyone until they were sure that they were comfortable and had what they needed, for example their handbag or newspaper. It was apparent from observing the general routines of the day that staff put residents needs first. Only a small number of residents were able to manage some of their own medicines. Care Homes for Older People Page 14 of 29 Evidence: They had safe storage and staff regularly monitored their ability and safety. All staff with responsibility for handling medicines were trained and had clear policies and procedures to refer to. On the day of the site visit we observed senior members of staff doing the medicine round safely and in accordance with good practice guidelines. There were safe systems for ordering and checking medication. There were complete records of medicines entering and leaving the home and of any stocks of medicines carried over from the previous month. These records contributed to the audit trail and helped to minimise any risk of mishandling. Medication administration record (MAR) charts were complete and up to date, which showed that residents were receiving their medication as it was prescribed. Staff kept a record of exact times when medication to be given four hourly was administered to ensure that it was not administered again too soon. Appropriate codes were used to show when and why medicines had not been given. Handwritten entries on MAR charts were accurate and included any special instructions for the medicine. However, they were not always signed and witnessed, which could increase the risk of transcribing errors. Medicines were stored safely and there was restricted access to the keys to the medicine room. All residents had a locking medicine cupboard in their room to store creams and other topical medicines. There were separate MAR charts to record these items. Controlled drugs were stored, recorded and administered safely and in accordance with the policy. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines in the home revolved around the people using the service, who said they were happy with their lifestyles. Evidence: Most of the care records we saw included information relating to the residents past social and family history. The manager told us that this information gave staff an insight into the residents past achievements and helped them to identify topics for discussion and reminiscence. It had also helped staff to choose Christmas gifts for some residents. Spiritual needs were identified on social care plans and several plans indicated that residents were assisted to attend church services. Staff were aware that residents may have special needs relating to their religion or culture but said this did not relate to anyone currently living at the home. Some people were able to occupy themselves during the day. One resident said, I am never bored, I walk about and I like to read. However, many others were dependent on staff to help them to find meaningful occupation. Records showed that there were Care Homes for Older People Page 16 of 29 Evidence: some group and one to one activities for those who wished to join. Four out of the five residents who completed surveys indicated that there were only sometimes activities that they could join in. A member of staff said they could not provide a daily activity programme because there were not always enough staff to spare. Another said that they would like to spend more quality time with residents but it was not always possible because of the lack of staff. The manager said her aim would be to provide social and recreational activities that were pre-planned to meet residents individual needs. Several residents said that they liked the home and were happy living there. One said, I had never been away from home before but I have settled in very well. Another said, I came here after a fall and I have never regretted it. Residents said they had choices about their daily lives. One person said, This is a first class place, there are no rules, we do as we wish. Another person said they always went to bed early because they liked to. A member of staff said they tried to accommodate everyones choices and preferences. Another said they offered residents choices about everything because, It is their home and staff just come in to help them. There was an open visiting policy. A family carer said that they were always made to feel welcome and were offered refreshments. Families were encouraged to be as involved as they wished to be in their relatives care. There was suite for relatives who may wish to stay over at the home. Relatives and other people in the local community were invited to celebrate special events at the home, for example, the manager talked about a large, Songs of Praise service that was held in the grounds of the home last year. Residents did not have any input into choosing the five week rotating menu, which was set by the provider for all the county council homes. However, there was a choice at every meal and the cook told us that if residents did not like what was on the menu they could have something else. Residents were asked when they were sitting at the table which meal they wanted, which meant they had visual cues to help them. All the residents told us that they liked the meals. One said, The meals are very good and nourishing, and another commented, The meals are wonderful, especially the cakes. On the day of the visit the lunchtime meal looked attractive and appetising. Residents could choose where to take their meals. Tables were set in the dining room and people were chatting to each other. It was a calm and social occasion. Staff provided help in a discreet and sensitive manner to those who needed it. Care Homes for Older People Page 17 of 29 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. Residents could be confident that their concerns would be listened to and acted upon. Procedures and training were in place to help to ensure that people were safeguarded from abuse. Evidence: There was a clear complaints procedure on display in the home and everyone received a summarised version in their service users guide. All the residents who completed surveys said they knew how to make a complaint. The residents we spoke to said they had no complaints about the home but would feel able to speak to the manager or staff if they were unhappy about anything. Staff who returned surveys indicated that they knew what to do if a resident or relative raised concerns about their care. The AQAA told us that the home had received one complaint since the last inspection. Records showed that the manager carried out a thorough investigation and kept the complainant informed throughout the process. New staff completed training in safeguarding as part of their induction programme. Although most had done refresher training, this was not mandatory for all. Staff had the Norfolk County Council procedure to refer to and there were a number of leaflets around the home alerting residents, visitors and staff to safeguarding procedures. All the staff we spoke to were aware of the indicators of abuse and understood their Care Homes for Older People Page 18 of 29 Evidence: responsibility to report any suspicions or allegations to the manager. The manager was also clear about her role. There had been no safeguarding referrals from the home in the past year. Care Homes for Older People Page 19 of 29 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. Most areas of the home were clean, comfortable and safe but some renovation was needed to ensure that some essential equipment was fit for purpose. Evidence: From looking around the building we could see that most areas were well maintained. There was a choice of lounges. All were decorated and furnished to a good standard and finishing touches such as fresh flowers, magazines and family photos gave a real feeling of homeliness in some of the areas. One of the lounges had tea and coffee making facilities, which helped residents to remain independent and offer their visitors refreshments if they wished. A number of areas had been redecorated since the last inspection and there was new furniture and carpets in some areas. The extensive grounds were well maintained and there was a new sensory garden, which gave residents a pleasant place to sit whilst outside. The manager told us that work was due to start to replace one of the bathrooms with a wet room, which would give residents the choice of having a bath or a shower. The AQAA told us that there were areas that could be improved upon. For example, the lift had not been replaced, which meant that it was still difficult to accommodate a Care Homes for Older People Page 20 of 29 Evidence: person in a wheelchair and an escort. Other shortfalls identified during the last inspection, such as the lack of individual thermostatic controls on radiators and the metal windows were still in evidence, although none of the residents made negative comments in relation to these. Other parts of the home that needed attention were pointed out to the manager during the tour. For example, the paintwork on one of the corridors had been damaged by a wheelchair and looked unsightly. The manager said she would be able to request that the work be carried out but there was no written plan for renewal and refurbishment to ensure that work was prioritised and carried out within realistic timescales. All the bedrooms we saw were personalised with pictures, ornaments and small items of furniture. The residents we spoke to were happy with their rooms. One said, My family helped me to make it nice. Another resident described their room as very comfortable. At the time of the visit the home was clean and free from unpleasant odours. The residents who completed surveys said it was always like that. The laundry was well organised and adequately equipped for the size of the home and the amount of clothing washed on the premises. However, the service does not employ or nominate anyone specifically for the laundry, which means that care staff are taken away from direct care tasks. Although staff had access to protective clothing, there is still a greater risk of the spread of infection if staff are wearing the same uniform for handling laundry as serving meals. The AQAA told us that there was an action plan with regard to infection control. Training is also to be made available to all staff. The manager notified us of an outbreak of infection last year and showed that they followed the correct procedures to prevent the infection spreading further. Care Homes for Older People Page 21 of 29 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. Staff were recruited safely and were provided with sufficient training to understand residents needs but there were not always sufficient numbers to meet social care needs. Evidence: The staffing rosters showed that the numbers of care staff remained consistent, rather than being flexible and calculated against the changing needs and dependencies of the residents. The manager said that she could, and did, roster extra staff to cover for short periods in special circumstances. The AQQA told us that the use of agency staff had reduced which meant that residents were being supported by staff who they were familiar with and who understood their needs. However, a visitor to the home commented that staff were, run off their feet. A resident said that they sometimes had to wait for a while for attention because staff were so busy. The staff we spoke to all said there were enough staff to provide personal care but it would be difficult if residents decided they wanted more baths or showers. Staff said there were not enough of them to always meet residents social care needs. One said they did not have enough quality time with residents. Four out of the five staff who completed surveys indicated that there were not always enough staff to meet the individual needs of all the residents. When asked what the service could do better, one wrote, Provide more staff. Care Homes for Older People Page 22 of 29 Evidence: Residents made very positive comments about the staff team. One said, They are very efficient, all on top of their jobs. Another wrote, Excellent manager backed up with conscientious and caring staff. A member of staff told us, There is a lovely rapport between residents and staff. There was a clear recruitment procedure, and staff were recruited with regard to equal opportunities guidance. We looked at the files of two recently appointed staff. The files were complete and contained all the relevant documents and information. All the required pre-employment checks were carried out to make sure that staff were suitable to work with residents. New staff went through an induction training programme. The programme met the standards of the induction training recommended by the national training organisation. This ensured that they had basic skills to help them understand and meet the needs of the residents. Most staff went on to NVQ training and the AQAA told us that over half of the care staff were qualified to level 2 or above. Most of the staff team were up to date with the mandatory training such as first aid, moving and handling and fire safety. Other training needs were identified during staff supervision or appraisal and staff were nominated to attend courses that were relevant to the needs of the residents. Staff who completed surveys indicated that they were provided with sufficient training. One wrote, We are always encouraged to update our knowledge and skills by attending the many training courses on offer. Care Homes for Older People Page 23 of 29 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 was run in the best interests of the people who live there and their health and safety were promoted and protected. Evidence: The Commission had registered a new manager since the last key inspection. She had many years experience of working at Springdale in a senior capacity and the change in management had not caused any disruption to the residents. The manager was undertaking the Registered Managers Award at the time of the visit. She was confident in her role and said she was well supported by higher management and by senior staff at the home. There were organised management and administration systems in place, which helped to ensure that the home was well run. It was apparent that the manager had good relationships with the residents and more than one commented that the home was well run. One said, Everything is in order, very well managed. Staff also said they appreciated the manager who they described as understanding and supportive. One wrote, The manager is always open to any Care Homes for Older People Page 24 of 29 Evidence: suggestions or comments about how to improve the quality of life for our residents. Residents, relatives and staff were invited to complete an annual survey where they could make their views of the service known and put forward suggestions for improvement. The results of the most recent surveys had been published in the service users guide. Most responses were positive. The manager had arranged meetings with the respective groups of people to discuss the surveys and to talk about the actions she planned to take to improve any areas of uncertainty. The manager also carried out internal audits of procedures and systems, such as medication and health and safety, to ensure that policies were being followed and staff were working safely. The manager did not act as appointee for anyone at the home. Residents who were not able to manage their own finances had families or other representatives to assist them. A number of residents had small amounts of money held at the home for safekeeping. There were secure facilities and clear records were kept of any financial transactions. We audited a small sample and found them to be correct. The administrator carried out an audit every three months to make sure the systems they used continued to protect the residents. All staff had received fire safety training and the manager held regular practice drills. The staff we spoke to were clear about the procedure to follow in the event of a fire. Fire alarms were tested regularly and other fire safety equipment had been serviced. The AQQA showed that the maintenance and servicing of other equipment and installations were up to date, which helped to protect the health and safety of people living and working in the home. There were a number of environmental risk assessments and strategies to ensure the safety of residents and staff. All potentially hazardous substances, such as cleaning materials, were stored safely. This had been recommended after the last key inspection. Care Homes for Older People Page 25 of 29 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 29 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 must be kept up 31/03/2009 to date and amended as and when the residents needs change. To ensure that staff have accurate and up to date directions and do not have to rely on verbal information. 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 9 To reduce the risk of transcribing errors, handwritten amendments on MAR charts should be signed and witnessed. Following an audit of all areas there should be a written plan for redecoration and renewal with realistic timescales for work to be completed. In order to minimise the risk of the spread of infection and to ensure that care staff are not taken from care tasks there should be nominated staff to work in the laundry. Staffing levels should be kept under review and, wherever necessary increased, to ensure that there are always sufficient staff on duty to meet the personal, health and Page 27 of 29 2 19 3 26 4 27 Care Homes for Older People social care needs of the people using the service at any time. Care Homes for Older People Page 28 of 29 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. Care Homes for Older People Page 29 of 29 - 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!