Inspection on 24/02/09 for St George`s Nursing Home

This inspection was carried out on 24th February 2009.

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

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

Other inspections for this house

St George`s Nursing Home 04/03/08

St George`s Nursing Home 23/01/07

St George`s Nursing Home 04/10/05

St George`s Nursing Home 15/04/05

St George`s Nursing Home 08/09/04

St George`s Nursing Home 01/04/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St George`s Nursing Home De La Warr Road Milford-on-Sea Lymington Hampshire SO41 0NE     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: Joyce Bingham     Date: 2 4 0 2 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. 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. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St George`s Nursing Home De La Warr Road Milford-on-Sea Lymington Hampshire SO41 0NE 01590648000 01590644210 StGeorgesMilford@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St George`s Hospital Ltd Name of registered manager (if applicable) Mrs Maria Jansen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category/ies of service only: Care with Nursing - 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 Physical disability - PD Date of last inspection Brief description of the care home St Georges Nursing Home is located in a quiet residential area of the coastal village of Milford-on-Sea. It is registered to provide nursing care for up to 36 older people and this can include up to 8 individuals who may be physically disabled. There are some amenities in the village, an area popular for retirement and holidays, including shops, churches, a surgery and dental practice. The home is very much part Care Homes for Older People Page 4 of 28 care home 36 Over 65 36 6 0 6 Brief description of the care home of the local community and many of the residents accommodated here used to live locally before moving in. The bedroom accommodation for residents is on two floors and a passenger lift and stairs provide access to the first floor. All bedrooms are single and eighteen of these have en-suite toilets. The building has equipment, aids and adaptations to help promote the independence of the residents. The communal /shared areas of the home comprise a lounge on the ground floor and a lounge/dining room on the first floor and a large conservatory on the ground floor. There is also level access to well planned and extensive landscaped gardens. The current fee charged to people needing residential care is £765 a week. This fee excludes any nursing care contribution, which is currently an additional £103.80 a week and is not paid by the person receiving the service. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service are experiencing good quality outcomes. The purpose of the inspection was to find out how St Georges is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included the Annual Quality Assurance Assessment (AQAA) completed by the home, and comments from the residents and the staff. An unannounced visit to the home was carried out on 24th February lasting a total of seven hours. We were accompanied in part by an expert by experience who is a lay person with particular experience of older persons, and they were able to concentrate on talking with a wide group of people and observing interactions between Care Homes for Older People Page 6 of 28 the residents and the staff. During this time we were able to have a full tour of the premises, including five bedrooms, two lounges, the kitchen and food stores, the dining room, and bathrooms. We had private discussions with Mr Russell, the Responsible Individual, Mrs Jansen the newly registered Manager, three staff, three visitors and contact with a large number of the residents of the home. We sampled staff and care records, and policies and procedures that relate to the running of the home. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection (CSCI). What the care home does well: What has improved since the last inspection? The home has noted comments from residents about the length of time taken between an initial expression of interest in a place in the home and the final assessment and availability of a room. The Director and Manager have attended to this and now the Care Homes for Older People Page 8 of 28 process has been made much quicker. At the last inspection a requirement had been made for the home to refer issues of adult protection to the CSCI and the Local Authority through the accepted protocol, rather than conducting their own internal investigations. The home is now notifying every incident of concern, to err on the side of caution, even when there is some uncertainty if it meets the criteria for reporting. The other requirement at the last inspection related to pre-employment checks on potential staff, and the home is now demonstrating thorough recruitment practices. 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.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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with information about the home, its facilities and services before they make the decision to live there. No-one moves in, even on short stay, without having their needs assessed and being assured that these will be met. Evidence: The AQAA informed us that St Georges Nursing Home provides comprehensive information to all prospective residents, including accommodation details, communal facilities, the homes philosophy, activities and a detailed breakdown of the fees. Residents are encouraged to visit before admission and the contract allows for a trial period during the first eight weeks. A thorough needs assessment is completed prior to admission by experienced staff and the home always confirms in writing whether they are able to meet the residents assessed needs. Care Homes for Older People Page 11 of 28 Evidence: The homes own internal quality assurance told the management that the residents felt the information they were offered gave them a good and accurate impression of what to expect. The home has noted comments from residents about the length of time taken between an initial expression of interest in a place in the home and the final assessment and availability of a room. The Director and Manager have attended to this and now the process has been made much quicker. An internet website has recently been established for the public to access. We saw a copy of the current Service User Guide, and were told that there is one provided in each room. It included a summary of the last inspection report with reference to obtaining a full copy on request, if desired. The service user guide contained all the information required in law. The master copy is kept at the reception desk for viewing. We spoke with four residents who agreed there were no surprises, other than how good it was! We also sampled four pre-admission assessments which were dated and signed. Each of the eight residents who completed the confidential surveys agreed that they had been given sufficient information in advance of admission to know what service the home supplied. The majority of residents were sure they had been given a contract of residence. One said, my relative had been resident here for a number of years before me and I knew how well they had been looked after. Another said, The decision to move in was based on the experience of a previous period as a patient and the excellent local reputation. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are treated with respect and provided with support to make their own decisions. They are supported by effective assessment of needs and individualised care plans which are kept under review. They are enabled to manage their own medication where possible or supported by trained nurses who ensure that all medicines are stored/handled and administered safely. Evidence: We inspected four care plans across the range of high needs, new and longstanding residents. In each case the care plan was well defined, had been agreed with the residents and where possible with a close family member. They were dated and signed and regularly reviewed. We saw reference to reviews and reminders to those organising them to involve the families. Where residents were not able to provide consent the family members had done so on their behalf. Risk assessments were in place covering aspects of care e.g. peg feeds, risk of choking and use of suckers, risks of falling, position of furniture, bedsides, lifting aids. One relative said they was most Care Homes for Older People Page 13 of 28 Evidence: impressed with the care, and Im a nurse and Im picky! In discussion one said all the staff are very kind without exception, but she wished there were not so many faces. All rooms were personalised and very clean. One said, I have everything I need, confirmed they knew how to complain but felt quite secure. The expert visiting with the inspector commented, the residents that were bed-bound appeared to be comfortable, clean and content. A member of staff said As it is now I would be more than happy to have my own parents stay at an establishment like St Georges. The care plans indicated where some residents are able to look after their own medication using pods i.e. small drug cupboards in their rooms, and care for some aspects of their own personal care. Day reports were sampled and we noted comments in reporting include reference to mood and comfort level, and not just the physical functions. A more comprehensive and accurate nutritional assessment than the one previously in use has been introduced. We were told by the manager that training in applying the nutritional monitoring tool was arranged the next day for staff. All the residents are registered with a local GP of their choice (some are local GP relatives). There was reference on each file to chiropody, opticians and specialist hospital/hospice involvement. A drug cupboard and a drug trolley were inspected. The drug records were well completed, and the audit trail was clear. All drugs are administered by Registered General Nurses and the Deputy Matron explained the process from ordering medicines to their administration. She confirmed those who self medicate do have small drug cupboards in their rooms. Each resident has a single room so their treatment and care are completed in private. To the question in the confidential survey five residents said they always receive the care they need, and three said they usually did. We were told they were very satisfied with the support they receive to access any medical services they require. All eight surveys indicated that staff listen and act on what they require, and one added and always help with a smile. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to maintain contact with family and friends and are encouraged to pursue social contact, recreational interests and religious activities of their choice. They are provided with daily choices of meals throughout the day, nicely presented, with ample variety in the location of their choice. Evidence: In the survey responses there were mixed comments about the activities that were available to the residents. Three felt there were always things to engage with; three felt there were activities sometimes, and one, usually. One resident said, I am extremely glad to be living here at St Georges. Another said, there is always something interesting and enjoyable. We asked one resident about personal autonomy to decide on the shape of their own day and were told she often has a lie in, and can get up and go to bed when she wants to. She told us she would not change anything in the routine as it suited her. Another resident said, I like staying in my room. I really enjoy it here. Another Care Homes for Older People Page 15 of 28 Evidence: relative told us that the staff are brilliant and when her relative was offered the possibility of returning home with support it was declined, as they are so comfortable where they are. Relatives confirmed they can visit whenever and for as long as they want to. We were told that the kitchen wheels in meals for them and they have umpteen cups of tea and cake etc. A list of current, planned activities was pinned to the notice boards and a member of staff is designated on the roster each afternoon to initiate/motivate activities in the lounge. A key worker system has recently been established to help develop this aspect of the home. Two people told us of trips out including a long day trip organised by the home e.g. to the Spinnaker tower, Exeter gardens, Poole Harbour, Braemore House. We go up the tower one at a time in our wheelchairs, said one lady. Gardening is also a popular activity with one lady explaining, I dug up a section in the garden and planted a row of bulbs, and watched them grow, with white plastic markers showing where they were. The care plans took note of residents particular religious affiliations and staff told us that they would suppport residents should they desire to contact a minister or link with a local church. A resident confirmed that her choice in this was respected. People were seen to be coming in and out during the day. They sign in at reception so that staff know who is in the building at any time. Staff greeted people warmly and a welcoming atmosphere prevailed. The expert by experience reported that the afternoon at St Georges was a pampering afternoon. One resident had a masseuse visiting her. The home has a variety of people who contribute to the feel good factor and the price of these services are incorporated into the fees. The lunchtime meal was observed, served on heated plates in private rooms or in the dining room with wine/sherry/fruit juice. Meals that were pureed were done separately to preserve colour and some texture. They were well presented. Feeding aids were seen to be in use. We were told that some people were assisted in private, from choice. The expert informed us that comments included, good food, nicely cooked, a good choice, not bad. The upstairs lounge was converted to a dining room at lunchtime for a married couple to have an intimate meal together. We spoke with the award winning chef on duty, who we were told home-cooks everything he serves. Residents allergies, likes and dislikes were kept on display boards in the private area of the kitchen. We were told that the chefs training updates in food handling had recently been completed and confirmed this in the staff records. We were told that recent surveys had shown up preferences for fish rather than meat, so the menu had been adjusted to include more fish dishes. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported to raise concerns and complain if necessary, and are confident that any matters of concern will be heeded and acted on. They are protected by the homes current procedures for reporting and investigating any hint of abuse, and by the homes recruitment and staff training policies. Evidence: From the surveys six residents said they always knew who to speak to if they were not happy about anything,and two said they usually did. All of the returns indicated the residents knew how to make a complaint if they needed to. The expert, who talked with many people, confirmed that no-one made any complaints to her. The staff surveys indicated that all the staff knew what to do and who to talk with if they had any concerns. We saw that the complaints policy forms part of the service user guide, and the full policy is also in the manual of procedures which is kept in reception. The policy includes the stages and timescales for investigation and response, and reference to the CSCI. The complaints log was inspected. Three complaints had been drawn to the attention of the CSCI between inspections. Two had been brought to conclusion with no further Care Homes for Older People Page 18 of 28 Evidence: action required on the part of the home. One had been referred by the CSCI for the complainant to take up directly with the home but they had decided not to. Mr Russell explained the detail of this concern. We noted an open and transparent attitude expressed by both the Director and the Manager. At the last inspection a requirement had been made for the home to refer issues of adult protection to the CSCI and the Local Authority through the accepted protocol, rather than conducting their own internal investigations. The home is now notifying every incident of concern, to err on the side of caution, even when there is some uncertainty if it meets the criteria for reporting. In relation to personal finances we were told that no personal monies are held on behalf of residents. The Director said that if a resident requires access to cash the home will provide it and subsequently invoice the financier at the end of the billing period. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a spacious, safe and well maintained environment. St Georges is very clean, hygienic and odour free. Evidence: The location of St Georges is close to the town centre, and has access to the sea. It has non-stigmatising signposting. The home is well maintained and appropriate for the particular lifestyle and needs of the residents. The fabric and decor is in good order. The grounds are tidy, well ordered, with colourful bedding. The expert by experience reported that St Georges has a warm and inviting entrance. There are a lovely selection of plants in the corridors, lounge and conservatory. The rooms were clean and tidy with no odours. The residents had their own personal belongings. We found the home to be spotless. Alcohol points are distributed near the entrance and around the house to assist with control of infection. There are wash hand basins at the nurse stations. We saw that the management has a pro-active infection control policy. St Georges is fully accessible throughout to people with physical disabilities. It provides aids and adaptations to meet the needs of all the residents. There are sufficient toilets to enable immediate access. Care Homes for Older People Page 20 of 28 Evidence: The laundry is equipped with a new gas fired double tumble dryer and two commercial washing machines and a domestic machine for small or delicate items. The laundry assistant has worked there for over twenty years and knows all the residents likes and dislikes well. She ensures that clothes are returned to the correct people and has a ticket system in operation to ensure this happens. Two of the washing machines have a sluice facility and there is a sink available. The survey returns told us that all the residents consider the home to be very clean, always. Beautifully clean was one comment. The selection of communal areas enables people to actively engage with others and choose where they want to meet with their family and friends, if not in their own private room. We saw evidence that the temperature could be changed in each room to suit personal choice. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by the high numbers and skill mix of the staff team, and are suitably protected by the homes recruitment policy and practices. A high calibre of staff training equips the whole team to provide a quality service. Evidence: Out of twenty staff requested, seven agreed to complete survey returns and these were all very satisfactory. Each one confirmed that routine pre-employment checks such as references, interviews, ID verification, criminal records checks had been conducted before they started work, and this was confirmed by sampling the files. The home scored almost full marks from the staff surveys for its induction of new staff and 100 for ongoing relevant training that equips staff to fulfil their roles. We have good staff training and regular updates. St Georges has extra training dates and is flexible to enable all staff to attend. We have a training manager who keeps the training sessions fresh and interesting. One staff member who had come from another home said she was so surprised to find the quality of training- it felt like heaven when I joined the team. Another said, formal and informal support and discussion are provided on a regular basis. Six out of seven staff said they felt there were usually sufficient staff to meet the individual needs of all the residents, and one felt there was always sufficient. Due to sickness sometimes we have to pull together as a team to ensure individual needs are still met. We were told that there had been an increase in Care Homes for Older People Page 22 of 28 Evidence: staffing at peak times when there were extra demands. During the day several staff were asked what they would do to improve things and at no time was employ more staff the response. Staff found it quite difficult to think of anything that had not already been processed through their routine communication channels, and when pressed, responded with a new ambulance, and more trips out for the residents. I cant think of anything the service could do better but, in order to maintain our high standards, I feel it is important to move with the times and continue learning in all levels of care. A sample of staff files were inspected, and we found they were in order and up-todate, containing the necessary pre-recruitment references and checks. We recommended to the Manager that a Rehabilitation of Offenders statement be incorporated into the staff application form which considered at short listing and is retained on file, and not to rely solely on the Criminal Records application which is processed with a different authority. The staff duty roster for the week was inspected. It evidenced routinely a Registered General nurse leading the shift on each of the two floors during the day, and one covering the home on an awake shift at night. During the mornings we see ten carers rostered and an additional named carer identified for supporting and promoting social needs. In the afternoons this reduces to six carers, plus the activities leader and a named carer for promoting activities. At night there are two carers on each floor in addition to the RGN. There was evidence of ample ancillary staff, cleaners, cooks, laundry and maintenance/decorating staff moving discretely about the home. One carers survey stated, All of the staff, not just the nursing staff but the whole team, the kitchen staff, maintenance crew, laundry, reception staff, activity co-ordinators and the management team go that little bit extra to make sure the the residents live their lives as happily as they can....... In relation to qualifications the AQAA informed us that the home employs 16 trained nurses and 78 of the carers are qualifed to National Vocational Qualification level 2 or above, which well exceeds the national target. In addition seven staff are nearing completion of NVQ level 3. The comprehensive staff training matrix was viewed. This informs the management of the status of training and need for updates for each member of staff. In relation to equality and diversity the home employs a small number of staff from different ethnic groups. Staff told us that equality and diversity training has been added to their mandatory training for 2009. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a home that is run by a competent and experienced manager who has been newly registered. Residents also benefit from the active participation on a day-to-day basis of an experienced Director. While functioning as a business, the home gives priority to the best interests of the residents. Evidence: The AQAA informed us that the Director has 38 years management experience and he is supported by a finance manager and a newly registered manager. Twice a year the home surveys the views of residents and we were told how the collection of views has contributed to some changes e.g. meal content, social activities. The home has an annual development plan and sustains continuous self monitoring. Policies and procedures are regularly reviewed and updated where necessary. The AQAA also confirmed regular attention to matters of maintenance and servicing of equipment. The manager has twenty three years experience as a registered nurse and has Care Homes for Older People Page 24 of 28 Evidence: recently been registered with the CSCI. Staff returns commented that, I have regular meetings with the matron, but I could discuss anything with her at anytime as she is very approachable and always willing to listen to any concerns. We found that the Director, Mr Russell, also takes an active part in the homes affairs, being present on a daily basis and being familiar with the different needs and characters of the residents and the staff. We were told that he takes a lead on issues of health and safety, fire prevention and maintenance matters. The home conducts its own quality internal audit twice a year and requests feedback from residents who have stayed on a short stay basis. Comments from staff, residents, relatives and stakeholders inform decisions and aid future planning. We were told that continual appraisal takes place through staff and management meetings. The staff spoken with also confirmed that the management express an open and transparent attitude towards ideas and opportunities for improvement. They are always looking for any improving that may need to be done. St Georges are very quick on improving any areas which may need improving. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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 28 of 28 - 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!