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Inspection on 10/03/09 for Talbot House Nursing Home

Also see our care home review for Talbot House Nursing Home for more information

This inspection was carried out on 10th March 2009.

CSCI found this care home to be providing an Excellent 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People that live at the service are very happy with the care they receive. The service provides individualised care identifying each person`s specific needs. People tell us that their health care needs are met. The doctor is called when they are ill and they have eye and dental checks. Comments include: `The staff are always available to help in any way` and `fantastic`. People feel that the staff provide them with good care. They feel that they are treated with respect and that their privacy is promoted. People have choices about how they live their lives. They can spend time in their bedrooms or in the communal rooms. They can have their meals where they want either in the company of others or on their own. The service provides a Church of England service for those that wish it and welcomes spiritual leaders from other denominations to visit people. People like the staff at the service feeling them to be kind and caring. Staff know about each individual`s person`s needs and how their needs should be met in a way that people want. Staff have training to be able to support people appropriately. People enjoy good homely accommodation. Although none of the rooms have en suite facilities rooms provide people with suitable space and furniture and are suitably decorated. People can personalise them with items of furniture and belongings from home. The service provides people with a choice of lounges and the two smaller lounges are particularly homely with a feel of being in someone`s own lounge. The service is well managed. The manager of the service has worked there for some years and is motivated by the wish to improve the wellbeing of the people that live there. She undertakes regular supervision and monitoring of staff and seeks the views of the people that live there, their relatives and the staff to look at ways to improve the service.

What has improved since the last inspection?

Since the last time we visited the service has undertaken a number of improvements. A new assessment has been put in place that gives the service more information about people`s individual needs. This helps the service to provide a more person centred service. The service has introduced a continence link nurse to improve the support people receive in this area of their care. Staff are undertaking specialised training in palliative care and have introduced a nationally recognised system of care planning for `end of life` care. The service has also made some improvement to the accommodation. The dining room and a number of bedrooms have been decorated. The service has also increased the number of nursing beds.

What the care home could do better:

We feel that this service provides excellent outcomes for people that live at the service. We did feel that people could be provided with more social activities and that people should be made aware of all the choices of meals that are available. We did seem some medication practices that need to be addressed although there is no evidence to show that people are not getting their medication as prescribed. We are confident that the service will address these issues and have asked the service to confirm in writing that this has been done.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Talbot House Nursing Home 28-30 Talbot Street Rugeley Staffordshire WS15 2EG     The quality rating for this care home is:   three star excellent 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 Capron     Date: 1 0 0 3 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 27 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 27 Information about the care home Name of care home: Address: Talbot House Nursing Home 28-30 Talbot Street Rugeley Staffordshire WS15 2EG 01889570527 01889570527 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Grov Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 25 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 25 Date of last inspection Brief description of the care home Situated close to Rugeley town, Talbot House is a 25 bedded care service that provides residential and nursing care. It comprises of one building, built in 1880 that has been extended at the rear. There is a garden at the rear where people can sit. The current Proprietor is Mr Gupta. Mrs Margaret Ford is the Manager and she is registered with the Commission for Social Care Inspection. The home comprises of 19 single bedrooms and three double bedrooms. None of the rooms have en-suite facilities but all have a Care Homes for Older People Page 4 of 27 Over 65 25 0 Brief description of the care home washbasin. There are three pleasant lounges and one dining room. Other facilities/services include a hairdressing salon and activities/craft room. All areas of the service are accessible having ramps and a passenger lift. The service is very homely and comfortable with a relaxed atmosphere. The services philosophy of care is to treat people as individuals and to provide them with the individual support and care they need. The service has a service user guide that provides people with information about the fees. The current fees are GBP421 - GBP650per week. These fees were applicable at the time of the inspection but people considering using the service should contact the service for up to date information. Care Homes for Older People Page 5 of 27 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over an eight hour period and the service did not know we were visiting. The information used as part of this inspection included: The annual quality assurance assessment (AQAA) that the service sent us. The AQAA is a self assessment document that focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. Four surveys provided by people living at the service. Two surveys from staff. Information from health care staff that support people living at the service. Information we have about any complaints and safeguarding received about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 27 Information provided by the registered individual about their monthly checks of the service. Discussions with people living at the service. Discussions with staff and the manager. Observation of staff supporting people. An examination of records relating to care practices, staff recruitment and training and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: We feel that this service provides excellent outcomes for people that live at the service. Care Homes for Older People Page 8 of 27 We did feel that people could be provided with more social activities and that people should be made aware of all the choices of meals that are available. We did seem some medication practices that need to be addressed although there is no evidence to show that people are not getting their medication as prescribed. We are confident that the service will address these issues and have asked the service to confirm in writing that this has been done. 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 27 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 27 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 moving to the service can be assured that their needs will be assessed before a place if offered. This will make sure that the service is able to meet their needs. Evidence: The services Annual Quality Assurance Assessment states that the service spends a significant time planning admissions to make it personal and well managed. It states that people are visited before an admission and that an assessment is completed to make sure that the service can meet the persons needs. The examination of a sample of case files confirms that the service completes an assessment before people are admitted. This assessment covers peoples health and personal care, their mobility, mental health as well as their likes and dislikes and their social care needs. We also spoke to a relative and one person that lived there about the admission process. Both these people told us that someone from the service had visited them to assess their needs to make sure that their needs could be met. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service can be confident that they are treated with dignity and that their privacy is promoted. People can be assured that the service will provide them with the individual nursing care they need. People appear to be receiving the medication they need but there are aspects of the current medication practices that should be addressed to ensure that no errors can occur. Evidence: The services AQAA states that care plans are person centred and focus on the persons strengths and personal preferences. It states that nutritional and tissue viability assessments are completed and all areas of care are evaluated monthly. Our examination of a sample of plans confirms that care plans are individualised identifying peoples specific needs. Case tracking confirms that people are having their nursing and personal care needs met. For example one person being nursed in bed requires care to maintain their skin and pressure relieving equipment is in place as well as records to confirm that they are being turned regularly and that their food and fluid intake is being monitored. Another person is receiving end of life care and this is being provided following a nationally recognised programme that is agreed with all Care Homes for Older People Page 12 of 27 Evidence: significant people including relatives and the doctor. The documents show that the plan agreed is being followed and if there are any changes these are recorded. Another person we checked had lost weight and records confirm that she is now on an increased weight monitoring programme. Everyone that can be is weighed monthly and if there are concerns about peoples weight the regularity of weighing is increased and referred to the doctor if necessary. When we spoke to staff about the care people need they could describe their needs and how they are to be met . Health care specialist we spoke to about the care at the service tell us that they have no concerns and that the service appropriately refers people. Responses to our surveys confirms that people feel that they are receiving the care including medical support they need. One person said the staff always try and get a doctor to me straight away and when necessary have called in paramedics. We spoke to several people living at the service and they said the service calls the doctor when there are ill, they have eye and dental check ups and that either the staff or the chiropodist trims their nails. Our discussions with staff and people that live there shows that people are having their personal care needs met. People are suitably dressed and have their hair and nail care attended to. We observed toothbrushes and toothpaste in peoples bedrooms. People tell us that the staff respect their privacy and show them respect. One person said they respect my privacy and keep me covered up. When we spoke to staff they could tell us how they maintained peoples dignity and privacy by for example always knocking on bedroom doors, keeping people covered when doing personal care and giving them privacy when bathing and toileting. We looked at the way the service manages peoples medication. Medication is stored securely. A record is kept of medication received. The staff receive medication training and are assessed for their competency to administer medication. We case tracked the arrangements for the administration of two people. Medication is recorded and there are no unexplained gaps in the records. When medication is not taken, usually due to a refusal, this is recorded and offered to the person later. In both cases we looked at, we saw evidence of some medication sharing. The service said it has written to the doctor for permission to do this. We saw a copy of a letter. We also observed that the service in some instances is leaving medication with people to take and then signing the sheet even though they have not observed the person taking the medication. When we raised this the nurse told us that they only did this with people they are confident can take the medication. We advised them this is not good practice as the service cannot be sure that the medication is taken by the correct person unless it is Care Homes for Older People Page 13 of 27 Evidence: observed. We did observe later on the nurse sitting with one person supporting them to take their medication. We referred these issues to the pharmacy inspector who followed this up with the service and he is confident that these issues will be addressed. The service has some Controlled Drugs and a check on these shows that they are correctly stored and recorded. The Controlled Drugs register is properly completed and is double signed. The amount of medication in the service corresponded to that recorded in the register. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service have the chance to take part in some activities but there is scope for this area to be developed. People can be assured that they will receive a varied diet however people should be offered a choice of food. Evidence: The AQAA tells us it provides some activities for people and supports people to have their spiritual needs met. It does identify a need to develop the social and recreational opportunities for people and states it has plans to do this in the next 12 months. A need for this area to be developed is supported by our survey responses that vary from activities being available sometimes to usually. The service employs an activity organiser for four hours a week and this time is used in doing for example crafts and games. It has started to include hand massage for people that cannot take part in more active pursuits. The service had bought some equipment such as large playing cards and dominoes to enable people with visual difficulties to take part in activities. People can also take part in a monthly session of gentle exercises. The service has a number of people that are quite poorly and are nursed in bed. The staff try to spend time with these people in their room talking to them to provide them with social and emotional support. The service has provision in Care Homes for Older People Page 15 of 27 Evidence: place to meet peoples spiritual needs relating to the Anglican faith. A service is held once a month. In addition to this the service welcomes individual religious leaders to meet with specific people living at the service. One person also goes with family to the local church. Talking to people it is evident that people can choose where and how to spend their time. One person told us that she prefers to spend time in her room reading and watching television but did join in with activities when they take place. This person also has her own telephone in her bedroom. She also said that the service celebrates peoples birthdays and significant events during the year. Other people prefer to spend time in the communal rooms and we saw that large print books and word searches are available. Throughout the day visitors came to the service and an examination of the visitors book shows that visitors regularly visit. The service tells us that it welcomes visitors at any time. The AQAA states meals are well balanced and highly nutritious and that staff support people that need help to eat their meals. Our surveys and discussions with people that live at the service confirm that people like the food. Comments include the food is excellent, always hot and well cooked and presentable and the food is four star. A menu board is on the dining room wall. This had only one main meal recorded on it. Staff tell us that that if people do not like the meal on offer they can have an alternative. One person said he has egg and chips one day a week as an alternative. We also saw that everyone had the same sweet although the cook said that there is always alternatives available. We did not see people being offered these alternatives. The service provides people with specialist diets including a soft diet for those with difficulty chewing or swallowing and for those requiring a diabetic diet. People that need support with eating are provided with it. Care Homes for Older People Page 16 of 27 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. People that use the service can be assured that their views are listened to and acted upon. People can be confident that the staff are aware of signs of safeguarding and know how to respond. Evidence: The services AQAA states that it welcomes complaints and suggestions about the service and uses them positively and learns from them. We saw a copy of the complaints procedure in the hallway of the service and the manager said that everyone is given a copy as part of their contract. Our surveys confirm that people know what to do if they feel unhappy about something. One person said Matron always makes herself available if I am worried about anything. Surveys also confirm that people feel staff listen to them and act on what they say. Also one person we spoke said she would raise any concerns with staff. Neither we, the commission nor the service have received any complaints over the last 12 months. The services AQAA tells us it has safeguarding and whistle blowing procedures in place. Staff said they are due to have training in the next few weeks. When we spoke to them there are aware of symptoms of abuse and of how they would respond if they have any concerns. We also spoke to the manager of the service and she is aware of the need to refer any potential safeguarding incidents to the local authority as the coordinating agency. There has been one incident referred but this was investigated and the local authority was satisfied that no abuse had occurred. We did remind the Care Homes for Older People Page 17 of 27 Evidence: manager of the need to refer to us, the commission, if any such incidents occur. We would also advice that the staff are fully aware of the multi agency safeguarding procedures. The service is making sure all the necessary checks on staff are completed before employing staff. The service does look after peoples money and there are effective records in place that are checked regularly. A number of people are using equipment such as bed rails that can be a means of restraint. Where rails are used assessments for their use are in place. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service can be assured that the accommodation can meet their needs and that the service is kept clean and tidy and that staffs practices will control the spread of infections. Evidence: The services AQAA tells us that the service is well maintained and kept clean and tidy. The service is located not far from the town centre. The premises is a large old property with a rear extension. The service has a small rear car park and a garden for people to sit in. The service tells us that it has improved the accommodation through decorating bedrooms and the dining room over the last 12 months. It also states it has improved the equipment available for peoples care having more nursing beds, more pressure relieving mattresses and buying more easy chairs. We saw that the service provides people with good communal accommodation having three lounges, two of which look like sitting rooms in someones own home. There is a separate dining room. This room overlooks the garden. Tables have tablecloths and flowers. There are three double bedrooms and 19 single bedrooms. None of the bedrooms have en suite facilities but all have a hand washbasin. Double bedrooms have privacy screens. The sample of bedrooms looked at show that people are provided with suitable private accommodation providing adequate storage and somewhere to sit. People can take in items of furniture and bedrooms are personalised with photos, Care Homes for Older People Page 19 of 27 Evidence: pictures and ornaments. Observation shows the service to be clean and tidy. Infection control procedures are in place and staff have received recent training in effective hand washing. The AQAA tells us that all the staff have had training in infection control. We saw that liquid soap and paper towels are provided and that that there is a ready supply of protective equipment for staff to use. Care Homes for Older People Page 20 of 27 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. People that use the service can be confident that the staff have the knowledge and training to provide them with the care they needs and that ample staff are available to support them. People are protected by the way the service recruits its staff. Evidence: The services AQAA states that it offers a high quality of care always having the full compliment of staff on duty. It states that there is a low staff turnover giving people continuity of care. The service states it has additional staff on duty at peak times during the day. People we spoke to say that the staff are good with comments like very caring staff and they are very good. This view is confirmed by our surveys that say that staff listen to them with one stating that the staff are fantastic. Staff are aware of the individual needs of people and how these should be met. We saw that staff treat people with respect and that there is a friendly relaxed atmosphere in the service. People also say that the staff are available to respond to their needs. One survey said the staff are always available to help in any way and one person we spoke to said that the staff come quickly if she presses the nurse call alarm. We also observed that staff are available to assist people. Over lunchtime plenty of staff are around to give people the support they need to eat their meals. Care Homes for Older People Page 21 of 27 Evidence: Talking to staff and examining the records shows that the service places an emphasis on staff training. Staff report in the surveys that they receive induction training and receive ongoing training that is relevant and helps them to understand peoples different needs. A training plan is in place covering the next few months that includes confusion and protection, vulnerable adults, health and Safety, moving and handling, first aid and infection control. Records show the nurse training has covered care of the dying, catherisation, stoma care, medication as well as Health and Safety practices. The service has over 50 per cent of staff trained to at least NVQ level 2. Checks on a sample of staff files shows that the service is making the required preemployment checks. All files seen contain a Criminal Bureau Record and Protection of Vulnerable Adult check and two references including one from the previous employee. Care Homes for Older People Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed in the interests of the people that live there. Evidence: The AQAA states that the manager is fully committed to the service and the wellbeing of the people that live there and the staff. It also states that the manager is visible on a daily basis and that she operates an open door policy for people that live at the service, their relatives and the staff. The manager has worked at the service for a number of years and has lengthy experience in working in care and health services. Records confirm that she undertakes training to keep keeps up to date with current practices. Records also confirm that she undertakes regular assessments of the nursing staffs competency to undertake specialist nursing tasks. The manager holds regular meetings with the nursing and care staff and also visits at night to meet with and support the night staff. She tells us she holds these meetings to make sure everyone is aware of any issues and developments and to pick any issues they may have. People speak positively about the management of the service. One staff survey stated the home is very well run and one person we spoke to said about the service Care Homes for Older People Page 23 of 27 Evidence: you cant fault it. A survey from someone living at the service said the manager has been very kind to me over the last six years. The service looks after money for people living there. A check of two peoples money shows that the amount of money held, corresponds with the records and that receipts are kept to show how money is spent. The service has a system in place to regularly audit these accounts. The service sent us their AQAA when we asked for it. It told us about the service and about areas where they feel they can improve. The service has systems in place to monitor and review the service. These include a range of audits on environmental issues and on care practices. The service also undertakes questionnaires of visitors to the service. Comments we saw were very positive with one stating sincere thanks to committed nursing team and for the wonderful care. The manager also has regular contact with people that live there and gains their views on a daily basis. A development plan for improvements to the service is in place. The services AQAA tell us that it has systems in place to ensure that all the environmental checks are in place. People we spoke to and seeing a sample of records confirms that staff receive training in health and safety practices including infection control, moving and handling and food safety. The service has fire safety procedures in place. Staff receive training in fire safety, a fire risk assessment in place and checks are completed on fire equipment. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 2 12 15 A greater range of activities should be made available to people. This will improve peoples quality of live. People should be made aware of the choices of meals that are available to them. This will make sure that they can choose the meal that they wish to eat. Care Homes for Older People Page 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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