Inspection on 28/01/09 for The Dales

This inspection was carried out on 28th January 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

The Dales 13/02/08

The Dales 12/12/06

The Dales 21/01/06

The Dales 07/06/05

The Dales 21/02/05

The Dales 17/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Dales Main Street Ellenborough Maryport Cumbria CA15 7DX     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: Nancy Saich     Date: 2 8 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. 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 30 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 30 Information about the care home Name of care home: Address: The Dales Main Street Ellenborough Maryport Cumbria CA15 7DX 01900817977 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dales Care Homes Limited Name of registered manager (if applicable) Mr Graham Baxter-Iredale 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 registered person may provide the following category of service only: Care home only - Code PC. 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, Physical disability - Code PD. The maximum number of service users who can be accommodated is: 40. Date of last inspection Brief description of the care home The Dales is an older property that has been extended and adapted to cater for up to 40 older people. It is situated in the centre of Ellenborough, a residential area of Maryport. It is near to all the amenities of the village and the town. The home is owned by the Iredale family, and the registered manager is Graham Iredale. Care Homes for Older People Page 4 of 30 care home 40 Over 65 40 1 0 0 Brief description of the care home The accommodation for residents is on two floors served by a passenger lift. Most of the bedrooms are single occupancy but there are some double rooms available. The home has a number of large and small lounges and a small patio area outside. Charges range from 386 to 434 pounds per week. There are no additional charges made for any service. Further information, including copies of our inspection reports, can be obtained from the home. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the main or key inspection for the year. The lead inspector Nancy Saich asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the the last inspection and for the plans for the coming year. This was completed promptly with plenty of detail. We (The Commission for Social Care Inspection) then sent out postal surveys to people who live in the home and to the staff group. We had a good response to these surveys and we quote from them in the report. The responses were fairly positive and gave us a good picture of what its like to live and work in the home. Care Homes for Older People Page 6 of 30 We toured the building, sat in lounges and shared a meal with residents. We also looked at files and documents that backed up what was said and what was seen. What the care home does well: This service is good at making sure that the only take new people once they know they can meet their needs and that they will fit in with the existing group. They make sure that peoples health care needs are met and people told us that they get good support from local doctors and nurses. People told us and we could see for ourselves that the management and staff of this service treat people with respect and dignity. Very caring staff...always friendly that make it home-from-home for clients and family... The managment and staff are very helpful and caring... We had evidence to show that people spend their time as they chose and no one imposed rules and regulations on them. I do what I want, when I want...they do keep an eye on me but I prefer to be in my room reading or watching TV...they ask me if I want to come down to activities but I can choose not to if I want... Visitors and people who live in the home told us that family and friends were always made very welcome and were included in entertainments and activities. People are offered a wide range of activities and this includes entertainments as well as crafts and hobbies. A number of people are actively involved in organising an annual local history exhibition. People told us they were happy with the quality and choice of meals and snacks on offer. The dining room is used as not only somewhere to take meals but as a venue to socialise with other people. The food is very good...we are taking no harm being here...some of us have put on plenty of weight !. People in this home tell us that they feel comfortable about making a complaint or a suggestion. No one had any complaints on the day. If I did I would soon tell one of the family (the Iredales) and they would sort it out... We had evidence to show that people in the home are protected from harm and abuse and that staff are confident about dealing with these matters. There was no suggestion of anything abusive happening in the service. The home has an established staff team and people said that there was enough staff most of the time to meet their needs. Care Homes for Older People Page 8 of 30 I cant say enough good things about The Dales...the care is amazing. The staff are always available, pleasant and genuinely like what they do... Staff have suitable training offered to them so that they can gain relevant qualifications and carry out their jobs to the best of their ability. What has improved since the last inspection? What they could do better: We want the manager to look at the care plans again so that all the details that people want and need are included. We ask that, as far as possible, people are involved with devising their own plan of care. Care Homes for Older People Page 9 of 30 We want the management team to make sure they keep all their records up-to-date so that they will always have available information about the way the home runs and this will help all of the systems to work correctly. We judged that there were some issues around health and safety in the service that might become a problem in the future and we want the management team to look at all the arrangements they have in place. This needs to be done so that small things are not overlooked and allowed to develop into problems. 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 10 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service is careful to only take people who they know they can provide appropriate care for and who will fit in with the other people who live there. Evidence: We saw a new brochure for the home and this gave plenty of information about the care and services provided. It also gave details of local amenities and up-to-date charges for staying in the home. The service also has a web site but this was currently not available due to a problem with the website provider. The manager said that this would be dealt with shortly. We met with a number of people who talked about why they decided to come into the home. Most people had decided on the Dales because it had been recommended. They had been given opportunities to visit, meet with other people and ask questions of staff. We looked at the files of a number of new people and we were satisfied that the Care Homes for Older People Page 12 of 30 Evidence: management team made sure that they could provide the right kind of care for the individual. Care Homes for Older People Page 13 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good levels of health and personal care and this allows them to be as well and as happy as possible. Evidence: We read a number of files belonging to people who live in the home. We checked on the written plans that help staff to give people the kind of care they want and need and we also read the notes that are taken about people on a daily basis. On our last visit we made a requirement because these Care Plans were not being kept up-todate. On this visit we saw that every person in the home, even if they had only been there for a matter of weeks, had an up-to-date care plan. Many of the plans met the persons needs in a detailed and appropriate way. Some files had good assessment of risk and social and personal histories. One or two plans needed a little more detail and we judged that where staff had seen any risk they now needed to include more information about how to manage the risk in the current care plan. Generally the plans had improved greatly and we look forward to seeing more detail and more strategies in place. We spoke to several people about the content of their care plans and most Care Homes for Older People Page 14 of 30 Evidence: people were quite vague about what was in the plan but were very precise about what they wanted and when. One or two of our surveys highlighted little things that people wanted included in their care. We want to see people having more influence over their care plans and we judged that there were a number of people who, if given the right kind of support, could write their own life histories and care plans. We looked at the files and spoke to people about the way they were helped to keep as well as possible. They told us that they had visits from doctors and nurses who gave them regular health checkups. They also told us that the doctor would change their medication if needed. They said they had regular visits from the chiropodists and that opticians and dentists would come to the home or they could go out to appointments. We saw that people looked well and that most people ate very well at mealtimes. Several people said that the good food had helped their health improve. One person told us that in a very short space of time his health care needs had been met and we saw in the records a dramatic improvement in him in a matter of weeks. Staff told us that they worked well with the local healthcare professionals and that the district nursing service trained them in basic home nursing skills. We looked at the medicines kept in the home and we judged that these were being managed properly. We saw that the management team had made improvements to the systems they were using and staff told us that they found this easy to manage. They also told us that they were trained in how to use the system and how to manage medicines. We asked people, either in person on the day or in our surveys, about whether they felt they were treated with respect and dignity. We received no negative responses. In fact most people were very complimentary about the way the staff team treated them. Everyone we had contact with spoke very highly about the members of the Iredale family who make up the management team.We were told that there was a real family feel to the Dales and thats why most people had chosen to come there. During the course of the visit we observed both staff and management responding to peoples needs in a warm and friendly way. There is a lot of humour and sensitivity in this service and we judged that people are given due respect and their needs are met in a way they prefer. We had discussions with both staff and management about ways in which they could formalise some of the good work they do but still keep this very relaxed atmosphere. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Dales provides people with a wide range of fulfilling options and choices that keep people alert and interested in life. Evidence: We spent a good part of the day in the home and we saw that people got up and came down to the shared areas as they wanted. Some people ate all their meals in their room and they told us that they preferred not to socialise. Some people said they liked their own company but did like to join in activities and liked to come to the dining room for meals. We were told that people chose what they did both by day and at night. One or two people said that they liked to stay up late and there was no problem with their choice of lifestyle. No one had any restrictions on what they did, although there was evidence to show that people were guided and persuaded if they needed support. We were told in surveys and on the day that one of the aims of this service is to make the family and friends of people who live there feel welcomed in the home. We had lots of evidence to show that families are happy to drop in and are encouraged to join in with activities or entertainments. A number of people went to great lengths to tell us Care Homes for Older People Page 16 of 30 Evidence: how important it was for them to be helped to remain in the centre of their family group. On the day of our visit there was a Communion service being held in one of the lounges and people told us that all denominations were catered for by the local clergy. We had evidence to prove to us that at certain times of the year services were held to celebrate Christian festivals. The management of the home explain to us that no one felt compelled to join in the services and that they were more than happy to support people who had different beliefs. We were told that there are regular entertainments in the home and that staff organise activities like quizzes and bingo every week. People in the home have had the chance to get involved in creative craftwork projects and we saw the decorated pottery from a recent class. We heard about plans for trips out when the weather got better and we saw photographs of groups of people going out to activities. We also saw records of people being supported in individual trips out. For example it was important for one person to lay his wreath on Remembrance Day and he was helped to do this. The Dales has held an exhibition in the building for a number of years. This is done with the local history group and a number of people spoke very enthusiastically about their successful exhibition in November and the plans for this year. They are going to put local history into a national and global context so that people who do not come from the area can feel more involved. People told us that they were trying to encourage all the local schools to be involved so that they, as older people, could give children an idea of their history. We saw people in the dining room at breakfast time and again for morning coffee and we joined them at lunchtime. Although some people do not come down to the dining room very much a lot of others enjoy walking up to the dining room so that they get a change of scenery and some exercise. Staff will always take people down to this area if they want. The dining room is very near to the front entrance of the home and to the office. As one person said it is the real heart of the home. The dining-room tables are nicely set all day with good quality linen and china. We were told that most people bring their visitors here and we saw a number of people being given cuppas and a selection of home baking. Two choices were offered at all mealtimes and there was a cooked choice for high tea. People ate their meals really well and said that they enjoyed everything about mealtime. The kitchen was well-stocked with fresh, good quality food. The menus were varied and nutritional. The cook explained that they provided special diets and that this was no problem to the catering staff. Care Homes for Older People Page 17 of 30 Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are listened to and protected from harm because of the way the staff and management treat any concerns they have. Evidence: We had received no complaints about this service and when we spoke to the manager he said that there had been no formal complaints. The home has an up-to-date complaints procedure and they also have a relative who will assist any person who wants to make a complaint. We saw copies of the complaints procedure in every bedroom in the home. People we spoke to said they had no complaints and they told us that they would not hesitate to speak to a member of the Iredale family if things were not to their liking. We were also told that people felt comfortable about talking to members of the staff team if they had any concerns. We also asked people about how well protected they felt from harm or abuse. Again people considered that both management and staff would listen to any concerns. The service has good policies and procedures about safeguarding people and access to local arrangements for this with Cumbria County Council. There had been one matter dealt with under safeguarding arrangements and this was in relation to a problem outside of the home. This had been dealt with by the manager in an appropriate way. Care Homes for Older People Page 19 of 30 Evidence: We spoke to several members of staff about protecting people and they were aware that they could contact ourselves or Social Services if they felt there was an issue where people were being abused. Staff said they had received training on these matters and were looking forward to updates to this. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home provides people with a relaxed and comfortable environment where they can have privacy and can socialise. Evidence: The Dales is an older property that has been extended and adapted to provide accommodation for up to forty older people. The property is on two floors served by a passenger lift. Accommodation is in single rooms with ensuite toilet facilities. There are specially adapted bathrooms on both floors. There are seven lounge areas of different sizes. Some of these are quiet areas, others have televisions and some larger spaces are used for entertainments. One room is used for craft and other activities. The property also has a large dining room. The home is situated in the centre of Ellenborough village and is within easy travelling distance to the centre of Maryport. Local shops, pub and hair dresser are within walking distance. There is a regular bus service with a stop outside the home. Parking is on the street. Externally there is a small front garden and a sitting area at the back of the property. This seating area at the rear of the building has been tidied up considerably to improve access once the weather improves. The rear entrance to the property has also been cleared and will be resurfaced to provide some parking spaces. Care Homes for Older People Page 21 of 30 Evidence: When we last visited the home we judged that a number of areas were not as tidy as they should be. At this visit we noted that all shared spaces had been tidied and generally the building seemed less cluttered. Both inside and out it could be seen that the management had removed unnecessary items. We also saw that corridors and some lounges had been redecorated and a new hall carpet laid in one area of the home. We were told that thirty windows had been replaced in the home and a new wireless call bell system installed. Several bedrooms had been redecorated and new floor coverings laid. People told us that they had been involved in choosing some of the new decoration. Bedrooms were personalised and a number of people enjoyed sitting in their own rooms surrounded by their own furniture and possessions. There had been a potential problem with one of the door alarms that alert staff to anyone leaving or entering the building. New door alarms had been installed that are connected into the call bell system and this should reduce any risks. Changes had been made to the arrangements for laundering clothing in the home. Some of our surveys and some people on the day told us that there had been quite a few problems with laundry not being returned. People did say that this had improved in the last few weeks because one member of the housekeeping team was controlling the laundry. The laundry is in an outside building and the management have provided a new area where clean washing can be sorted, ironed and returned. There were suitable arrangements around the home to help prevent cross infection. Staff had been trained in infection control and on the day we could see that reasonably good practice was maintained. Staff were aware of the need to take extra precautions at certain times. We could not detect any foul odours on the day anywhere in the home. People were happy with the levels of cleanliness in the building. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service has a suitably trained staff team in sufficient numbers to give people good levels of care and service. Evidence: We were given copies of the last four weeks rosters for the home and we judged that there were suitable staffing levels in the service. Some staff and residents did say that at times staffing levels could be improved on. However we judged that this might be due to holidays or other absences. The AQAA tells us that this service has a low turn over of staff and very few unexplained absences in the staff team. Most members of the team have worked in the home for a number of years and we could see in surveys and by talking to people on the day that the staff are very focused on peoples care and they want to spend as much time as possible with them. The management team told us that they continue to look at the way staff are deployed so that people get the best care and services possible. There was evidence to show that new people had been taken on and that some peoples areas of responsibility had changed. For example there is now a dedicated member of staff doing laundry and a full-time maintenance person on the team. People told us they were happy with the attitude and approach of team members. Care Homes for Older People Page 23 of 30 Evidence: We checked on the way new members of staff were recruited because there had been some problems when we last visited. We looked at the staff files and spoke to a new member of staff. We could see that the management staff are now very careful about references and background checks for any new member of staff. We judged that new recruits had been vetted carefully so that people could be confident that they were the right sort of staff to work with vulnerable people. This service encourages staff to complete a National Vocational Qualification in care at level 2. Several people are registering for the level 3 award. Staff were keen to complete these qualifications and wanted more training. We spoke to members of the staff team and checked individual training files. We could see that new starters went through an induction programme that explained the aims and objectives of the home and the duties expected of them. There are two supervisors who make sure that they train new starters in the basic skills and knowledge needed to give people individual personal care. Staff told us that they also covered basic home nursing knowledge and skills and that the local district nurse helped with this training. A number of people had undertaken other forms of short course training. Some staff had completed courses on dementia care or the management of medication. We asked the manager for the training plan for the following year and we were given a brief outline of the types of training they hoped to access for the staff team. We advised the manager to formalise some of this process a little more so that when training needs were seen in supervision these could be put into planning a more formal training programme. We were told by management and by supervisory staff that they had started to do this and were working towards specific training dates. People told us that they judged the staff to be quite well trained and they felt comfortable being cared for by the team. A number of people told us that in particular they felt that the two supervisors were very skilled and knowledgeable and could be relied on to meet any kind of personal care or health need. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements in place to help the management team ensure that people have the care and services they need. Evidence: Since the last inspection Graham Iredale has become the registered manager and his brother Stephen has become the representative of the company. Their parents continue as directors of the company but no longer play such a major role in the home. The manager has worked in the home for a number of years and has suitable experience and skills to manage the home. He is helped in this by another member of the family and together these three people control the management of the home. People who live in the home tell us that things are different since these changes. No one considered things to be worse or better -- just different. During our visit we saw a lot of evidence showing that the new management team were making changes and were planning for the future. This is a home that is in the process of change and we Care Homes for Older People Page 25 of 30 Evidence: look forward to seeing this continuing so that things will develop but people who live in the home will continue to feel comfortable with the pace of change. The manager had sent surveys out to people and their relatives and we saw that there had been a review of the systems that run the home. We saw the beginnings of a new system for delegating work to individual members of the team. We judged that all of this together meant that this service is involved in monitoring quality and in improvement. We could see that this work is in progress and look forward to seeing a formal audit completed within the year. We were told by the management team that they do not control anyones financial arrangements and do not keep any cash on behalf of people. The supervisors did have a tiny amount of cash for two people that had not been used since admission and they agreed to return it or begin to keep an account of this. During our visit we looked at number of records kept about all aspects of the service. We could see that there had been improvements to the way records were kept and the general office was much tidier and files were easier to access. We did however have evidence that some records were not been handled correctly. For example registered homes must notify us as soon as possible of any events of importance. These things were being recorded but the management team were not sending them straight away. There were also some other records that werent being kept up-to-date and we want the manager to make sure that things like health and safety and training records are updated as soon as possible. We checked on a number of things concerning health and safety matters in the home. We found that the home has suitable systems in place but that sometimes the systems werent working as well as they might. We judged that a health and safety review of the service needs to take place because we found one or two things that could lead to problems. For example there was a potential problem with an external door, a record of training hadnt been noted and there was some hazardous substances (paint and other decorating materials) in the home that should have been stored outside. We also noted that a member of the kitchen team needed an update to her food hygiene training. We did not find anything particularly hazardous on the day but did think that the time was right for the management team to look again at all aspects of health and safety to make sure that they were lessening potential risk and managing any problems that could arise. Care Homes for Older People Page 26 of 30 Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 7 It is recommended that care plans include more detail, especially where staff are supporting residents to manage risk and that, where possible, people are encouraged to participate in writing their own plans of care. It is recommended that the registered manager looks at the recording systems in the home and makes sure that when ever an event happens it is recorded as soon as possible and that appropriate people are informed. This needs to be done so that he always had evidence to prove that the management systems work correctly. It is recommended that the registered person completes a review of all health and safety systems in the home. 2 37 3 38 Care Homes for Older People Page 29 of 30 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. 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