Inspection on 06/11/08 for The Ridings

This inspection was carried out on 6th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Ridings 08/10/09

The Ridings 20/11/07

The Ridings 29/05/07

The Ridings 16/01/07

The Ridings 30/08/06

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Ridings Farnborough Road Castle Vale Birmingham B35 7JG     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisa Evitts     Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 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 31 Information about the care home Name of care home: Address: The Ridings Farnborough Road Castle Vale Birmingham B35 7JG 01217488770 01217470163 theridings@dukerieshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Dukeries Healthcare Type of registration: Number of places registered: care home 82 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: One named resident over the age of 65 years can be accommodated on the nursing unit for people under the age of 65. The home can accommodate up to 82 people in total within the following categories: A maximum of 20 people under the age of 65 years of age can be accommodated to include 11 people also receiving nursing care. In addition 5 of the 20 beds can be used for either care (maximum 25 care only) or care with nursing (maximum 16 nursing care). A maximum number of 62 people can be accommodated over the age of 65 years for reasons of dementia to include 34 persons also receiving nursing care. In adddition 5 of the 62 beds can be used for either care (maximum of 23 care only) or care with nursing (maximum 39 nursing care) Date of last inspection Brief description of the care home The Ridings is a large care home in Castle Vale that is registered to provide a service for up to 20 younger adults with dementia care needs of whom 11 can receive nursing care and up to 62 older adults with dementia care needs of whom 34 can receive nursing care. There are two residential units called Aintree and Doncaster, two units Care Homes for Older People Page 4 of 31 Over 65 62 20 Brief description of the care home which provide nursing care called Cheltenham and Ascot and two units for younger adults known as Champion Crescent. The bedrooms all have single en-suite facilities and are spread across six independent units. All units have their own dining room, lounge areas and bathing facilities. There is a fully adapted bathroom and a shower room to meet a wide range of movement and additional toilets are available for wheelchair users. All areas of the home including the first and second floors are accessible by a large passenger lift. There are enclosed gardens for people on all units to access. There are disabled parking spaces and limited car parking at the front of the building with additional car parking behind the home. The home is close to bus and rail routes in and out of the city and is within close proximity of local shops and other community facilities such as a retail park. Current fee rates for living at the home were not included in the service user guide, however the home can supply this information on request. There are a number of noticeboards which supply information about the home and the last inspection report is on display for people to read if they chose to. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. We, the Commission undertook a random visit to the home in May 2008 when concerns were raised that the home was not informing us about accidents and incidents, as they are required to. The outcome of the visit was that the home was recording incidents and taking the appropriate action, however was not always reporting it to us. This was discussed with the home and a requirement was made that they needed to inform us about things which happened in the home. During this key visit this requirement has Care Homes for Older People Page 6 of 31 been met as the home keep us informed of any incidents. One inspector visited the home and completed a Short Observational Framework for Inspection (SOFI). Because people with dementia are not always able to tell us about their experiences, we use a formal way to observe people to help us understand. The SOFI involved us observing up to five people who use the services for two hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use the service and the environment. The results of this observation are included within the report. Two inspectors undertook the fieldwork visit to the home over ten hours and the deputy manager and manager assisted us throughout. There were 77 people living at the home on the day of the visit, one person was receiving hospital care and one person was being transferred to hospital. The home did not know that we were visiting that day. Information was gathered from speaking to and observing people who lived at the home. Four people were case tracked and this involves discovering their experiences of living at the home by meeting or observing them, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service.We also looked partly at two further files. Staff files, training records and health and safety files were also reviewed. Before the visit we sent random questionnaires to six people who live at the home and ten staff but none of these were returned. Two people who live at the home, two relatives and three staff were spoken to. Prior to the inspection the manager had completed the Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about how well the home thinks they are performing. It tells us about the home, staff and people who live there, what the home do well and what they need to improve. Since the last inspection in November 2007, the home has recently had a twelve week suspension placed on admissions by Birmingham Social Care and Health. This was following concerns being raised about care delivery and staffing levels. The home have drawn up an action plan to address the concerns and the suspension has now been lifted which means that new people can move into the home. No immediate requirements were made as a result of this visit, which means there was nothing serious that the home had to put right to ensure the safety and well being of the people living at the home. What the care home does well: What has improved since the last inspection? The home has addressed all the requirements made at previous inspections, which shows that the providers and managers want to run a home that meets requirements and is run in the best interests of the people who live there. All of the units have been redecorated to ensure that people live in a homely environment. The recruitment process is robust and ensures that people are safe from harm. New staff have been appointed so that the home can reduce the amount of agency staff which will mean that people will know who will be assisting them to meet their needs. Staff training has increased which means that staff have gained further knowledge and skills to meet the needs of the people living at the home. A new manager has been appointed and people feel more confident that they are listened to and that concerns will be addressed. One person said I have faith in the Care Homes for Older People Page 8 of 31 manager and I am waiting to see it all come together. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 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 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have information about the home to enable them to make a decision about whether they would like to live there. Pre admission assessments mean that people know their needs can be met prior to moving in. Evidence: The statement of purpose was displayed in the reception area of the home. The service users guide is available in each persons bedroom so that people can access this information if they choose to. The documents can be made available in large print upon request so that people with visual impairments can access the information. It is recommended that other formats are considered as people living at the home have dementia care needs and may not be able to recognise the information. The service user guide did not contain information about charges for living at the home and this is recommended so that people have access to all information about the home. Care Homes for Older People Page 11 of 31 Evidence: The certificates of registration and Public Liability Insurance were on display along with the previous inspection report so people could read this information if they chose to. Comprehensive pre admission assessments are undertaken prior to people coming to live at the home and this means that people know their needs can be met prior to moving in. The Annual Quality Assurance Assessment told us that people are able to visit the home before they move in to see what it would be like to live there. The home currently has three intermediate care beds within the Working Age Dementia Unit and has interim beds available. This is where people come to be further assessed before making any decisons about longer term care needs and where they will live. One person told us Its ok here Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements do not always ensure that the health needs of the people living there are met and this could impact on their well being. Evidence: Each person has a written care plan. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order for the person to meet their needs. We looked at four peoples care files in detail and reviewed two further plans for specific needs of individuals. The care files we looked at contained a lot of personal information about peoples needs and about their personal preferences. For example, plans for someone who entered other peoples rooms and collected items were in place and gave staff guidelines to follow to redirect this person when she started to enter other peoples rooms. Care plans for personal hygiene were detailed and focused on what the person was able to do for themselves to help them maintain their independence for as long as possible. Care Homes for Older People Page 13 of 31 Evidence: One persons nutritional plan stated weight hard to assess, but the person had been weighed monthly with the exception of October and had gained weight. It was not clear why it was hard to assess this persons weight. It was of concern that two days before our visit staff had written in one persons notes that the skin surrounding a wound was hot to touch and red. Staff were considering a possible infection and noted that the GP was to review on his next visit. The GP had visited the home on the day of our visit but when we asked staff if he had seen this person staff said no. The nurse told us that the next visit would be the following Monday. We brought this to the attention of the manager and operations manager during feedback as if this person did have an infection, it may have meant that they could have waited to see a GP for six days before any treatment was given. A relative told us that they had informed staff that their relative had a swollen leg. Staff told us that they had not noticed this and would ask the GP to visit the next day. We observed this persons leg to be swollen and informed the manager of this so that action could be taken. One person had a number of falls. There were risk assessments in place and care plans however these had different information recorded and it was not clear what staff were to do to try and minimise the risk of falls. For example the care plan said no issues with mobility at present but the evaluation said will need supervision. The falls risk assessment indicated no falls in the last year but records demonstrated a number of falls had occurred. Plans for diabetes were generally detailed, however one person who required insulin did not have a plan which gave staff details about what to do if blood sugars levels were too high or too low. Risk assessments were in place for moving and handling and gave staff instructions about how to move people if they should fall. Risk assessments were also completed for falls, nutrition and skin soreness. There was evidence that people are seen by the GP, chiropodist, optician, occupational therapist, dietician and tissue viability nurse. This means that people receive specialist advise about their healthcare needs. The management of medication was reviewed. Each unit manager completes a weekly audit and investigates any inaccuracies. We looked at the medication on two of the units. Drugs were signed in upon receipt into the home and copies of prescriptions are kept so that staff could check they received the correct medication. The majority of Care Homes for Older People Page 14 of 31 Evidence: audits were correct with the exception of an antibiotic, which was signed to say the course had been completed. There were 28 signatures, however one tablet remained in the box, which means that someone had signed the chart but had not administered the tablet. A second chart had gaps on it, the audit meant that people had been given the tablets but staff had not signed the chart when administered. Fridge temperatures were being recorded as minus 5 to minus 8 degrees and this was brought to the managers attention as may mean that drugs are not being stored within their product licence. People were observed to be well presented and wearing clothing to meet their needs. Ladies were seen to wear jewellery and make up as they chose. Care Homes for Older People Page 15 of 31 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 are able to choose the activities that they participate in which promotes their individuality and independence. People are offered a choice of meal to meet their dietary, cultural needs or preferences. Evidence: The home has two dedicated activity coordinators who both work 30 hours per week. There are a range of activities offered to people including arts and crafts, board games, manicures, sing a longs and dancing. There had recently been a Halloween party and an open day at the home. People who are able to go out of the home are supported to local shops and library. People living on the Working Age Dementia Unit are encouraged to go out into the local community and attend the local community centre. People were seen to come and go throughout the day and this maintains their independence. This unit has a kitchen; laundry and utility area were people are encouraged to participate in these activities as part of their rehabilitation. We were told that the hairdresser visits two or three days per week and that a church Care Homes for Older People Page 16 of 31 Evidence: service is held every week so that people can continue with their religious beliefs. An inspector had visited the home prior to this visit to undertake a Short Observational Framework Inspection (SOFI). This is a formal way we observe people to help us understand what it is like to live in the home and is helpful to us when people have dementia and are not always able to tell us about their experiences. Some of the people we chose to observe were asleep for part of the observation, however we saw good interactions from staff. We noted that staff spent time talking to people about things that were meaningful to them. Some people were looking at and talking about photo cards, some were colouring and staff sang happy birthday to a person who was to have a birthday party in the afternoon. During the second day we continued to see good interactions, with staff dancing with people and singing. Some people were happy tidying up and closing the curtains, while others watched TV. One person said I do a bit of knitting occasionally and a relative said I have not seen any activities but know they happen as my sister said yesterday they were doing ball games. There is an open visiting policy, which means that people can see their friends and relatives as they chose and can continue with relationships that are meaningful to them. One relative told us that they were made welcome. There is a four weekly rolling menu and these showed choices of meals. Caribbean dishes were provided to meet the needs of the Afro Caribbean people and anyone else who enjoyed this food. The menu currently offers two hot choices at lunchtime and a hot choice or soup and sandwiches in the evening. Salads, fresh fruit and yoghurts are available on request and a full English breakfast is available if chosen. Staff were observed to assist people to eat their meals in a manner, which promoted their dignity. People told us: The food is alright The food isnt bad at all Relatives told us: Food is not very nutritious Care Homes for Older People Page 17 of 31 Evidence: There is no thought put in to the soft diet The manager is planning to change the menus and ask for external advice regarding the nutritional values and this will be reviewed at our next visit to the home. Care Homes for Older People Page 18 of 31 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 complaints procedure is comprehensive and is accessible to people should they need to make a complaint. The home has policies, procedures and staff training, which should safeguard people from harm. Evidence: The complaint procedure is displayed in the home and is included in the statement of purpose and service users guide so that people know how to make a complaint if they need to. Since our last visit to the home we have received two complaints about care needs, staffing levels and meals, and we asked the provider to investigate these using their own procedure. We looked at the complaints records and the home had received 13 complaints since January 2008. Complaints had been responded to and actions taken had been recorded so that we knew how the home had addressed the concerns. One person who lives at the home said its not bad here you cant grumble. There is a suggestions box in reception so that people can make their opinions known. The manager holds a weekly surgery so that people can discuss any concerns on a one to one basis and has an open door policy so that people can see him at anytime. Care Homes for Older People Page 19 of 31 Evidence: The home had recently had a twelve week suspension on its beds, which meant that the home were not able to admit any new people. This was following concerns, which had been raised about care, and staffing in the home. The home had submitted an action plan to the Birmingham City Council and the suspension has now been lifted. There had been five incidents, which had been raised as adult protection allegations. These had been addressed and the cases closed. Both the homes staff and external professionals had made these referrals. 95 percent of staff had completed training in Protection Of Vulnerable Adults and the remaining staff were to start this training the following week of our visit. At the random visit in May 2008 we spoke to four staff and we spoke to three staff during this visit about their knowledge of adult protection procedures. Staff were able to demonstrate a good knowledge of what they would need to do to safeguard people in the event of an allegation being made. Care Homes for Older People Page 20 of 31 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 are provided with a homely, clean and comfortable environment in which to live with meets their needs. Evidence: We looked at some areas of the home to review communal areas, and areas relevant to the people we case tracked. As we walked around the home there was a good atmosphere on each of the units. People who live at the home were moving around the home in areas as they chose to and we saw some people go out into the garden with staff. Each unit has its own communal area and dining space and bedrooms are all en suite toilet and handbasin. Corridors are wide and spacious and have handrails so that people can move around and maximise their independence. Communal areas have been redecorated and are bright and clean. There are a number of tactile pictures on the walls to improve stimulation. The home has further plans to redecorate peoples rooms with colours and fabrics of their individual choices. Bedrooms seen were personalised as people had chosen and had items that were familiar to them to make their room as comfortable as possible. Each bedroom has its own heating control and one person asked a member of staff to turn the heating down, Care Homes for Older People Page 21 of 31 Evidence: as it was too warm. The staff member returned to her and told her that he had turned down the heating so that she knew this had been completed. There is a programme of routine maintenance to ensure that the home is a safe place for people to live in. The kitchen and laundry were visited and were found to be clean and tidy. The Annual Quality Assurance Assessment told us that the laundry was open longer now and this had resulted in a faster turn around of clothing and fewer items being lost therefore reducing complaints. There were a couple of rooms, which had offensive odours, but this was being addressed with the cleaning of the carpets. Care Homes for Older People Page 22 of 31 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. People are supported by staff who receive training to ensure that they have the knowledge to meet individual needs. The recruitment procedure ensures that people are safeguarded from harm. Evidence: Each unit has its own staff rota so that it is clear who is working a shift. Previously the home had used a lot of agency staff however recently had recruited 13 new care staff who were awaiting their safety checks before they could commence working at the home. This should bring some stability to the workforce and will ensure that people know who will be helping them to meet their needs. In addition to the nursing and care staff the home also employs domestic, laundry, administration and maintenance staff to ensure that all peoples needs are met. One relative told us There are more staff and less agency. Relatives told us that there were still some concerns about staffing at the weekend as staff did not come to work but were confident that the new manager was dealing with this. 64 percent of staff have completed a National Vocational Qualification level 2 in care and other staff are enrolled to complete this training. This should ensure that staff have the knowledge and skills to care for people individually and collectively. Care Homes for Older People Page 23 of 31 Evidence: During the Short Observational Framework Inspection (SOFI) and throughout our visit to the home we observed good interactions between the staff and the people who lived at the home. There was a nice atmosphere and staff appeared to know peoples likes and dislikes. Prior to being employed by the home, potential staff attend a full recruitment and selection day, which includes presentations, orientation and communication exercises before a interview in the afternoon. The manager feels this has been successful in appointing people with the appropriate skills needed to work with people who have dementia care needs. We looked at three staff files and these contained all the required information to ensure that people were safe from harm. Staff complete a basic induction into the home that, is then followed by a more detailed 12 week induction. The home has a training matrix, which is updated weekly and showed a significant improvement in the training that staff had undertaken to increase their knowledge and skills. Training includes medication management, first aid, health and safety, dementia, moving and handling, fire and control of substances hazardous to health. The home has introduced E Learning courses where staff can complete the training at their own pace. Staff were very enthusiastic about this training and commented: It is good, you have to read it yourself and do a test at the end I have learnt a lot while I have been here Care Homes for Older People Page 24 of 31 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 registered providers and manager are keen to ensure that the home is run in the best interests of the people who live there. They need time to continue with and sustain the improvements, which are in place. Evidence: Since the last key visit to the home a new manager had been appointed and had been in post for approximately eight weeks. He had worked at the home since April 2008 as a Registered Mental Nurse. The manager has previous management experience within care homes and showed enthusiasm to move the home forward in the best interests of the people who live there. It is recommended that he submits an application to become the registered manager as this will show a commitment to the home. Staff and relatives meetings are arranged at different times to give everyone the opportunity to join in if they wish to. Minutes from the relatives meeting were displayed in the reception area of the home so that people could read them if they Care Homes for Older People Page 25 of 31 Evidence: chose to. These meetings give people the opportunity to discuss any ideas or concerns they may have. The manager has an open door policy so that people can speak with him at any time. Staff told us: The manager is approachable and always on the units He will do anything to help A relative told us that they had a good feeling about the manager and that there was a lot of proactive work which they were waiting to see come together and enhance the lives of the people living at the home. External managers visit the home and write a monthly report about the quality of service provided. The home also complete audits and customer satisfaction questionnaires so that information about how well the home is performing is collected. Prior to the inspection the manager had completed the Annual Quality Assurance Assessment. This gave us detailed information about how the home thought they were performing, what they do well and how they could improve. The manager had identified areas where improvements could be made and had plans in place how to achieve this. The home is able to hold small amounts of personal money for people and all the audits were correct. Each person has their own record of money and receipts are kept when money is spent. The home audits the money monthly and this should ensure that peoples money is held safely. It is recommended that two signatures are recorded for all transactions. In May 2008 we carried out a random visit to the home as concerns had been raised that we were not being informed about incidents in the home. We looked at the accident and incident records and found that staff had taken appropriate actions but had not always informed us, as they are required to. A requirement was made for them to tell us about any incidents, which affected the health and well being of people living at the home. During this visit the accident records were reviewed and they were well recorded with a monthly analysis taking place. We are informed of incidents as they occur. Health and safety and maintenance checks had been undertaken in the home to ensure that equipment was safe and in working order. Care Homes for Older People Page 26 of 31 Evidence: We were unable to find any recent fire drill records and fire training records, however this training was booked for December and will be reviewed at the next visit to the home. This training will ensure that people will know how to safeguard people in the event of a fire occurring. Care Homes for Older People Page 27 of 31 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 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 12 Care plans must provide sufficient and current information. So that staff know how to assist people to meet their needs. 31/12/2008 2 8 12 Provison must be made for 19/12/2008 supervision and treatment of people. So that their health care needs are met. 3 9 13 Medication must be managed. To ensure that people receive this as prescribed. 19/12/2008 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 1 Information about the home should be detailed and available in a range of formats so that it is accessible to all people. Care Homes for Older People Page 29 of 31 2 3 9 12 Fridge temperatures should be within an acceptable range to ensure that medicines are stored safely. Information about individuals interests should be consistently available so that staff know what people like to do. The home should have a registered manager so the home is run in the best interests of the people who live there. Two signatures should be recorded so that peoples money is safe. 4 5 31 35 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 31 of 31 - 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!