Inspection on 26/11/08 for The Steppes Residential Care Home

This inspection was carried out on 26th November 2008.

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 Steppes Residential Care Home 13/12/06

The Steppes Residential Care Home 02/03/06

The Steppes Residential Care Home 07/07/05

The Steppes Residential Care Home 30/12/04

The Steppes Residential Care Home 03/08/04

The Steppes Residential Care Home 03/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Steppes Residential Care Home Cossack Square Nailsworth Glos GL6 0DB     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: Pauline Lintern     Date: 2 6 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 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 Steppes Residential Care Home Cossack Square Nailsworth Glos GL6 0DB 01453832406 Telephone number: Fax number: Email address: Provider web address: steppescare@aol.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Joanne Kim Smith Type of registration: Number of places registered: The Steppes Care Limited care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Steppes is a care home registered to provide personal care for twenty-one older people. The home is an older style property that has been extended over time and adapted for its current purpose and accommodates fifteen service users. Adjacent to the main house is a smaller and more recently constructed house with six service users accommodated there. Both parts of the home provide a domestic style environment and easy access with a stair lift in the small house and a shaft lift in the main house. The main house has a small communal lounge and dining room on the ground floor. Service users accommodation is provided on the ground and first floor. All service users accommodation is provided in single rooms, most have en-suite facilities. A communal bathroom providing an assisted bathing facility is situated in each house. The amenities of the local town are in close proximity. The fee ranges for this home is #400 to #500 per week and extras to this include hairdressing, newspapers and chiropody. This information was given to the inspector prior to the inspection. The Care Homes for Older People Page 4 of 30 0 Over 65 21 Brief description of the care home home has an information file in the main reception that contains the homes Statement of Purpose and Service Users Guide. 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 service was last inspected on 13/12/2006. We carried out our unannounced inspection between 9:30 am and 4:30 pm on 26/11/2008. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The registered manager of the home is Mrs Smith, who was available to assist us throughout our visit. The Registered Provider was also available for the majority of the Care Homes for Older People Page 6 of 30 day. We had the opportunity to meet with two staff members, during the afternoon to discuss the service. We also met with people using the service, both in groups in communal areas and in the privacy of their rooms. People spoke very highly of the service they are receiving. During the day, we were able to speak to relatives visiting the home. No adverse comments were received from family members. As part of the inspection process we looked at care plans, risk assessments, health and safety records, staff recruitment and training, medication and documents relating to quality assurance. We sent Mrs Smith an Annual Quality Assurance Assessment (AQAA) to complete. Information from the AQAA is detailed within this report. Prior to our visit, we sent surveys to the home for people to complete, if they wanted to. We received twelve responses. Comments received are also included within our report. What the care home does well: What has improved since the last inspection? What they could do better: When people are prescribed as required medication, protocols for its use need to be included within the care plan. Within care plans, more detail should be included, in relation to how personal care will be carried out. Care must be taken to ensure that all hand written entries on the medication Care Homes for Older People Page 8 of 30 administration record (MAR) are dated and signed by two staff members. 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 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 10 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. People are provided with sufficient information, to enable them to decide if they wish to move into the home. People have their needs fully assessed prior to being offered a place at the home. Evidence: There is an information file in the main entrance, which contains a copy of the most recent Statement of Purpose and Service User Guide. Also included within the file, is a copy of the homes complaints procedure, a copy of the most recent quality assurance survey, a copy of the AQAA, minutes from the last residents meeting, the safeguarding Alerters guide and a copy of the last CSCI inspection report. There is an information sheet on how to access a local Advocacy service, if required. The manager reported that two people living at the home currently have an advocate from this service. Care Homes for Older People Page 11 of 30 Evidence: People told us they, or their representative, had the opportunity to visit the service or stay on respite; prior to making the decision whether they wanted to move into the home. Comments received within our surveys included, it was helpful to have had a period of respite care prior to permanent residence. This reassured X that the Steppes was the right choice, my son visited and felt it was the place for me. I had a visit from The Steppes manager, while I was in hospital and I got on very well with her and X is very happy at The Steppes. It has a relaxed, caring, friendly atmosphere. X especially likes her room, which has a view of Nailsworth, although a supplement is paid for this. X always greets people with a smile and has nothing but positive things to say about the home and the staff. In the circumstances we could not wish for a better placement. One visiting relative told us, prior to mum needing residential care I used to walk pass The Steppes on my way to work and could always hear them singing and music being played. When it was time for mum to move into care I knew that this was the home I wanted for her. Mrs Smith reported that she carries out all pre-admission assessments herself, by visiting people in their homes or in hospital. When it is agreed that the home can meet the persons needs, Mrs Smith confirms this in writing. After one month of receiving a service, a satisfaction survey is sent to the person receiving the service, or their relative to complete. Assessments cover all aspects of the persons care needs including, health, social and medical care, mobility, communication, comprehension and an insight into their life history. We looked at the assessments of two recently admitted people. We saw that they or their family were included in the initial assessment process. The home does not provide intermediate care. Care Homes for Older People Page 12 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. Each person has a care plan in the revised format. People told us that their health care needs are met. The arrangements for managing medication are satisfactory, however care must be taken with hand written entries on the MAR sheets. People confirmed that they are always treated with respect and their right to privacy is upheld. Evidence: As part of the inspection process we case tracked three people. Two plans were of recently admitted people. Plans reflect the persons initial pre admission assessment. Mrs Smith explained that the new care plan format, now being used is much more informative and provides the staff with more details on how someones needs should be met. It was noted that in care plans sampled, under personal care, it often records staff to assist with bathing etc. This does not provide the reader with sufficient detail as to the amount of support required. We asked Mrs Smith to provide more detail on how personal care routines should be carried out. Care Homes for Older People Page 13 of 30 Evidence: Records demonstrate that care plans are kept under review. The person being supported signs the monthly review to show that they agree the content and any changes to be made. The home currently has separate files for care plans, health appointments and outcomes and recording weights. We discussed whether it would be easier to combine this information into one file for each person being supported. Mrs Smith explained that the current system works well for them as they have limited storage space in the home. Assessments are in place for manual handling and falls. All people, who access the community independently, are risk assessed to ensure their safety. The manager explained that risk assessments are reviewed annually, unless there are changes to the persons needs. Changes would be identified at the care plan review stage and then the risk assessment would be amended to take these changes into account. We noted that one persons care plan stated no resuscitation. We asked Mrs Smith to remove this as only a doctor can make this decision. Within the AQAA it states, we have recently refurbished our bathroom and installed a hi tec bath. This helps in 2 ways, firstly it means that the person only has to be transferred once, instead of twice and secondly the bath rises meaning the person can be washed more comfortably. People using the service commented on the care they receive. They said, excellent support by staff and other services and whenever any doubts Doctors attend, promptly called by staff. Daily records and the house diary demonstrate that people are supported to attend health appointments, such as visits to the hospital, visits to the audiologist, dentist and eye clinic. Mrs Smith reported that the Doctors surgery is very close to the home and that they have excellent support from both the Doctor and the District Nurse. The arrangements for managing medication were examined during our visit. The home uses a weekly monitored dosage system. We sampled the MAR sheets and found that records of administration are completed properly, with no gaps. Each individual record had a photograph of the person, to ensure that they were easily identified. It was noted that some handwritten entries had not been dated and signed by two staff members. We discussed this with Mrs Smith who confirmed that she would be Care Homes for Older People Page 14 of 30 Evidence: reminding staff of the importance of this, the following day. Where a person may be prescribed as required medication we recommended that the protocols for its use are included in individual care plans. Staff members receive training in the safe administration of medication. Dates of opening were seen on liquid medication and boxes of medication. At the time of the inspection the manager reported that no one was self-administering medication. It was noted that the medication file contained a self-medicating checklist and a self-medicating policy. During our visit to the home we observed staff members knocking on peoples doors before entering and respecting their privacy. People we spoke to confirmed that they are treated respectfully. One person commented, I am very content and grateful; staff are marvellous and come very quickly. Another person added,everyone is very nice here. 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. People using the service are encouraged to be part of the local community and participate in various activities. Visitors to the home tell us that they are made welcome. People using the service enjoy the food, as it is varied, home cooked and well presented. Evidence: The manager reported that there are two staff members, who take responsibility for arranging activities and entertainment for the people living at the home. We spoke to one of the staff during the day. She confirmed that she ensures that each person living at the home has a copy of the weeks activities programme so that they are aware of what is on offer. She added that she also informs everyone verbally when activities are to take place. The entertainments list for November showed that a variety of activities had been arranged such as, I spy, exercises, bingo, pampering, darts, beetle drive, sing a long, dominoes and board games. Poetry reading had taken place on the day prior to our visit. It was noted that brass cleaning was included in the list of activities, which showed Care Homes for Older People Page 16 of 30 Evidence: that some consideration had been given to the age group living at The Steppes. Mrs Smith reported that the people being supported also loved to ice cakes. One staff member told us that people enjoyed preparing vegetables. On the day of our visit people were seen socialising in the lounge area. There were newspapers and magazines available. There was a quiz taking place and people were seen to be going to the hairdressers and the bank. Mrs Smith told us that she has arranged for a trip to the Pantomime in December to see Dick Whittington. The home were also participating in the local festivities by providing a stall for the evening, when the Christmas lights are switched on in Nailsworth. Mrs Smith reported that they would be providing mulled wine and minced pies. Photographs in the dining room show people from the home enjoying previous local events, which have taken place. People are encouraged and supported to attend religious services of their choice. The home currently has two people living there who are Quakers and attend the local Quaker hall. Another person is a Jehovahs Witness and although they are no longer able to attend the meetings, they receive visitors from the mission. One person living at the home is a Methodist Lay preacher and regularly attends the Methodist church nearby in Nailsworth. Within our surveys we received the following comments relating to activities, X is not inclined to participate in group activities such as bingo and music, but she really enjoys the occasional outings such as the Willow Trust canal trip. activities are arranged mornings and afternoons, but I dont take part. I prefer to be on my own. many activities are a bit juvenile, but appropriate to many residents and I get taken to the shops, hairdressers, library and church. The manager told us that they often have outside entertainers come to the home. They had recently had a drama group, who encourage the audience to participate. They visit about three times a year. Mrs Smith told us that another favourite entertainer is the Magic Man, who is also a ventriloquist. One person using the service is an accomplished artist and Mrs Smith ensures that they has the equipment that they need at hand. The person told us that they enjoy sketching in the garden when the weather allows. Many of their paintings are hung around the house. A feature of this service is the way people are clearly involved and recognised as part of the local community. One person using the service told us that as their room has a good view of the street Care Homes for Older People Page 17 of 30 Evidence: outside, they feel part of the world and not shut off. They explained that they are able to go out independently, but always let the staff know when they are going out. Another person who goes out by themselves takes a mobile phone with them, which enables them to keep in touch with the home. People spoken to confirm that they can make choices about the way they live their lives. One member of staff reported that the previous night one person living at the home had told the night staff that they were tired and would like to have a lie in the next day. This was passed on to the day staff the next day and the person stayed in bed until they were ready to get up. There was further evidence of choices being made. People were given out the menu for the next day and they could make their choice of what meals they preferred. One staff member explained how they offer choices to people when they are assisting them to wash or dress. One person using the service explained that they enjoy spending time alone in their room, however they also enjoy going to the dining room for meals and to the entertainments so that they can also socialise with others. We received many positive comments, regarding the meals provided by the home. These include, meals are very good, I am generally grateful, meals are very good and staff listen to you and remove items you dont like and meals are not cordon bleu, but always appetising and nutritionally well balanced. On the day of our visit we observed the lunchtime meal-taking place. The meal consisted of three vegetables, gammon steak, a choice of potatoes and parsley sauce There was also a vegetarian option available. People were not rushed and the atmosphere in the dining room was pleasant, with people chatting at the tables. Mrs Smith offered each person refreshments, including sherry, white or red wine, whiskey or a glass of squash. The cook showed us the food storage facilities, which included an external storeroom. There were three upright freezers for storing various foods, potatoes and onions. She confirmed that she is provided with a good budget for purchasing food. Training records show that the cook has attended training in basic food hygiene, manual handling, fire awareness and health and safety. Regular checks such as the fridge and freezer temperatures are carried out. Care Homes for Older People Page 18 of 30 Care Homes for Older People Page 19 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 told us that they know how to raise any concerns or complaints. They feel confident that their views would be listened to and acted upon. Policies and Procedures are in place to protect people where possible. Evidence: The Steppes has a complaints policy and procedure in place to enable the people using the service, their relatives and representatives to raise any concerns. A copy of the complaints procedure can be found, within the service users guide. There is also a copy within the information situated in the entrance hall. There is a suggestion box in the hallway. The home does have a complaints log, but Mrs Smith confirmed that there have been no complaints received, since the last inspection. Within the complaints policy, it states that any complaints will be acknowledged within 72 hours and a resolution sought within 21 days. The people we met and spoke to, told us that they feel confident that any concerns they may raise, are taken seriously. Within our surveys one person commented, I would speak to the boss lady if I were unhappy. Another person added I would let others know if I was unhappy about things, at the time. Care Homes for Older People Page 20 of 30 Evidence: Relatives who met with us also confirmed that they have no complaints, but would know the procedure to follow if anything arose. One relative told us I am very involved with mums care, I cant fault it here. Within the AQAA it states, the Steppes has the necessary policies and procedures in place that are required to protect our service users from the different forms of abuse. The management carefully reviews these. The staff have attended an Alerters Guide course concerning safeguarding and the Mental Capacity Act. The staff-training matrix showed that eight staff members have attended the Alerters Guide training course. Staff members were able to confirm that they knew the procedure to follow if they suspected any form of abuse might have taken place. Care Homes for Older People Page 21 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. People living at the home have a clean, comfortable and well-maintained environment. Evidence: As part of the inspection process, we toured the main building and visited The Steppes 2, which is the adjacent house, where six more independent people live. People who live at Steppes 2 are able to join others in the main house, whenever they wish. We found all areas of the home to be well-maintained and comfortable. The bedrooms vary greatly in shape and size. All were found to be well decorated and furnished. Most bedrooms have en-suite facilities, which were also found to be clean and hygienic. Furnishings and fittings throughout the home are of a good quality and appropriate to the needs of the people living there. During our visit the maintenance man was busy, replacing doors on the first floor. On the first floor there is a pleasant library area with comfortable armchairs, for people to relax in. One staff member told us that one person using the service loves to sit there quietly and read. The lounge has plenty of seating and a large screen television. There is also a music Care Homes for Older People Page 22 of 30 Evidence: centre in the lounge and plenty of occasional tables around the room. People we spoke to during our visit confirmed that they are happy with the accommodation. One relative said mum loves her room. Within our surveys we received the following comment regarding the accommodation, very homely, anything that needs adjusting or fixing sorted without delay and the home is always fresh and clean. We noted that throughout our visit there were no unpleasant odours within any areas of the home. Staff were seen wearing protective clothing when required. The laundry is sited away from food storage and preparation areas. People appeared happy with the laundry arrangements. One person commented the laundry comes back good as new, another person said we need our clothes labelled of course but the laundry service is good. Care Homes for Older People Page 23 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. The low turn over of staff at The Steppes, ensures that the people living at the home, are being supported by staff, who have a sound underpinning knowledge of their needs. Records show that people using the service are protected by the homes recruitment policies and procedures. Staff members receive training, which is appropriate to their role. Evidence: The duty rota indicates that there is sufficient staff on duty to meet the needs of the people living there. Between 9.00 am and 1.00pm staffing levels are increased from 3 to 4. This ensures sufficient staff is on duty during a busy period. Two waking night staff are on duty throughout the night. One is based in the main building and the other person works at the Steppes 2. People using the service told us that staff come quickly when they use the call bell. We discussed, with one member of staff, the arrangements for supporting people to bed. They explained that it was an individuals choice when they retired. They told us about one person living at the home, who likes to get ready for bed, and then likes to come downstairs and watch television. Throughout our visit and within our surveys, Care Homes for Older People Page 24 of 30 Evidence: people spoke highly of the staff and no negative comments were received. Within the AQAA it states that over 50 of the care is provided by staff who have a National Vocational Qualification (NVQ) level 2/3. All staff are given the opportunity to attend this training. Mrs Smith reported that all new members of staff are now enrolled at Stroud College to attend an induction course. This is a new initiative by the College, which encompasses all parts of the Common Induction Standards. This will provide the staff member with evidence, which can go towards their NVQ at a later date. The training matrix was sampled and showed that staff attend mandatory training in first aid, medication, basic food hygiene, safeguarding, health and safety and fire awareness. Mrs Smith is a manual-handling trainer, so she is able to carry out training in house. This would include manual handling annual refresher courses. Additional training is offered in subjects such as, infection control, dementia and strokes. Mrs Smith confirmed that she attends the same training courses as the staff. She added that she is planning to attend a train the trainer course for Dementia awareness in the near future, which will enable her to deliver the training in house to the staff team. We sampled the recruitment files of two recently appointed staff and one of a longer serving member of staff. All had the required checks in place. Two references and proof of identity had been sought prior to being offered a position. Care Homes for Older People Page 25 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. The home is run in the best interests of the people living there, by a qualified and competent manager. The home has robust mechanisms in place to ensure that peoples views are listened to. Staff members receive regular one to one support from their line manager. As far as is reasonably practicable the health, safety and welfare of the people using the service are promoted and protected. Evidence: The registered manager has been managing The Steppes since November 2004. Mrs Smith has achieved her Registered Managers Award (RMA) and is qualified and competent to manage the home, in the best interests of the people living there. On the day of our visit, Mrs Smith was seen to be working along side the staff on duty. It was evident throughout the day that Mrs Smiths approach is very hands on. She Care Homes for Older People Page 26 of 30 Evidence: was observed interacting with both the staff on duty and the people being supported. She was involved in the lunchtime meal arrangements, handing out plates and ensuring that everyone was happy. People spoke well of the manager, one relative told us she is great. Evidence shows that satisfaction questionnaires are regularly sent out to people using the service, their relatives and representatives. Questionnaires are also sent out to visitors and stakeholders to obtain their views of the service. When the responses are received an action plan is formulated and this is available to any interested parties. Mrs Smith reported that meetings are held six monthly for the people using the service. Copies of the minutes from the last meeting could be found in the information file in the hallway. Monitoring systems are in place to include accidents, food and health and safety within the home. As part of the inspection process, we checked monies held by the home, on behalf of people using the service. Records were found to be well maintained and balanced with the cash and receipts held. Staff that we spoke to confirmed that they receive regular supervision. Records showed this to be correct. Staff members have the opportunity to take part in team meetings. The Registered Provider and the maintenance man complete the majority of the health and safety checks in the home. Evidence shows that regular services are carried out on electrical systems and fire equipment. Fire training is updated regularly and the home has a fire risk assessment in place. Records show that the Environmental Health Officer carried out an inspection on 30/02/2008. Following their findings a risk assessment has been put in place for Legionella and there is a record of weekly flushing of little used water outlets. 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 2 3 4 7 7 9 9 Care plans should provide more detail on how a persons personal care is to be delivered. Any reference to resuscitation should be at the doctors discretion. All handwritten entries on the MAR sheet must be dated and signed by two staff members. Protocols for as required medication should be included within the care plan. 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. Care Homes for Older People Page 30 of 30 - 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!