Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 03/10/08 for Valentine House

Also see our care home review for Valentine House for more information

This inspection was carried out on 3rd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The manager is committed to improving the service and developing the staff`s skills in meeting people`s needs. She is seeking ways in which she can inform herself and her team in their understanding of dementia care. There are two enthusiastic and committed activities co-ordinators who are running and developing a programme of activity that will meet both the ability and expectations of the people living at the home. They are supported in achieving this by the manager and the organisation as a whole. After some staff resignations earlier in the year, that left a deficit in the team numbers, the staff group have stabilized and formed a cohesive group of care workers who are committed to the home and the standards of care provided. The meal provision at the home is consistently praised by the people living at the service. They said that they appreciated the range of choices available on the menu and felt that they would be provided with anything they wanted within reason. They said the standard of cooking was good.

What has improved since the last inspection?

The service had developed a more robust response to complaints. They have developed a policy and procedure that ensures that all levels of complaints are responded to and they ensure that the complainant is satisfied with the response before the matter is closed. The new manager and operations manager work well together in addressing issues in the underpinning elements of how the service operates. They have demonstrated a committment to operating in an open and honest manner that will benefit the service in the long term. They are working towards the provision of a consistently applied management of the service. They have introduced new documentation across all aspects of the service and in particular in areas such as initial assessments, care planning and quality assurance. They are seeking to provide a consistent approach to the way the service is managed and developed.

What the care home could do better:

The service appears to have suffered from an inconsistent management style in the past resulting in standards not being upheld in all areas. The new manager had inherited significant gaps in the way the service was organised. They have audited all areas of the administration processes and developed an action plan to address the shortfalls. Areas that require further development included the quality of information in initial assessments and care planning documents, staff supervision and training. In each case the documents were in place but the quality and consistency of the information they contained requires attention.Staff support people living at the home to the best of their ability, however there have been instance where the needs of people with dementia have presented a challenge to their skills. This has resulted in complaints from families and supporters of residents. The service needs to support staff to develop strategies for supporting people with challenging and complex needs.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Valentine House Broadway Silver End Witham Essex CM8 3RF     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: Sara Naylor-Wild     Date: 1 4 1 0 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 © (2008) 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: Valentine House Broadway Silver End Witham Essex CM8 3RF 01376585965 01376585916 valentine@atlantishealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Atlantis Healthcare Limited care home 49 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Only the room agreed with the Commission (room number 17) can be used as a double room Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 12 persons) Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 49 persons) The total number of service users accommodated must not exceed 49 persons Date of last inspection Brief description of the care home Valentine House is a large detached house, situated opposite a small parade of shops in a village location. The home has three floors that are accessed by a through floor passenger lift, and residents are accommodated in single bedrooms, all with ensuite toilets. Facilities include lounge areas on all three floors, a large dining room, a number of bathrooms (some with assisted bathing facilities), and a secure garden area with Care Homes for Older People Page 4 of 30 Over 65 12 49 0 0 Brief description of the care home seating available. The home is registered to provide 24-hour personal care and support for up to 49 older people (i.e. over the age of 65), including up to twelve people who suffer with dementia. The home provides both permanent accommodation and also short (respite) stays. The last inspection of the service took place on 3rd and 4th May 2006. 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: The last key inspection of this service took place on the 3rd and 4th of May 2006. This key inspection took place on the 3rd and 14th of October 2008. As part of the inspection we checked information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 3rd and 4th May 2006, looking at records and documents at the care home and talking to the manager, Gina Mickle, care staff and the people living at the home. In addition the Annual Quality Assurance Assessment (AQAA) completed in March 2008 was considered as part of the inspection process and a tour of the premises undertaken at the visit to the care home. Care Homes for Older People Page 6 of 30 Feedback was received from people who use the service, their relatives and staff who completed the surveys sent by the Commission. The service sent us their AQAA when we asked for it. this contained information about what they felt they did well and how they planned to improve the service. The manager assisted the inspector at the site visit. Feedback on the findings was given during the visit with the opportunity for discussion or clarification. We would like to thank the manager, the staff team and the people living at the service and their relatives for their help throughout the inspection process. The range of fees charged by the service are between 450.00 and 550.00 pounds per week. Additional charges were made for toiletries, hairdressing, private chiropody and some activities. What the care home does well: What has improved since the last inspection? What they could do better: The service appears to have suffered from an inconsistent management style in the past resulting in standards not being upheld in all areas. The new manager had inherited significant gaps in the way the service was organised. They have audited all areas of the administration processes and developed an action plan to address the shortfalls. Areas that require further development included the quality of information in initial assessments and care planning documents, staff supervision and training. In each case the documents were in place but the quality and consistency of the information they contained requires attention. Care Homes for Older People Page 8 of 30 Staff support people living at the home to the best of their ability, however there have been instance where the needs of people with dementia have presented a challenge to their skills. This has resulted in complaints from families and supporters of residents. The service needs to support staff to develop strategies for supporting people with challenging and complex needs. 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 considering moving to the service can expect to have information available to them that will help them understand what the service does. They can be generally be assured that the service will understand their needs and know that it can support them prior to agreeing to their admission. Evidence: The services statement of purpose and service users guide has been updated since the last inspection. It reflects the changes to the organisations management structure and the appointment of the new manager for the service. The information contained in the service users guide would help people considering the home to understand what they can expect from the services delivery. The service does not provide intermediate care. Care Homes for Older People Page 11 of 30 Evidence: The pre admission assessments of people most recently admitted to the home were reviewed at this visit. The format of the document encourages the person carrying out the assessment to gather details across the whole range of peoples daily living skills and the background to the individual they are assessing. This information would provide the service with a good indication of the persons needs and how best they could meet these. In the two samples seen at this visit, one persons assessment had not been fully completed and did not contain a depth of detail. The manager was aware of the shortfall and demonstrated that the quality of other assessments was better. The service offers people the opportunity to visit the service before they move in to the home, and meet other people living there as well as staff. A key worker system has been devloped and the manager stated that it was aimed for the person to meet their key worker as part of their admission processes. 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. People living at the service can be confident that some of their needs are understood and documented in a care plan. They cannot however always be sure that the way in which their independence is supported is fully understood. They can be confident that they will be protected and supported by the services medication administration system. Evidence: The care planning documents relating to 8 people were considered at this visit. The manager advised that the way in which the care plan worked and the documents used were all under review and this would be reflected in gaps in the documentation. The documents sampled contained a varied quality of information completed. The care plans did not always reflect all the information known about the individual and tended to focus on specific needs rather than the strengths the person had and how these Care Homes for Older People Page 13 of 30 Evidence: should be supported. So for example under personal care issues the plan stated xxx cannot dress themselves and will require staff to support them . A more person centered approach would identify first what the person could do for themselves and then indicate the specific way in which staff should support them to complete the task they are undertaking. This was discussed with the manager who understood the shortfalls in the documents and aimed to address these as the new care planning formats were introduced. Staff practice in meeting peoples needs were observed during the visits to the home. They generally demonstrated a caring and respectful approach to people living at the home. There was evidence of good relationships between staff and people they supported. In one example a person who was distressed was supported by a non care member of the staff team in sympathetic and caring manner. However there was also evidence that staff were not always conscious of the needs of people with cognitive impairments, so for example a person was left at a dining table who was slumped forward in sleep for some time whilst staff moved in and out of the dining room before a member of staff noticed their situation and attended to them. The Commission had recieved feedback from supporters of people living at the home that indicated that staff were not always aware of the needs of people with dementia and did not support their needs sufficiently. From discussions with the manager and staff it was evident that there was a good knowledge of individuals and how their needs changed from day to day. In particular they were able to describe in some detail the needs of the person slumped at the dining table and gave indications of an understanding of the individuals situation and the difficulties they encountered in meeting the persons needs. The plans contained risk assessments for issues such as nutrition, moving and handling and pressure care. The assessments were all completed in the samples seen but the information from their outcomes was not always incorporated into the persons care plans. This means that although the assessments stated that the person was at risk there was no identified action taken to reduce the risks present. The plans did contain health monitoring records relating to visits people had received from health professionals and how issues such as weight and diet were monitored. The records were a good source of information about the well being of individuals. The way in which medication was managed and administered was considered during the inspection visit. Staff were observed dispensing the lunchtime medication and following this discussed their understanding of the medication system. This demonstrated a good understanding and practice in the safe storage, recording, Care Homes for Older People Page 14 of 30 Evidence: dispensing and returning of medication. This included the storage and recording of controlled drugs. The staff responsible for medication administration had all undertaken training and provided a good account of their knowledge and skills in this area. 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 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 can be confident that they will be offered opportunities for social stimulation, and that these will be based on their preferences. Evidence: The service employs two people to work as activity co-ordinators, and between them they cover a 6 hour day during the week. This provides opportunity to support people living at the service in meeting their social needs. The co-ordinators have developed a weekly programme that has a variety of activity developed from their discussions with people living at the home. These included inhouse exercise, music, entertainment, trips out to the local park, shops and coffee mornings. They also plan time to spend with individuals who do not wish to take part in the group activities planned. A record is kept of the activity, who participated and how they enjoyed it. This helps the co-ordinators in developing an understanding of what people like. They did not at the time of the inspection carry out and individual assessment of peoples interests and include this as part of their care plan. Care Homes for Older People Page 16 of 30 Evidence: During the inspection visit people were observed taking part in activities on offer with great enthusiasm. One person told us I like being able to go out to my coffee mornings with my friends, we have a good time and laugh a lot. The service provides equipment and resources to support the co-ordinators and a regular budget allowance is provided to fund this. The daily menu is promoted on a large white board in the dining room. This displays the main choice as well as a number of alternatives on offer. People spoken with were complimentary about the meal, stating that they were cooked to peoples preferences as much as possible. They were confident about making choices if they did not want the main option on the menu and felt what ever they asked for would be catered for. Care Homes for Older People Page 17 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 can be confident that they will be listened to and that their comments will be acted upon. Evidence: The complaints policy and procedures had been reviewed by the manager since the last inspection and amendments made. In particular the policy now required that all levels of dissatisfied feedback are responded to at the appropriate level and when the complainant is satisfied they are asked to sign off their satisfaction. The procedures were reviewed following the outcomes of a serious complaint that the service had received prior to the appointment of the current manager. The failures of the previous procedures to respond adequately to the complainant had compounded their dissatisfaction and as a consequence the complaint had escalated. The safeguarding policy and procedures for the reporting of alleged abuse were in place and reflected the guidance provided by the lead agency of the local authority. The staff had all undertaken refresher courses in safeguarding in the past 12 months. Staff spoken with were confident about their responsiblity in reporting signs of abuse and how the service would deal with the matter. Care Homes for Older People Page 18 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 benefit from an environment that meets their needs in a homely way. Evidence: The premises of Valentine House were maintained in clean, safe manner. There had been ongoing redecoration and refurbishment to areas of the home, including the communal areas and some peoples bedrooms. The manager had instigated the decoration of the communal areas which she felt had looked tired and worn. The choice of decor and furnishings were not consulted upon with people living at the service for this work, and although there had been positive comments from people who lived at the home, this should be carried out for any future plans, as a part of the good practice in helping people make decisions about the place in which they live. Prior to the inspection a problem with drainage had caused leaks under the main corridor to the dining room causing damage to the floor. This was responded to and works were being undertaken to repair the leaks and drain issues. The manager stated that the damaged flooring in the corridor would also be replaced as part of the works. Care Homes for Older People Page 19 of 30 Evidence: The manager stated that other planned improvements to the building included changing an upstairs room to provide a dedicated activities room for people to use away from the main communal areas. The gardens are well maintained and enclosed for safety. There were a number of seating areas and shade provided by gazebos. The service benefits from the employment of a maintenance person who is pro-active in maintaining the premises to a good standard, but also monitors any works being carried out in the home. This person is also responsible for monitoring the health and safety of the premises along with the manager. The laundry arrangements had not changed from previous inspections and provide sufficient equipment to meet the needs of people living at the service. All the staff undertake infection control training as part of their induction to the service with refresher courses carried out within the annual training plan. The service provides staff with protective clothing including gloves and aprons and hand washing facilities are in all bathrooms and toilets. Care Homes for Older People Page 20 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. People living at the home can be confident that staff have been supported in gaining some skills in meeting their needs. They cannot be sure that this is planned and will continue to develop. Evidence: The service aims to provide a minimum of 6 care staff, including the senior care in charge of the shift, in the morning from 07:00hrs to 14:30 hrs each day. In the afternoon from 14:30hrs to 22:00hrs there are five care staff on duty, including the senior in charge of the shift. The overnight staffing consists of four waking staff, including the senior staff in charge of the shift. The manager stated that this number has been previously agreed with the Commission, and this is referred to in previous inspection reports. However the Care Homes Regulations 2001 state that the responsible persons must staff the home in accordance with the assessed needs of people living at the service, this was discussed with the manager for future reference. The staff on duty on the day of the inspection did not appear rushed and they were present in communal areas where people were sitting for much of the time. Additionally people living at the service are supported by housekeeping, maintenance, catering and activities staff. Care Homes for Older People Page 21 of 30 Evidence: People living at the service told us that they felt there were enough staff to meet their needs they said sometimes you have to wait at busy times, but they do not keep you long before they come. In previous months there had been some staff vacancies that had caused shortages on the rota and the manager had had to use agency staff for this period. Staff told us they found this difficult as the temporary staff did not know the routine and the people living at the home as well as permanent staff. However new staff had since been recruited and the posts were now full. The staff are recruited according to the services policy and procedures. A sample of files belonging to the people most recently recruited to the service demonstrated a robust recruitment process that included completed application forms, two written references, proof of identity and checks against the Criminal Records Bureau (CRB) and Department of Healths Protection of Vulnerable Adults list (POVA). New staff had not undertaken a formal induction into the service, but those spoken with identified how they were supervised whilst they were getting to know their role. The manager stated that the induction format had been devised in response to previous feedback from the Essex County Council monitoring team, but that this had not yet been implemented. The staff handbook had been re-designed and this along with the General Social Care Council book and the Essex Safeguarding Strategy book was being given to staff. The manager has implemented a number of training initiatives in the last year, with staff undertaking both external and internal courses. All but four of the staff had participated in ASET courses in dementia care. Staff were also scheduled to take part in courses aimed to enhance the delivery of the service such as therapeutic activities for dementia care, care planning, personal care delivery, managing behaviors that challenge and supervision training. In addition all staff were participating in core training in issues such as health and safety, moving and handling, first aid, fire safety and safeguarding adults. The manager had audited the staffs skills and developed an annual training plan in response to feedback received from Essex County Council monitoring team. However due to the shortfall in staffs basic training needs this had proved to be too ambitious and had not been fully achieved within the timescale she had set. Staff spoken with had all attended some training and felt that there was more opportunity than they had previously enjoyed. They valued the training they had taken Care Homes for Older People Page 22 of 30 Evidence: part in and were able to relate it to their day to day work in supporting people at the home. Care Homes for Older People Page 23 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. People living at the home can be confident that they will be listened to and that the leadership of the home will understand their responsibility to respond. Evidence: The manager of Valentine House had been appointed in January 2008, having previously held posts as the deputy manager and senior care in the same service. She benefits from many years experience in the care sector, although this is the first time she has been in overall charge of a service. She had not applied for registration with the Commission at the time of the inspection, but stated that she intended to do so in the near future. The organisation have also appointed a new operations manager who is directly responsible for the supervision of the companys residential homes managers. The person appointed has worked along side the manager of the home in creating and developing the documentation, policies and procedures in the last few months. Care Homes for Older People Page 24 of 30 Evidence: Both post holders reported to the Commission that there they found a range of shortfalls in the documents required by the Care Homes Regulations 2001 when they took over the running of the service. However they have made strident attempts to address these in the first half of the year. This has meant that whilst they have not fully achieved a full response to the Care Homes Regulations 2001, the impact on people living at the home has been minimised. Both post holders demonstrated a clear understanding of the standards they needed to achieve. The way in which the service managed money belonging to people living at the service was inspected at this visit. The service maintains individual record of accounts for each person that details all income and expenditure with corresponding copies of receipts. the balance of cash held in a sample of accounts matched the current totals on their account sheet and demonstrated a robust system of accounting. The service had conducted a quality assurance survey at the time of the inspection and some responses had been received. These indicated an overall satisfaction with the service with some concern in respect of care planning and communication with the service. The manager was planning to collate this information and produce a report that set out the action the service aimed to take in response to the feedback. There were monthly team meetings taking place for all staff and the discussions from these were minuted. There were also some residents meetings conducted to give people living at the home opportunity to comment on the series. The service had submitted the AQAA required by the Commission when we requested it and it contained indications of how the service had improved over the last 12 months as well as their plans for future developments. The quality of the information could have been improved to ensure it reflected consultations with people who use the service and their supporters and this was discussed with the manager. Staff supervision has been reviewed since the previous inspection with new formats for the forms and training for senior care staff in carrying out supervision. The manager stated that it had not been feasible for them to carry out all the staff supervision and as a result these had not been consistently managed. She said that it was her intention to cascade the responsibility for supervision to the senior care team and other heads of departments within the next few months, and that they in turn would be supervised by her and the deputy when appointed. The documents that evidenced the services compliance with health and safety regulations were inspected and these included fire safety records, certificates for the Care Homes for Older People Page 25 of 30 Evidence: safety of electrical and gas systems, maintenance checks on lifting equipment and the passenger lift. These were all present and within date. Care Homes for Older People Page 26 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 27 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 1 8 13 People living at the service must be supported in managing the risks present in their daily lives. The outcomes of these assessments must be included in their plan of care. The service must be able to understand the risks present in individuals lives and how they can best support them to manage these. 12/12/2008 2 36 18 The staff must receive regular one to one supervision from a line manager. Staff who are given feedback on their performance will understand how they contribute to the overall quality of the service, and this will improve the quality of life for people living there. 28/12/2008 Care Homes for Older People Page 28 of 30 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 The assessment of people who are considering moving into the home, should demonstrate how their needs meet the criteria of the service and what considerations the assessor has made in terms of meeting their holistic needs. People living at the service should be supported by care plans that reflect their abilities and how staff can best support these to maintain their independence. People living at the service should be supported by care plans that are updated to reflect the information known about them from health professionals visits. People living at the home should be supported by staff who have sufficient diversity of skills to meet their assessed needs. 2 7 3 8 4 30 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 © (2008) 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!