Inspection on 23/06/09 for Ward House Nursing Home

This inspection was carried out on 23rd June 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ward House Nursing Home 28/04/09

Ward House Nursing Home 04/03/09

Ward House Nursing Home 30/06/08

Ward House Nursing Home 20/11/07

Ward House Nursing Home 12/07/06

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2009.

Key inspection report Care homes for older people Name: Address: Ward House Nursing Home Ward House Nursing Home 21 - 23 Alpine Road Ventnor Isle Of Wight PO38 1BT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mick Gough     Date: 2 3 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Ward House Nursing Home Ward House Nursing Home 21 - 23 Alpine Road Ventnor Isle Of Wight PO38 1BT 01983854122 01983854410 matron.whl@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ward House Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 23 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Physical disability (PD) Dementia (DE) old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ward House is a registered care home providing personal and nursing care for up to twenty-three older people. The home has been converted from two older terraced properties to make one home. Accommodation is provided in thirteen single and five Care Homes for Older People Page 4 of 29 2 8 0 4 2 0 0 9 23 0 23 Over 65 0 23 0 Brief description of the care home twin rooms, some with en-suite facilities. The home provides pleasant and comfortable communal space and has an enclosed rear garden with extensive sea views. There is outdoor seating for residents to enjoy the garden and sea views in the warmer months of the year. Limited car parking space is available at the front of the home. The building is accessible and there is a passenger lift for residents to access the upper floors. Details of current fees are available from the home Care Homes for Older People Page 5 of 29 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: This report details the evaluation of the quality of the service provided at Ward House Nursing Home and takes into account the accumulated evidence of the activity at the home since the last inspection key inspection, which was carried out in June 2008. It also takes into account the evidence gathered at a Random inspection which was conducted in March 2009 and a pharmacy inspection which was carried out in April 2009. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA), which arrived when we asked for it and was completed satisfactorily. The AQAA is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Included in the inspection was an unannounced site visit to the home, which took place on the 23 June 2009 between 0930 and 1430. For this visit we involved 7 users of the Care Homes for Older People Page 6 of 29 service and 5 members of staff who provided us with information about the home and other evidence for this report was obtained from reading and inspecting records, including pre admission assessments, plans of care and some of the homes policies and procedures. We also observed the interaction between staff and users of the service. The manager of the service was not available during the site visit and we were assisted throughout the visit by the senior nurse on duty at the home. The home is registered to provide support for 23 residents and at the time of the inspection there were 20 people living at the home. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The report will make 3 requirements to help improve the service for residents and there is one outstanding requirement from the recent pharmacy inspection, however the timescale for this requirement to be met has not yet expired. The report also details other areas where the home could do better. Although care plans contain information about the health, personal and social care needs of residents the day to day recording in care plans do not always provide Care Homes for Older People Page 8 of 29 evidence of what care has been given. More information is needed in the recording so that it can be seen what care has been provided and to show that staff are providing the support to residents that has been identified that they need. There was some evidence that care plans are reviewed each month but the reviews do not provide any evaluation of how the care plan is working for individual residents. There was just a date and signature but there was no evidence that residents had been involved in the review process or any information that the care plans was continuing to meet the needs of individual residents. More information is needed in the recording to provide evidence that peoples needs are being met. The recording procedures with regard to daily recording and also monthly reviews were not in sufficient detail, therefore it was not possible to see how the outcomes for residents regarding their identified care needs were being met. There is not the information in the reviews, including consultation with people who use the service to ensure that their changing needs are met. The current storage arrangements for controlled drugs does not meet the legal requirements and the home must ensure that a suitable drugs cabinet is obtained in order to comply with the law. The home provides a range of activities for residents but these normally take place in the main lounge area of the home. There is no record of who takes part in activities and there is no evidence to show that those residents who like to stay in their rooms are provided with any stimulation or if they are made aware that activities are taking place. Residents who choose to stay in their rooms could easily feel isolated and become bored and the home must ensure that the needs of all residents are taken into consideration. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 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 29 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. Potential new residents have a needs assessment undertaken prior to moving into the home and this allows the home, the resident and their representative to see if the home can meet the residents needs. The home does not provide intermediate care. Evidence: The homes completed AQAA told us that new service users are admitted only after an assessment, carried out by the manager of the home. At this visit the manager was not available. We looked at pre admission assessments for 3 residents and the needs assessments seen had information on medical history, mobility, medication, personal care need, communication, religious needs, leisure, eating and drink and elimination. Assessments were made using a needs assessment form and all covered the same issues for everyone. We spoke with 5 residents on the day of the visit and they told us that their families had made arrangements for them to move to the home, one confirmed that he had been able to visit the home prior to moving in and another told us that they received some information before moving in and that the services that Care Homes for Older People Page 11 of 29 Evidence: were available were explained to them when they arrived. Intermediate care is not provided at the home. Care Homes for Older People Page 12 of 29 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. The health, personal and social care needs of residents are set out in an individual plan of care, the recording in care plans and monthly review do not involve people or show that changing needs are being identified and met. Due to the lack of information in recording it was not possible to see how the outcomes for residents regarding their identified care needs were being met. Residents and have access to all relevant health care professionals and the administration of medication is satisfactory. Residents at the home are treated with dignity and respect. Evidence: Care plans were inspected for 3 residents and these were broken down into sections and were easy to follow. Each care plan had information on the support needed, for example the care plan for one service user stated that the person was not able to access the call bell and gave information for staff to check the service users every hour or more frequently if required. Although this information was in the care plan the recording in care plans did not provide evidence that regular checks had been carried Care Homes for Older People Page 13 of 29 Evidence: out therefore it was not evident if peoples needs were being met The daily recording in care plans did not contain consistent information on care delivery and the daily recording we saw had information such as; all care given, care as per plan, has had a face wash and fluids given. The care plan for another of the residents stated the service user was at risk of becoming bored or isolated and needed stimulation, however there was no information as to what staff should do to help with this. Staff spoken with told us that they regularly pop into the room for a chat but there is no record of any intervention. We spoke to staff who told us that at the start of each shift they were given a list of residents who they would be supporting throughout their shift and that it was then their responsibility to ensure that the care plan was followed, however there is no written monitoring in place to support effective outcomes for people. Each care plan was reviewed monthly, however the reviews on care plans were just signed and dated this was discussed with the senior nurse on duty. Monthly reviews were not in place and people were not involved in reviews to ensure that their changing and ongoing were being met. The recording procedures with regard to daily recording and also monthly reviews were not in sufficient detail, therefore it was not possible to see how the outcomes for residents regarding their identified care needs were being met. We looked at wound care plans for 2 service users and these gave details of the wound, the action to take to promote healing and they also gave information on the size and type of dressing to be used. All care plans contained risk assessment forms and these detailed, what if any risks had been identified, where a risk had been noted a detailed risk assessment was in place which gave information on the risk and also provided information on how the risk could be minimised. Residents said that staff were always very helpful and one commented; I am well looked after here and another said; there is always someone around to help me whenever I ask. Residents are registered with a local health centre and have a number of different GPs. We saw records of health care appointments and we were informed that appointments or visits by any health care professionals are arranged through GP referral. Dental care is provided by a local dentist although residents may keep their own dentist if they wish. There is a visiting optician and a chiropodist calls every 4 to Care Homes for Older People Page 14 of 29 Evidence: 6 weeks. The home has a policy for the receipt, storage, return and administration of medication and all staff at the home who are authorised to administer medication have undertaken training with regard to medication. The home uses a monitored dose system from a local pharmacy and the medication administration records sheets (MAR) were inspected and found to be up to date. A recent pharmacy inspection highlighted the need for more information to be provided for staff to support residents with any when required medication. We saw that each service user who was prescribed any when required medication had detailed information on the medication and there was a protocol for its use. The pharmacy inspection also highlighted the need for the home to obtain a suitable medication cabinet for the storage arrangements for any controlled drugs. We were informed that a new drug cupboard which meets the legal requirements has been ordered. During the visit staff were seen to behave appropriately with residents and we observed staff interacting well with residents and using their preferred form of address, the carers had a quiet friendly way with the residents and there was a good rapport between residents and staff and we observed staff knocking on residents doors before entering and residents we spoke with confirmed that staff always treat them with dignity and respect. One resident said; the staff are lovely and another told us that they are always cheerful. Care Homes for Older People Page 15 of 29 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. The home provides a range of activities for residents, however there is no record of who is involved in any activities and there is no evidence to show that those residents who like to stay in their rooms are made aware that activities are taking place. Residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and are provided with a balanced diet in pleasant surroundings at a time convenient to them. Evidence: Activities at the home are arranged by an activities co-ordinator who works part time and she is backed up by activities provided by people outside the home; these includes visiting entertainers and remembrance sessions. Other activities include games, hand massage, exercise to music, a visiting PAT dog, bingo, discussion groups music, quiz, videos and films. There was a list of activities for June displayed on the notice board at the home and there was also an activities file and this had information about the type of activity each resident enjoyed. The majority of activities take place in the main lounge at the home and people we spoke with told us that they enjoyed the activities provided at the home but the majority of residents choose not to get involved. There is a portable TV and video player which can be taken around the home Care Homes for Older People Page 16 of 29 Evidence: to service users rooms if they would like to watch a DVD/video. Although the activities file had information on what activities service users enjoyed there was no record of what actual activities take place or who was involved, there was also no record that people who choose to stay in their rooms were aware of the activities that take place. Due to the lack of information it was not possible to see how the outcomes for residents regarding activities were being met. Two residents care plans that we looked at said that they needed more stimulation but there was no evidence that this takes place and there was no evidence that these people had been offered other opportunities for social engagement. We spoke to some people in their own rooms and they told us that they were quite content in their own company and that they liked to watch TV. The home has a clear visitors policy and there are no set times, visitors sign in at the home and the visitors book is kept in the hallway, residents spoken to said that their visitors were always made welcome and we had the opportunity to speak with 1 visitor to the home who confirmed that visiting times were flexible and they had never experienced any restrictions. There is a 3 week rotating menu which is changed seasonally and the menu includes suggestions from residents. The cook told us breakfast runs from 0730 to approximately 0900 and resident have a choice of cereals and toast but they may have a cooked breakfast if they prefer. The kitchen porter goes round after breakfast and tells all of the residents what is on for lunch and they are able to request an alternative if the main meal is not to their liking. On the day of the visit lunch was fish cakes with saute potatoes and fresh vegetables and two residents had decided to have an omelet instead Tea is at 1645 and this is normally a snack type meal and on the day of the visit it was cauliflower cheese and veg or sandwiches. Supper is available at 1930 and residents are able to have a snack or biscuits. We were told by the cook that the kitchen is open 24 hours a day and staff are able to make snacks and drinks for residents at any time. The daily menu was written up on a notice board outside the kitchen and fresh fruit was available on request. We observed lunch being taken in the dining room and this was unhurried and staff provided support when needed. A number of residents had their lunch in their own rooms and staff told us that they are appropriately supported. Residents we spoke with told us that they had enjoyed their meals and one resident said, the meals here are good and another told us that they particularly enjoyed eating their lunch outside in the garden. Residents spoke with were happy with the times of meals at the home. Care Homes for Older People Page 17 of 29 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. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately. The homes policies and procedures help protect users of the service from any form of abuse Evidence: The home has a clear complaints procedure, which contains all of the required information and a copy is issued to all residents and relatives when they move into the home. Residents spoken to said if they had any complaints they would speak to a member of staff. Staff members spoken to were aware of the complaints procedure and said that they would support any service user to make a complaint if they wished to do so. The homes completed AQAA told us that there had been one complaint received in the home in the past 12 months. Previous inspection reports informed us that the home keeps a record of all complaints, however as the manager was unavailable we were not able to view the complaints log on this occasions. All staff we spoke with confirmed to us that they have received training on adult protection and they were aware that the. Staff understood what action they should take if they had any concerns regarding any adult protection issues, home has a Care Homes for Older People Page 18 of 29 Evidence: whistle blowing policy and the manager and staff spoken to were aware of their responsibilities in this area and knew what to do should they suspect any form of abuse had taken place. Care Homes for Older People Page 19 of 29 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. Residents live in a safe and well maintained environment and have access to comfortable indoor and outdoor facilities. Residents have the specialist equipment they require to maximise their independence and the home was clean, pleasant and hygienic Evidence: During the visit we observed all areas of the home to be clean and tidy and furniture was in a reasonable state of repair. Some residents were seen mobilising around the home and they had no problems getting and finding their way around. There were suitable toilets adjacent to the lounge and dining areas and there was suitable hand washing facilities. Staff were seen to support residents around the home where necessary and a number of residents were seen to be utilising the rear garden of the home. The home employs domestic staff to keep the home clean and tidy and there is a maintenance man who carries out routine maintenance. Residents told us that the home was always kept clean and they were happy with the appearance of the home. Staff told us that the maintenance man was very quick to repair any defects that arose. The home provides a pleasant clean environment for the people who use the service. The home has a laundry, which is situated in the downstairs part of the home; this is equipped with industrial washing machines and tumble driers and the home employs a Care Homes for Older People Page 20 of 29 Evidence: dedicated member of staff to carry out laundry duties between Monday and Friday. At weekends care staff carry out laundry duties. We were told that bedding is sent out to a local contractor to be laundered to ease the pressure on the laundry at the home. All residents had named laundry baskets where clean clothes were placed and the laundry person delivered clean items to residents rooms. Laundry is collected and brought down to the laundry in bags with any soiled items clearly identified. All staff have received training with regard to infection control and the home was generally clean and tidy and there were no unpleasant odurs. Care Homes for Older People Page 21 of 29 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 home has a mix of staff that has a range of skills to meet residents needs and the homes recruitment policy and practice is satisfactoryy. The staff team receives training to meet the needs of residents. Evidence: The homes staff rota showed that there is a nurse on duty plus three other care staff members on duty between 0730 and 2130 and at night there is one nurse and one other staff member awake throughout the night. The staff rota showed that this level of staffing is consistent and that occasional bank staff are used to cover for sickness and holidays. The registered manager who is also a nurse works 37 hours per week in addition to the the normal staffing levels. The home also employs domestic staff an administrative assistance and a maintenance man. Residents spoken to said that staff worked really hard and that they were always busy, one residents told us staff find time to sit and have a chat and another told us that the staff were very good another said I am well looked after. The home employs a total of 18 care staff, 6 are qualified nurses and of the 12 care staff 5 hold a minimum of NVQ2. Previous inspections have told us that recruitment procedures were satisfactory and due to the fact that the registered manager was not available during the visit no Care Homes for Older People Page 22 of 29 Evidence: recruitment records were seen as they were all locked away securely. The completed AQAA told us that the home operates a robust recruitment practice and staff spoken with also told us that their recruitment was thorough. Staff training records were also not available as these were locked away with staff records. The completed AQAA told us that staff receive regular training from an outside training organisation and that the staff rota allows staff to attend training sessions when arranged. Staff spoke with told us that training has been provided in; first aid, food hygiene, moving and handling, fire, infection control, adult protection, medication, health and safety, communication and care skills and they said that they are provided with appropriate training in order to carry out their care tasks. Care Homes for Older People Page 23 of 29 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 management arrangements in place at the home are satisfactory and the home is operated in the best interests of residents. Quality assurance procedures are in place and service users financial interests are protected. The health, safety and welfare of residents and staff are promoted and protected. Evidence: The registered manager was not available on the day of the inspection, however previous inspections have identified that the manager of the service is a qualified nurse and she has obtained the registered managers award, she has the skills and experience to manage the home. The completed AQAA told us that she continues to update her skills and that she has recently undertaken training with regard to safeguarding. We looked at quality assurance questionnaire that had been sent out by the home and these were sent to relatives, service users, and health care professionals, responses to these have not yet been received and collated. Staff told us that there are regular Care Homes for Older People Page 24 of 29 Evidence: staff meetings and that a residents meeting was held last month. The home sends us information about any incidents in the home and the provider carries out monthly visits in accordance with Regulation 26 of the care home regulations. We were told that the home does not manage the finances of any residents and the administrator told us that the home on occasions holds some personal spending money on behalf of residents and these are always kept secure with clear records of all transactions, however at the time of the visit the home did not hold any money on behalf of residents. We looked at the home fire log book and this showed us that all relevant training and testing has been carried out. We looked at the homes Gas safety certificate and the certificate for the homes fixed electrical wiring and these were both in date. Certificates were also in place for the servicing of fixed hoists and for the homes passenger lift. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 Controlled Drugs must be stored in a Controlled Drugs cupboard that complies with the Misuse of Drugs (Safe Custody) Regualtions 1973 In order to comply with the law 01/08/2009 Care Homes for Older People Page 26 of 29 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 17 The registered persons must 27/07/2009 ensure that the daily recording in residents plans of care provide accurate records of care delivery This will ensure that peoples health and well-being needs are supported and met. 2 7 15 The registered person must 30/06/2009 ensure that the recording of the monthly reviews in care plans provide information as to how the plan is meeting the service users needs. This will ensure that care meets the changing needs and wishes of people living in the home. 3 9 13 Controlled Drugs must be stored in a Controlled Drugs cupboard that complies with the Misuse of Drugs (Safe Custody) Regualtions 1973 01/08/2009 Care Homes for Older People Page 27 of 29 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 this will ensure that controleed drugs are kept in a cupboard that meets the legal requirements 4 12 16 The home must ensure that 03/08/2009 all users of the service are provided with the stimulation they needs and that there are clear records of the activities that take place at the home together with information on those who did or did not take part. This will ensure that all service users are aware of the activities that are taking place in the home and they will have the choice to participate if they so wish. 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 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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