Inspection on 27/01/09 for Woodcote Hall

This inspection was carried out on 27th January 2009.

CSCI found this care home to be providing an Adequate 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

Woodcote Hall 11/11/09

Woodcote Hall 08/05/08

Woodcote Hall 18/04/07

Woodcote Hall 16/08/06

Woodcote Hall 01/03/06

Woodcote Hall 04/10/05

Woodcote Hall 30/03/05

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodcote Hall Woodcote Newport Shropshire TF10 9BW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joy Hoelzel     Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Woodcote Hall Woodcote Newport Shropshire TF10 9BW 01952691383 01952691635 woodcotehall@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Select Healthcare Limited care home 56 Number of places (if applicable): Under 65 Over 65 0 56 dementia old age, not falling within any other category Additional conditions: 1 0 One named resident as per discussion of 13.09.05 The home may accommodate a maximum of 28 users requiring nursing care. The home may accommodate a maximum of 56 Older Persons and a maximum of 1 Younger Adult. The home must provide for 56 service users:- 08.00-14.00 14.00-22.00 22.00-08.00 2 RGNs 2 RGNs 1 RGN 6 Care Assistants 6 Care Assistants 5 Care Assistants Date of last inspection Brief description of the care home Woodcote Hall is a care home providing accommodation, personal and nursing care for up to fifty-six older people. It is privately owned by Select Healthcare Ltd. and is one of a number of care homes within the company. The Home is set within its own grounds and sited directly off the A41, south of the town of Newport. There is a selection of communal use rooms, most bedrooms are single occupancy and some have en suite facilities. There is a passenger lift to access the first floor. Information of the home and the provision of the service are available in the statement of purpose. Care Homes for Older People Page 4 of 29 Brief description of the care home Currently this document does not include information on the current level of fees for the service. The reader may wish to obtain more up to date information from the care service. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk 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: The last unannounced key inspection was conducted 9th May 2007 with an annual service review 8th December 2008. The home did not know that we would be visiting to inspect the service on this occasion. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions Care Homes for Older People Page 6 of 29 offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to the annual service review a Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to the commission within a given timescale. The manager completed this document and returned it the commission. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 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 9 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. People can be confident that the care home can meet their individual care needs. This is because an assessment of their needs has been made. This tells the home all about them and the support they need. Evidence: Information on the service and what it offers is available in a statement of purpose and contains full details of the aims and objectives of the service. A short colour brochure has been produced designed to give people a quick guide and overview of Woodcote Hall. The service users guide to the home was unavailable on this occasion and as such it was not possible to determine the level of weekly fees for the service. The information provided by the service ensures that people can decide whether the care home can meet their support and accommodation needs. The case file of the person who recently moved into the home was looked at to see if Care Homes for Older People Page 10 of 29 Evidence: information had been sought regarding this persons needs prior to moving in. Information had been gathered from the previous social care setting and community assessments. This person arrived at short notice, the home did not have the opportunity to visit and meet them beforehand. An assessment of the persons care needs was completed shortly after they arrived at the home. This person discussed the admission, stating that they found it quite satisfactory but too far away from the family home. They are hopeful that the situation in the family home will be resolved quickly and they will be able to return. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. One person completed our survey and made an additional comment regarding their admission - The choice had to be made quickly so I went on the recommendations of people who had relatives previously staying here and were very happy with the standard of care. Since moving in this has fulfilled everything I was looking for. A member of the senior staff confirmed that for all planned admissions the matron visits in the persons place of residence. When ever possible people are invited to visit the service to have a look around. This ensures that the service is well prepared and can fully meet individual care needs in a satisfactory way. The home does not provide an intermediate care service. Care Homes for Older People Page 11 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. Each individual has a care plan but the current practice of involving residents and/or their representative in the development and review of the plan is variable. There is evidence in the care plan of health care treatment and intervention, and a record of general care information. There are some gaps in information but staff are able to think in a person centred way and are able to give a verbal update. Evidence: Each person has a written plan of their care that is based on the assessments of their care needs. Four plans were selected to be looked at in depth with other plans looked at briefly to follow up any observations made during the day. Each plan contained assessments for maintaining a persons safety and when a risk is identified it is linked with a corresponding plan of care. Some of the documents within the plan had been signed as agreed by the persons next of kin. There was no evidence that the person was included or indeed involved in the planning process. One person stated that they were unaware of any care plan and was unsure of what it actually was. It is acknowledged that some people may be unable or do not wish to be involved but Care Homes for Older People Page 12 of 29 Evidence: people should be offered the opportunity to comment. The matron commented that people and or their representative are usually invited to the social worker reviews but not routinely when the home is reviewing the plan of care. Mostly core care plans are used to document the care needs and generally the plans contained the information and guidance for staff. For example one person required regular interventions from the nursing and care staff for a specific condition. Records were seen for the monitoring of this and included the frequency of the interventions and any changes to the condition that may be observed. Staff discussed the care needs and described the way they helped this person each day. Some of the plans looked at contained some conflicting information, for example, the use of bedrails were identified as required to ensure that people remain safe whilst they are in bed. Observations and discussions with people indicated that there was no assessed need for the use of this piece of equipment. Other plans did not contain any specific reference to gender issues and a persons preference for personal care being provided by male or female staff. This information is most important for ensuring that cultural and religious preferences are observed. It was reported in our last inspection report (May 2008) that the new matron had instructed staff on the required standard of documentation and recording of care needs. A review and revision of the care plans was ongoing. This inspection has shown that some improvements have been made with documenting important information but further improvements and attention to detail is still required. The matron discussed with us, the arrangements for further expanding the plans this will include an individual approach based on the preferences and expectations of the person. This will then ensure that the care plan fully reflects the needs, wishes and aspirations of each individual person. Medication is administered to people by the registered nurses using a monitored dose system with additional boxes and bottles of medicines. The staff explained the amendments to the daily routines made recently, to ensure that people do not have to wait excessive periods of time for their medications. The procedures were looked at, staff explained the processes and all evidence points to good arrangements being in place for the safe administration of medications. Staff were observed during the day to be addressing people in a correct and respectful way and appeared to have a good knowledge of the care needs of each person. One person who completed our survey made the additional comment Everyone is kind and caring Three out of the four surveys indicated that staff listen to them and act on their wishes. Care Homes for Older People Page 13 of 29 Evidence: People stated that most of the staff were very good and helpful. With one person commenting that they consider they are well cared for and that staff respect their privacy and dignity. Care Homes for Older People Page 14 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. People living at the home have the opportunity to participate in daytime activities according to their individual interests, diverse needs and capabilities Evidence: A person has been employed as a social activity coordinator and dedicated space adjacent to the main lounge has been made available. People told us that recently the recreational activity has increased with a variety of activity happening each day. We saw people engaging in various activities either in a group setting or on a one to one basis. The expert by experience was asked to speak with people and observe the activities of the day and reported - The coordinator is a very dynamic individual who provides a varied programme of activities and has transformed a room into a colourful activities area. The walls are covered with artwork, all done by the residents. There is a tea/coffee area with easy chairs where tea and coffee is freely available for residents and their visitors alike. Reflexology and gentle massage is available for all residents including the bed bound. Those able to take part in gentle armchair aerobics did so during the morning, the less able are encouraged to participate by the good humoured banter that appears to be part of all activities. Care Homes for Older People Page 15 of 29 Evidence: One person, who told us that they stay in their room most of the time, stated that they went recently to a religious service that was arranged. They stated that they enjoyed it and went on to say that previously they were a regular churchgoer and feels it is important to continue with this observance. The monthly newsletter continues to be circulated to people and includes the news of the home, birthdays and special events. This months edition included a questionnaire asking for comments on the recent changes made to the menus. People stated that friends and families are able to visit at suitable times and that they found the arrangements very satisfactory. One person commented - My visitors are always made welcome and they can now help themselves to tea and coffee in the activity room. The main front door is kept locked at all times for security reasons; a controlled circuit television camera is sited at the front door enabling staff to see the identity of the caller. No other doors within the home were seen to be locked with the exception of storage cupboards, the treatment room and some private bedrooms. People can have free access to all areas of the home if they so wish. During the day many people were seen to be moving from area to area around the home. The meals are prepared by the catering staff and served either in the dining room or the persons bedroom, dependent on the wishes of the individual. The expert by experience observed and commented - Meals are served in a bright clean welcoming dining area. Residents desiring to eat in their own rooms can do so if they please. The chef is undergoing ongoing training in catering for the specific dietary needs of this age group. We spoke with people during the inspection and asked about how they find the meals. We received very mixed reactions and comments Poor, Cant grumble, Very nice dinner, Always plenty to eat, good choice, I have my breakfast in my room I can get up then afterwards without rushing, The food here is very poor, and there is no variation. Care Homes for Older People Page 16 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. Residents and others involved with the service say that they are satisfied with the service provided and know what action to take if they have concerns. Evidence: The complaints procedure is clearly displayed at the entrance to the home and is included in the service information documents. Several people stated that they would report any mishap to the matron or any other member of staff. They said they would be confident that appropriate action would be taken. All four people who completed our survey indicated that they know how to make a complaint. The matron confirmed that no concerns or complaints have been made to her since September 2008. We, the commission, have not received any concerns or complaints since the last inspection in May 2008. Two referrals have been made to the Safeguarding adults multi agency team in December 2008 following some concerns raised about the service. The investigation is ongoing and has yet to reach a satisfactory conclusion. Staff are currently all receiving training in the protection of vulnerable adults with sessions arranged later this month. The home offers a facility for residents to deposit personal monies for safekeeping; Care Homes for Older People Page 17 of 29 Evidence: records relating to this were seen. All transactions are recorded on individual balance sheets with invoices and receipts kept. Care Homes for Older People Page 18 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 adequate 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 physical environment that generally meets the specific needs of the people who live there. Continued investment is required to provide people with a more homely and warm environment to which to live. Evidence: Woodcote Hall is a large manor house situated in a rural locality set in countryside close to Newport in Shropshire. The home is currently not easily accessible by public transport. The property has been extended over the years and the provider intends to further develop the home creating additional purpose built accommodation in the future, subject to planning approval. The grounds are accessible and generally well maintained. The main drive up to the property has not been given attention, as identified in our last inspection report, therefore the potholes potentially pose a safety risk for people wishing to visit the home by foot. It was reported that this is not priority given the plans to provide a new road system. People we spoke with told us that they are generally satisfied with the accommodation provided. They said that their bedrooms are warm, the beds comfortable and that they can personalise their own rooms with family photographs, pictures, ornaments and Care Homes for Older People Page 19 of 29 Evidence: electrical items such as televisions and stereos, as seen during a brief tour of the home. We looked at the rooms of some of the people and overall these were furnished appropriate to their needs and ethnicity, although some rooms were very sparse with furniture. During the inspection a delivery of new wardrobes, side cabinets and drawers were delivered to the home and the decorators were on site redecorating two rooms and replacing floor coverings. Communal areas include a very large lounge and dining room. The former office has been refurbished into an activity room where visitors can also help themselves to refreshments. The heating throughout the home continues to be problematic and portable electrical heaters were seen in a number of rooms throughout the home. Radiators in some parts of the home were not working and a number of residents spoken with told us that the lounge is always cold, which was observed during the inspection. This was also raised as an issue requiring attention in a survey that we recently received. The problem was fully acknowledged by the matron however this still requires monitoring to ensure people living at the home are kept warm. A number of improvements have been made since we last visited the home and these include: Ten bedrooms have been redecorated, some new furniture provided and a further four rooms have been identified for redecoration. Four beds have been replaced, a new dishwasher purchased, an activities room created and the dining room redecorated. New table linen has been purchased in addition to new crockery and cutlery. It was also reported that new stock of bed linen has been ordered, two new hoists purchased and a bingo and karaoke machine purchased for the new activities room. The matron agreed to record these on a programme of renewal and refurbishment, which will also demonstrate the providers commitment to improve the home in the best interests of people using the service. The parts of the home we toured were generally clean. People we spoke with indicated they are satisfied with the cleanliness of their rooms and the communal areas. The home employs four domestic staff and discussions with one of the domestic staff evidenced that they had been provided with training appropriate to their work such as hazardous substances, manual handling and infection control procedures. The member of staff considered that they are given sufficient time to carry out their duties effectively. Care Homes for Older People Page 20 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. 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 they are suitable to care for them. Their care needs are met and they are cared for by staff that get relevant training. Evidence: People we spoke with said they were happy with the care they receive and spoke positively about the staff group. Comments include: Staff here are very good, they are excellent, nothing is too much trouble, Staff are very good here and are very nice, especially those who run it, they are so kind, Staff are very good, Staff go out of their way to help here. We observed staff working positively with the people in their care and they appeared motivated and committed to their work and demonstrated a good understanding of the individual needs of people. They spoke positively about the changes made under the new matron and reported that staff morale is good. The staff spoken with considered the home provides sufficient staff to meet the individual needs of the people living at the home. The matron reported that she uses a dependency tool to assist with ensuring staffing is appropriate to need. We looked at the rota, this indicated that throughout the day there are two registered nurses and six staff and during the night Care Homes for Older People Page 21 of 29 Evidence: one registered nurse and three carers. This is to remain under review based on the assessed needs of the people accommodated and the layout of the home. The matron reported that the home employs 7 registered nurses and of the 16 care staff employed 4 hold a National Vocational Qualification (NVQ) 2 in care and above, with a further 4 staff working towards NVQ level 2. Three staff are due to commence NVQ level 3 shortly. This will help provide a qualified workforce to care for the people living at the home. The rota seen and discussions held with the staff and matron evidence that the use of agency staff has considerably reduced, thus providing residents with a continuity of care. There has recently been a recruitment drive and all posts advertised have since been filled and pre-recruitment checks are currently being undertaken prior to new staff commencing employment. We sampled the files of staff recruited since our last inspection for various positions within the home. All files were well presented and contained the information required to safeguard the residents living at Woodcote Hall. We advised the matron to ensure a full employment history is obtained and to record discussions with staff where they have declared any criminal convictions. Staff spoken with considered they are now provided with good training opportunities to include mandatory and service specific topics such as infection control, moving and handling, dementia awareness and palliative care. We saw training certificates on the staff files we sampled and leaflets advertising future courses, dates and nominees were seen displayed. A failure to attend courses without prior arrangement may result in disciplinary action being undertaken and we saw evidence of one file where this had occurred and the matron had taken action. New staff complete induction training to the required specification. Care Homes for Older People Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The matron is qualified and has the necessary experience to run the service and is improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. The matron has identified areas where they need to make improvements and has plans to deal with this. Evidence: Ms Kay Davis continues in the role of manager at the home. Ms Davis is a first level nurse and has considerable experience with managing a social care home. Ms Davis has to go through the formal process for the position of registered manager; we acknowledge the delays in the process. Since being at the home Ms Davis, matron, has identified problematic areas, has implemented changes and guided staff to improve the outcomes and quality of life for the people in residence. Ms Davis acknowledges that further improvements are required and has plans to address them. People spoke positively about the management of the home and comments include: The manager is very approachable and helpful, we can rely on her, she is always there to help and is Care Homes for Older People Page 23 of 29 Evidence: very professional. The matron is open to suggestions to improve the home The manager is nice and I always see her walking around and speaking to people The Aqaa was completed by the matron as requested prior to this inspection. The information gives a reasonable picture of the current situation within the service. The evidence to support the comments made is satisfactory, although there are areas where more supporting evidence would have been useful to illustrate what the service has done in the last year, or how it is planning to improve. The service has developed a quality assurance and monitoring system that makes certain the home is operating as it states it does and meets its stated aims and objectives. Satisfaction surveys are sent to residents and their families, staff and to other health care professionals that are involved with the home. The surveys cover various topic areas including the meals and the environment; results of the surveys are then considered and actioned. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. We found no evidence of formal staff supervision in the five personnel files sampled, the two registered nurses spoken with confirmed they have not received formal supervision but said the matron has had to prioritise work and concentrate on care plans, staffing, improving the environment and recruitment. This shortfall was fully acknowledged by the manager. Records, documents and certificates are available for inspection to ensure that the weekly, monthly and annual health and safety checks are being carried out. The are some areas in the environment and the provision of equipment that have the potential of posing a risk to people living in, working in and visiting the home. For example The wardrobes seen in rooms sampled around the home continue not to be secured to the wall. The water sampled in ground floor shower room was hot to the touch. The sluice room was unsecured and contained some chemical and cleaning substances and items. The heating throughout the home remains problematic. There are numerous potholes in the main drive. Some of the magnetic door closures fitted to private and communal area doors were not working, with some doors being propped open with pieces of furniture. The matron advised the engineers were on site rectifying situation. This was identified as a concern at the inspection in May 2008 with matron taking action to ensure they were in safe Care Homes for Older People Page 24 of 29 Evidence: working condition. The matron confirmed that the handy man inspects the bedrails in use monthly to ensure they are safe and fit for the purpose, however the records to support this were unavailable. Care Homes for Older People Page 25 of 29 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 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The service users guide should be readily available and include details of the current level of weekly fees. This will ensure that people are able to access the information required to assist with making a decision to move into the home. When ever possible care plans should be developed, agreed and reviewed with the individual person and/or representative Arrangements should be made to ensure that a persons privacy and dignity is respected with regard to offering and providing personal care. All areas of the home should be maintained at a temperature that is comfortable for the people in residence. Repairs to the main drive would reduce the risk of accidents to all people living, working and visiting the home. The home should achieve a ratio of 50 of trained care staff to ensure that suitably qualified, competent and experienced staff are working at the care home at all times The application for the position of registered manager of the service should be completed as soon as practicably Page 27 of 29 2 7 3 10 4 5 19 19 6 28 7 31 Care Homes for Older People possible. 8 36 All staff should receive formal supervision with their line managers at least every two months. This will ensure that the care needs of people in residence are carried out in a consistent and effective way. Procedures should be in place to ensure that the health, safety and welfare of residents, staff and visitors are promoted and protected. 9 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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