Care Home: Abbey Care Home

What the care home does well People using the service and their representatives expressed a good level of satisfaction with the home. When asked what they do well, a person living there who completed a survey told us, "Everything". People are treated with courtesy and respect. The staff team provide a good standard of care and look after people in a professional manner. The home has policies, procedures and systems in place for staff to follow to ensure people using the service are safeguarded. There is a robust system in place for supporting people with medication, including appropriate storage, administration and good recording on Medicines Administration Record sheets. What has improved since the last inspection? Since the last inspection there have been further improvements to the environment including an ongoing programme of maintenance and redecoration. There have been significant improvements to access both inside and outside the home. Building work to provide an extension to house a passenger lift has now been completed and the lift is installed and working. This greatly improves the environment for people who are becoming less mobile as a result of the aging process. The building work also included installing ramped access to the property, enabling better access for people using wheelchairs. A new `wet room` with a shower has been installed downstairs providing easier access to bathing facilities for people with restricted mobility. What the care home could do better: The home should continue to build on the significant improvements made in all areas in the past year. In particular they should continue with the ongoing programme of improving the environment to include kitchen area. Key inspection report Care homes for older people Name: Address: Abbey Care Home 28 North Road Great Clacton Clacton On Sea Essex CO15 4DA     The quality rating for this care home is:   two star good 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: Ray Finney     Date: 2 0 0 4 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Abbey Care Home 28 North Road Great Clacton Clacton On Sea Essex CO15 4DA 01255420660 01255420660 info@careone.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care One Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following categories of service: Care Home - PC to service users of the following gender: Both Whose primary care needs on admisstion to the home are within the following categories: Old age, not falling within any other category - code OP Dementia - code DE Mental disorder, excluding learning disability code MD Physical Disability - code PD Date of last inspection 1 1 1 1 2 0 0 9 11 11 0 11 Over 65 0 0 11 0 Care Homes for Older People Page 4 of 27 Brief description of the care home Abbey Care home is an established care home that provides residential care for older people. It is registered to care for eleven elderly people over the age of sixty-five, who may or may not have dementia, mental disorder or physical disability. Abbey Care Home is a detached period property situated in the centre of Great Clacton, close to the seaside town of Clacton-on-Sea. There are local shops, a supermarket, a G.P. surgery, pubs, churches and public transport nearby. Accommodation is in five single rooms and three double rooms; two of the shared bedrooms (with bath or shower) are on the ground floor and all other bedrooms are on the first floor. The bathroom is on the first floor and there is a wet room on the ground floor that is accessible to people with mobility difficulties. Access to the first floor is by means of a staircase or a passenger lift. The home charges between £391.00 and £800.00 a week for the service they provide. Other services such as hairdressing and chiropody are available at an additional charge. Information about the home is available in the Service User Guide which can be obtained by contacting the home. Care Homes for Older People Page 5 of 27 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: A range of evidence was looked at when compiling this report. An unannounced visit to the home took place on 20 April 2010 and we were given every assistance throughout the inspection by the provider and staff team. The visit included a tour of the premises and discussions with staff. The manager completed an Annual Quality Assurance Assessment with information about the service they provide. Throughout the report this document will be referred to as the AQAA. Documentary evidence was examined such as care plans and personnel records. Completed surveys were received from people living in the home or their representative, members of staff and health care professionals. Some of the comments made are recorded in the report. Care Homes for Older People Page 6 of 27 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 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 7 of 27 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 8 of 27 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 choosing to live at Abbey Care Home can be confident they will be able to make an informed choice based on the information the service provides and their needs will be assessed. Evidence: The manager told us in the AQAA, we have an up-to-date Statement of Purpose that gives clear information about the service we provide to help people decide whether or not this home will suit them. As reported at the last inspection, Abbey Care Home has an up-to-date Service User Guide. This is available to anyone wishing to use the service and is on display on the noticeboard in the entrance hall of the home. As previously reported the service user guide is available in a range of formats including a large print version and a spoken word recording. Care Homes for Older People Page 9 of 27 Evidence: The manager told us in the AQAA, All new service users are assessed using our preadmissions assessment. From this service users needs are identified and care plans are made to care for the service users. We also devise risk assessments to manage the risks of these new service users. We collect information from the service users, relatives, friends, social workers and from the service users GP and their consultants if any. We carry out nutritional screening before people move in and monitor the intake of food and drinks once they are with us if we have concerns we contact the appropriate primary health care services. The manager also told us, We invite prospective service users to visit us so they can get a true picture of how the home works. A sample of records examined confirm that each person has an appropriately detailed assessment of their needs in place, which is updated as their individual needs change. The assessment covers a range of areas including the persons ability to maintain a safe environment, communication, health needs, pain management, eating and drinking, mobility, mental health, expressing sexuality, controlling body temperature, personal hygiene and dressing, elimination and continence needs, sleep and rest. The provider told us in the AQAA their plans for improvement in the next 12 months. We will use the trial visits made by people who want to move into our home as a more formal part of the pre-admission process. For example we will observe how people get on with others, what they like and how they manage mealtimes and use this information to help us develop person centred care plans. Although there have been no new admissions since the last inspection there is sufficient information available for people to make a decision about whether they wish to move into Abbey Care Home. There is also an appropriate process in place for assessing peoples needs before admission to the home Care Homes for Older People Page 10 of 27 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 using the service can be confident their personal and healthcare needs will be met as they would wish. Evidence: The manager told us in the AQAA, Our care plans address our service users health, personal and social needs from the information gathered in the pre-admission assessment and information we continue to gather as we get to know people better. We also use the Department of Health clinical guidelines in consultation with primary care staff to ensure we have the most up-to-date information to help us care for people with, for example, diabetes or other medical conditions. Since the last inspection the manager has continued to make improvements to the homes care planning system. On the day of the inspection we examined a sample of three individual care plans. Each Person Centred Plan has got a photograph of the person on the front and the information is written from the individuals point of view, giving some background information about the persons past life, abilities, likes and needs. Significant events such as birthdays and anniversaries are recorded as well as Care Homes for Older People Page 11 of 27 Evidence: any particular life achievement. One persons care plan stated, I was in the land Army. The manager told us in the AQAA, Staff have completed training in care planning and risk assessment. They are being supported to put this training into practice and We review our service users care plans every month along with the risk assessment when there is an accident or incident. Each care plan file has a range of risk assessments in place including manual handling, outings and falls. A relative who completed a survey told us their relative, always looks clean and tidy whenever I go to the home. Someone living in the home who completed a survey told us, they look after me very well and someone else stated, The home cares for me well and the staff are great. The manager told us in the AQAA, Our carers are mostly qualified nurses in their country of origin and are currently studying to obtain qualifications in NVQ 3 in Health and Social Care. We do not provide nursing care but their knowledge means we can identify quickly where health service input is required and Our service users are registered with their GPs of their choice. I chiropodist visits the home every six weeks, a dentist visits the home on a six monthly basis, opticians is the home annually to carry out eye tests. Hearing tests on a range when the need arises. Care plans contain a range of charts documenting peoples individual health and personal care needs. There are charts to document peoples nutritional intake, bathing records and weight charts. People are supported to see healthcare professionals according to their individual needs including doctors, district nursing services, community psychiatric nursing services and Essex Guardians (Court of Protection). An optician was due to visit the home for everyone to have an eye test. We had discussions with the visiting healthcare professional who explained that the service is good at contacting them for advice. The healthcare professional confirmed that they have no problems with the care provided and peoples health care needs are met. When asked what the service does well a health care professional told us, provides comprehensive 24 hour care for [complex people]. Care Homes for Older People Page 12 of 27 Evidence: The manager told us in the AQAA, Our home has a comprehensive policy regarding the receipt, administration, storage and disposal of medication. Our staff are aware of this policy and procedure. We maintain a MAR sheet for each for each person that receives medication. Our service user photos are displayed on the MAR sheet for easy identification along with a medications name, their use and their side effects. We also maintain records for the return of medication to the pharmacy for disposal. The manager further told us, Medications are kept in a locked cupboard in the home in accordance with legal requirements and guidance from the Royal Pharmaceutical Society. None of our service users currently use controlled drugs but we have suitable storage facilities should this be necessary. We monitor the medicine cupboard temperature as well as the medicine fridge temperature on a daily basis. The home continues to have appropriate processes in place to support people with medication. The home operates a monitored dose system (MDS). Medication is storage in a secure corporate, which is tidy and well organised. The home also has a specific controlled drugs covered to ensure there is appropriate storage for drugs that require an enhanced level of security. Medicines Administration Record (MAR) sheets examined were all completed and signed appropriately. Each person has a front sheet with their MAR containing details of their doctor, allergies and diagnosed conditions. Each MAR sheet has a photograph of the individual on the front. Prescribed medication for each individual is listed together with information about what the medication has been prescribed for and any potential side-effects. The manager told us in the AQAA, All of our staff are trained before they administer medication. Staff for observed administering medication to ensure they are doing so competently. Records of the observation are kept in each staff members personal file. Since the last inspection staff have received medication training, which entails them working their way through a workbook. Records examined confirmed that further medication training has been booked. The manager told us in the AQAA, We treat our service users with dignity and respect at all times. We address them by their preferred names. We maintain privacy when we provide personal care by ensuring that doors are closed and people are kept as covered as possible. We talk to people whilst we are providing care to ensure that they are comfortable. Consultations with healthcare professionals are carried out in the privacy of a persons room. Care Homes for Older People Page 13 of 27 Evidence: As reported at the last inspection, people spoken with were complimentary about the way they were cared for. Our observations on the day of the inspection confirmed that staff treated people with courtesy and respect. Care Homes for Older People Page 14 of 27 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 in the home can expect to enjoy a lifestyle that meets their wishes, needs and interests. Evidence: The manager told us in the AQAA, We allow our service users to exercise their choice in relation to daily living and activities. We have planned activities for service users including gentle armchair exercise and we have improved the amount of one-to-one time staff spend with service users talking to them about their interests and their past as well as current affairs. The manager also told us, We have involved the local vicar to visit the home once a month to provide holy Communion for our service users who want it. As at the last inspection peoples care plans contain activities logs which document how the person spends their time. People like to watch television and listen to music, one person enjoys reading the newspaper. On the day of the inspection carers played in indoor ballgame with residents in the lounge before lunch. The manager explained one person likes to go regularly to the bank and some residents accompany staff to the supermarket. Care Homes for Older People Page 15 of 27 Evidence: People living in the home and their relatives who completed surveys were complimentary about the food. When asked what the home does well someone told us, everything from food and the care standards are good or better if not more and another person said, meals - well cooked and regular. A relative said, It does provide regular, well-cooked meals and my [relative] is eating really well at present. A relative who completed a survey told us they are always kept well informed about their relative. The manager told us in the AQAA, Our service users receive a varied, appealing, wholesome and nutritious diet. Our service users have their meals in their rooms or in the dining area whatever they want and hot and cold drinks are available at all times to our service users. The manager explained that the now have a pictorial menu and food is discussed with residents at the regular discussion group. People spoken with on the day of the inspection said they enjoy the food. Care Homes for Older People Page 16 of 27 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 using the service can be confident that their concerns about how they are treated are listened to and acted upon and they will be kept safe. Evidence: The manager told us in the AQAA, We have a simple, clear and accessible complaints procedure in place. Our complaints procedure is given to our service users and pinned to our noticeboard. We also have our complaints procedure in an audio format and we welcome complaints because we think they help us to improve our service. Abbey Care Home continues to have an appropriate complaints procedure in place. We have not received any complaints about the home since the last inspection. Our observations at this inspection confirmed, as previously reported, that staff are courteous and listen to people and dealing with any minor concerns as they arise. People living in the home and their relatives who completed surveys all indicated that they knew how to make a complaint should they need to do so. The manager told us in the AQAA, We take any form of abuse very seriously and we all must inform the local authoritys Adult Protection Team and the Care Quality Commission if we have any concerns or any allegations have been made and All of our staff are vetted before appointment. We carry out CRB checks and obtain two references, one of which from the last employer. Our staff cover safeguarding issues Care Homes for Older People Page 17 of 27 Evidence: before they start duty at Abbey Care Home in their induction. Staff working in the home understand their responsibilities around keeping people safe. Personnel records confirm that staff undergo appropriate checks before they are employed, including enhanced Criminal Record Bureau (CRB) checks and staff have received training around safeguarding (previously referred to as Protection of Vulnerable Adults or POVA). Care Homes for Older People Page 18 of 27 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 can enjoy living in an environment that suits their lifestyle and which is homely, well maintained and clean. Evidence: The manager told us in the AQAA, Our home has been decorated recently and the carpets changed. Our gardens are kept tidy, safe, attractive and accessible to our service users and Our home is safe for all users, well maintained and accessible and meets service users individual and collective needs. Since the last inspection there have been further improvements to the environment. We previously reported that there had been redecoration in many areas and some new furnishings. This programme of redecoration and refurbishment has continued and the home was clean, comfortable and well maintained. The manager told us in the AQAA, We recently fitted a new lift and a disabled toilet and shower to make access to all parts of the home easier for users. A significant improvement has been the completion of an extension to house the new passenger left which has now been installed. This has greatly improved access for people whose mobility is reduced as a result of the ageing process. A new wet room with shower has also been installed on the ground floor. We discussed with the Care Homes for Older People Page 19 of 27 Evidence: manager how this has improved outcomes for some of the people in the home with poor mobility. Now that the building work has been completed, there is ramped access to enable people with restricted mobility or people who use wheelchairs to access the gardens and the local community more easily. The manager provided information in the AQAA about improvements in the last 12 months. These include, routine maintenance plan in place. All our staff have received infection-control training. We clean the areas with disinfection solution. Staff wear protective clothing. The manager further told us, Our premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection in accordance with relevant legislation and guidance. Our laundry facilities are in a separate building. Soiled articles, clothing and any infected linen are not carried through the areas where food is stored, prepared or eaten. There are handwashing facilities sited where infected materials and clinical waste are handled. A tour of the premises confirmed that the home was clean throughout including bathrooms, toilets and the laundry area. The kitchen area was also clean, although there remains room for improvement in this area. Overall, however, the home provides clean, comfortable and homely accommodation for the people who live there. A visiting health care professional who completed a survey said Abbey Care Home provides, a clean environment without any odours. Care Homes for Older People Page 20 of 27 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 in the home can be confident they are cared for by a competent staff team who can meet their needs. Evidence: The manager told us in the AQAA, We have a minimum of two staff all the time on duty to provide care for our service users. As noted at the last inspection, staffing levels remain good. We observed that peoples needs were being met promptly by staff on duty and support was being provided in a relaxed manner. Staff took time to talk to people and explain what they were doing. The manager told us in the AQAA, We operate and robust recruitment procedure based on equal opportunities and ensuring the protection of our users. As previously reported, there continues to be an appropriate process in place for recruiting staff. Personnel records examined contained all the information required by regulation. This includes appropriate written references, relevant proofs of identity and CRB (Criminal Record Bureau) checks. The manager told us in the AQAA, Most of our staff currently are qualified nurses in their own country of origin and they are studying to gain either NVQ level 3 or 2 in Care Homes for Older People Page 21 of 27 Evidence: Health and Social Care qualifications. All our carers have completed the Skills for Care, induction programme, health and safety courses, infection-control courses, fire safety courses, safe administration of medication courses and Safeguarding of Vulnerable Adults. All staff are given a copy of the GSCC code of conduct. Individual training records in personnel files examined contained evidence of a range of training. This included NVQ (National Vocational Qualification), Moving and Handling, Equality and Diversity, Fire Safety, Food Safety, administration of medication, safeguarding and direct observations of competency in care. Staff who completed surveys made complimentary comments about training. One person told us, The service does well in training staff for them to become more competent in their work. When asked what the service does well, two members of staff responded, training and supervision. Personnel files also contained evidence of appraisals and supervision of staff. Care Homes for Older People Page 22 of 27 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 in Abbey Care Home can be assured it is appropriately managed in their best interests. Evidence: The manager has completed the AQAA to a good standard, containing evidence of what they do well, how they have improved in the past 12 months and their plans for improvement in the next year. Each outcome group has been completed with sufficient detail of how the service ensures good outcomes for people living there. As previously reported the provider continues to manage the home on a day-to-day basis. All requirements from the last inspection have now been met. Since the last inspection there have been a number of staff changes but we observed that the current staff team are working well with the manager. The homes quality assurance process which was examined at the last inspection remains in place and the manager continues to seek the views of people using the Care Homes for Older People Page 23 of 27 Evidence: service through questionnaires, discussion groups and meetings. A sample of documentation relating to health and safety was examined and all was found to be in order. This included portable appliance testing (PAT), maintenance of hoists, gas safety certificate and a positive report from a recent environmental services inspection. The home operates a master key policy for emergency exits to ensure the security and safety of people living in the home and all members of staff hold keys. On the afternoon of the inspection staff were having COSHH (Control of Substances Hazardous to Health) training. Care Homes for Older People Page 24 of 27 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 25 of 27 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 Care Homes for Older People Page 26 of 27 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). 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