Care Home: Ashley Park Nursing Home

What the care home does well The AQAA informs "personal care is delivered according to each service user`s plan of care" this was evidenced by the signing of the care plans by service user or their representative and by the careers after they have completed a task. We noted care plans are reviewed regularly some on a monthly basis and others more often as required. Observation of care staff and service users interactions and in discussion with service users confirm service users are treated with respect and have their dignity maintained. Standards in bedrooms and in the home in general indicated service users lived in a well-maintained home. What has improved since the last inspection? The food has improved immensely. The Chef was awarded the UK Care Chef Manager Award in November 2008. This award open to all care homes in the UK, is not merely a cooking award but also involves an element of care by the Chef. The home has implemented and maintained the menu manager which has enabled the home to plan and provide a nutritious menu to ensure suitable dietary intakes for the service users at the home. They also incorporate a `Night bite` menu which consists of a hot or cold snack out of hours to ensure no one goes to bed hungry. The home has joined Dial a Ride for eight service users to enable them to have trips outside if they wish without having to wait to book the minibus from the other local BUPA home. What the care home could do better: The home continues to offer good outcomes for service users. The manager is proactive and is able to self analyse the running of the home and initiates improvements before they become obvious. Key inspection report Care homes for older people Name: Address: Ashley Park Nursing Home The Street West Clandon Guildford Surrey GU4 7SU     The quality rating for this care home is   three star excellent 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: Mavis Clahar     Date: 0 4 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 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) 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 27 Information about the care home Name of care home: Address: Ashley Park Nursing Home The Street West Clandon Guildford Surrey GU4 7SU 01483222296 01483211099 frenchla@bupa.com www.bupa.com BUPA Care Homes (BNH) Ltd care home 47 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) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 47 The registered person may provide the following category of service: Care home with nursing(N) t service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ashley Park is a large, attractively presented detached property set in pleasant grounds in the village of West Clandon. The home is owned by BUPA and the service is registered to provide care, accommodation and facilities for up to 47 older persons requiring nursing care. The accommodation and facilities are set over three floors with a passenger lift access to all floors. However, there are two bedrooms that require service users to negotiate two sets of four stairs from the lift to the rooms. These rooms are reserved for respite care or people who are independent and mobile. The communal areas are all found on the ground floor and consist of a sun lounge, a Care Homes for Older People Page 4 of 27 Over 65 47 0 Brief description of the care home drawing room, a large dining room and a very large activities room that is also used as the hairdressing salon and physiotherapy room. The home has very large gardens that run down to the neighbouring golf course. The grounds closest to the home are well maintained, with many seating areas around the house and a sun gazebo in the grounds. There is plenty of parking to the front and around the side of 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection for this service was completed on 7th August 2007. Fees charged at this home are in the range of eight hundred and fifty pounds to eleven hundred pounds per week and does not include costs for hairdressing, chiropody and personal toiletries. The quality rating for this service is 3star. This means people who use the service experience excellent quality outcomes. This unannounced site visit, which forms part of the first key inspection to be undertaken by the Care Quality Commission, (CQC) was undertaken by Mrs Mavis Clahar on the 4th June 2009 and lasted for six hours and fifty minutes; commencing at 08:20 hours and concluding at 15:10 hours. The CQC Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a Care Homes for Older People Page 6 of 27 variety of sources which initially helps us to priorities the order of the inspection and identify areas that require more attention during the inspection process was sent to CQC (us) in good time. The AQAA is referred to throughout the report. We spoke with four service users and four members of staff, three visitors and their responses and views of the home are also incorporated into the report. The registered manager assisted on this inspection visit. The majority of the service users spoken to were able to express their thoughts and feelings about their home and the care they receive. The information contained in this report is gathered mainly from speaking with a number of service users, observations by the inspector, discussion with the Chef, caring staff, the registered manager and the deputy manager. Further information was gathered from records kept at the home. The first part of the inspection was spent discussing and agreeing the inspection process with the registered manager and deputy manager, followed by a partial tour of the home and garden which included time spent in discussions with service users and staff. Special time was made to speak with visitors to the home in private and they all praised the care and support their relatives received at the home. One couple told us We have decided when our time comes to go into a home we will be booking into this home. We are so pleased with the standard of care our relative is receiving. The manager and care staff are aware of the laws regarding equality and diversity and this was reflected in the staff mix. All service users in this home are Caucasians and mostly British and reflect the population of the area in which the home is situated. First impression of the home was, it was clean and tidy, it felt peaceful and no malodours were present. Comments made by service users were very positive about the care they receive at the home such as the treatment is excellent the staff are very kind and they know me well. The staff falls over themselves to help you. All service users records sampled were up to date with care plans being signed by service users or relatives. The final part of the inspection was spent giving feedback to the deputy manager about the findings of this visit. No requirement or recommendation of good practise was made on this visit. We would like to thank all the service users, visitors and care staff who took time out of their busy schedule to speak with us on the day of the visit. Care Homes for Older People Page 7 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 8 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 9 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. Admissions are not made to the home until a full needs assessment has been carried out. For people who are self funding and without a care management assessment the manager or her deputy who are both skilled and experienced in assessments undertakes the assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative. People are thus enabled to make an informed choice. Evidence: Review of service users documents demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The Registered Manager, and in her absence, the deputy manager who is trained in the principles of assessment of service users needs based on what the care the home says it will provide carries out pre admission assessments of service users prior to them being admitted into the home. Re admission assessment following discharge Care Homes for Older People Page 10 of 27 Evidence: from hospital is also carried out to ensure the home is still able to meet the needs of the service users. Review of a random sample of service users files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. Care Homes for Older People Page 11 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. Service users receive effective personal and health care support using a person centred approach with support provided based on the rights of dignity, equality, fairness, autonomy and respect. The home fully respects the rights of the individual in the areas of health care and medication. Staff members are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. Evidence: The randomly selected care plans were clear, identifying potential and actual risks to service users and detailing how these risks would be managed. The daily work sheet along with discussion with service users and care workers demonstrated that service users care needs are fully met. The service user or relative signed the care plans to indicate their involvement in deciding what care they received. It was evidenced that care staff undertaking the development and monthly review of the care plans also signed and dated them. Information contained in the homes Annual Quality Assurance Assessment (AQAA) informs each care plan is written in a manner which each client and staff member can understand and follow to ensure the needs of the service users Care Homes for Older People Page 12 of 27 Evidence: are met. Personal discussions on the day of the visit with service users revealed that they were involved in the assessment of their care needs. We observed on the day of the visit that care plans with appropriate risk assessments were kept in the nursing office. All service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist health care professionals through their GP practise as required and these visits are also recorded in the service users folder. Service users are offered access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. In discussion with the Registered manager, the deputy manager of the home and care workers they were extremely proud of the high standard of care they provided to all service users in the home. This was supported by the service users spoken to and by the review of the many letters of thanks received by the home. Care staff identified as capable to administer medication are requested to leave a sample of their signature, which is dated in the medication trolley. All service users have a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We were told by care workers that no service users on the day of the site visit were assessed as capable to self medicate. However the home had policies and procedures for self medication should this become necessary. Medication records were checked and found to be correct as documented on the Medication Administration Record (MAR) sheet. Review of the homes record of receipt and disposal of medication was satisfactory, dated and signed. We spoke with three relatives on the day of the visit and they were very complimentary about the standard of care given to their relatives in this home. They also mentioned how pleasant and kind the staff were and felt they were able to approach any member of staff without fear. One visitor told us If we ever need to be admitted into a nursing home this is the one we would choose. We observed that care workers wore name badges to enable visitors and service users with memory impairment to be sure of whom they are speaking with. We observed Service users being treated in a friendly but respectful manner by care workers. Service users spoken to rate the personal care they receive as excellent. Service users unanimously said, We are treated with respect. They said the staff team are friendly and they attend all appointments accompanied either by staff or if their relative decides to accompany them. In discussion with service users they told us that they are treated with respect and dignity, and that they are able to make their own choice. One service user told us I am very happy here. Everything is so nice. I have my own room; I can have as much privacy as I want. Another service user said We have good staff here; they do not ill treat me. I have help to choose my own clothing every day. Care Homes for Older People Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care staff are sensitive to the needs of those service users who find it difficult to eat and give assistance with feeding. They are aware of the importance of feeding at the pace of the individual service user, making them feel comfortable and unhurried. Evidence: The home ensures the activities co-ordinator along with outside entertainers manage the activities programme for the service users. The Manager and staff in agreement with the service users and their relatives provide a range of activities based on the individual assessed and agreed needs, including their preferences, cultural beliefs and customs. The AQAA informs us that wherever possible relatives are encouraged to participate in the planning and carrying out of service users activities. Activities provided include board game,various crafts, knitting, reminiscence therapy, sing-along, scrabble, quiz afternoons and bingo. The home also provides outside visiting entertainers to the home to provide extra activities for the service users. We were told the home has good contact with religious denominations and Holy Communion is provided for all service users who would like to participate. In discussion with service users we were told the home respects those service users who wish not to participate in an activity on any given day. A record of each service users Care Homes for Older People Page 14 of 27 Evidence: daily activity is recorded in their care plans and their files demonstrated activities undertaken and refused. Service users told us visiting is open, and that they can entertain their guests in their bedrooms in private or in the spacious communal areas of the home. This statement was supported by visitors spoken to on the day of the visit. We observed a variety of fresh fruits were made available for service users in the home. Four of the service users spoken to said they had choice in their clothing and sometimes they receive help from their key worker. On the day of inspection all service users were dressed appropriately for the weather. We were told the Chef who has recently received an award for her cookery and consideration of service users nutritional and social needs has been at the home for a long time and operates from a four week menu and there is always a choice of two hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelet etc. One service user told us there is always a choice of two hot dishes for the evening meal, or we can choose to have sandwiches filled with our own choice. Morning coffee and afternoon tea is served daily and our visitors are served the same as us. We observed jugs of fruit juices and squash with glasses were placed in the lounges whilst service users were present, and staff was seen offering drinks to service users. The inspector did not sample the lunch, but service users said the food was very good, tasty and the right amount. The inspector observed the presentation of the food was done in a way to stimulate appetite. A choice of squash, fruit juices or wine was served with lunch, which was served in the dinning room unless a service user requested to have their meal in their bedroom. We observed care workers interacting in a friendly but dignified manner with service users whilst helping them with their Care Homes for Older People Page 15 of 27 Evidence: meals. 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. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon.Robust Safeguarding adults policies are in place to protect the service users from abuse. Evidence: The Regulatory Body Previously (CSCI) and now CQC received no complaints about the home. The AQAA informs seven complaints were received and investigated since the last report. The deputy manager informed us that both her and the registered manager of the home are in touch with service users on a daily basis and issues raised are dealt with immediately; this prevents any need for service users to complain. Service users spoken to said they have no need to complain, as they are able to discuss everything with the manager or deputy.The care workers were aware of the homes policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use the whistle blowing procedure they would be supported.It was observed that the homes guest information notice board situated in the main entrance of the home and also in the the living room and the managers office contained a complaints procedure and policy, whistle blowing policy, statement of purpose and a recent copy of the last Regulatory body (CSCI) inspection report for the benefit of all visitors to the home. The home has received a number of complimentary letters and cards from relatives of service users, commenting in a positive way about the care their relatives received at the home.A random sample of care workers Care Homes for Older People Page 17 of 27 Evidence: training record demonstrated that care workers are being POVA trained and to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Visitors to the home on the day of the site visit told us they knew how to complain but so far have not had the need to do so. 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. The physical design and layout of the home enables service users to live in a safe, well- maintained and comfortable environment, which encourages independence, and protect their privacy and dignity. Evidence: The management and staff encourage service users to see the home as their own home. It presents as a comfortable, attractive home, which has all the specialist adaptations, needed to meet the service users needs. It was observed that call bells were left within reach of each service user and service users said the bells are answered promptly. We also observed service users safety is promoted and there is suitable protection for the part of the home that is being used for service users with mobility difficulties. The home has attractive, secure secluded gardens.which are well maintained and there is good access to the gardens from the home. Some service users told the inspector that they try to go out daily weather permitting to enjoy the gardens. The inspector noted that adverse weather would not stop service users enjoying the garden, as the windows are low enough to allow service users to view the gardens from their armchairs. It was noted that service users were able to personalise their bedrooms with small items of furniture, paintings on the wall and many family photographs. Generally, the home presents as clean, safe, pleasant, hygienic and tidy and free from offencive odours. Random review of care workers training record Care Homes for Older People Page 19 of 27 Evidence: demonstrated they have had training in infection control and this was evident in the storage of waste. The AQAA informs us staff are trained on the safe disposal of clinical waste and are provided with protective clothing to minimise the risk of spreading infection. We observed staff wearing disposable gloves and aprons whilst undertaking tasks during the visit. 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. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. Evidence: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four hour period was suitable to meet the assessed care needs of the service user. The home has a programme of planned training in place and all members of staff have an individual training record. Over 50 of care workers have attained the National Vocation Qualification at Level 2 (NVQ L2) or above. Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training. All newly appointed staff undertakes the Skills for Care Common Induction programme. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the care workers and review of carers training records. It was observed that staff turnover at the home is relatively low. All care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and they are in receipt of terms and conditions of employment, as evidenced in their randomly selected files, which contained the information required under care Homes Regulations 2001 Schedule 2. We observed supervision records were up to date during random sampling of care workers files. Documented evidence indicated that the home Care Homes for Older People Page 21 of 27 Evidence: ensures that care workers receives the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with care workers. The AQAA informs the home has improved staff training and standard of care in the last twelve months by ensuring all newly appointed staff undertakes the (EWART) Early Warning Audit Tool test every month to ensure the highest standard of care is maintained within the home. The AQAA further informs that the home motivates staff by nominating them for BUPA one life awards. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home and the views of service users and their relatives are actively sought.Service users financial interests are safeguarded and the health, safety and welfare of service users and staff are protected and promoted by the homes policies and procedures. Evidence: The AQAA informs us that the manager has demonstrated that she has kept herself updated on issues relating to care of the service users and staff in her charge. She has attained the Registered Managers Award and also the National Vocational Qualification Level 4 in care. In discussion with the registered manager she confirmed this.with the deputy manager it was evident both the registered manager and the deputy manager are knowledgeable about the care needs of the service users and the training needs of the care workers to meet these identified needs. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of Care Homes for Older People Page 23 of 27 Evidence: their role and responsibilities. We were told that the majority of the service users are capable to be fully involved in the running of the home, and their relatives are encouraged to be as involved as their time allows them to be. The service users of the home are treated as part of a large family and meetings are held at regular intervals to allow service users, their relatives, carers, registered manager and the deputy manager to discuss issues pertaining to the smooth running of the home. Every one is then able to contribute to the running of the home, whether it is to change the four weekly menus or to replace major items in the home. One service user explained that this approach is preferable by all concern parties as any occurrence in the home affects us all.The home does not become involved in service users finance. Their relatives manages all their finance. Good records are kept with receipts for any expenditure.Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. The AQAA informs that fire drills, fire alarm, and water temperature were regularly checked and records kept verifying this. Random sample of care workers training files demonstrated that up to date and relevant training were carried out by care workers to protect service users health, welfare and safety. Throughout the service there is a highly evolved understanding of the equality and diversity needs of the individual service users. Care workers are confident in delivering high quality outcomes for service users in the areas of age, sexuality, gender, disability and belief. Although the care workers are knowledgeable about issues relating to race and equality and diversity, they are not able at the moment to put this knowledge into practise, as the current service users are all British Caucasians.Random checking of policies revealed that the homes policies are up to date. The AQAA informs the home collects yearly questionnaires from other professionals who visit the home. 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). 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. 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