Care Home: Ashlyns Residential Home

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What the care home does well Ashlyns is very well managed by a stable and long-serving team of managers and core workers. Their consistency in providing excellent care and support has been very beneficial to the residents, particularly those suffering from dementia. These residents seemed alert, active, happy and content. There is a high level of one-to-one attention, conversation and stimulation given to them as observed on the day of the inspection. Residents felt well supported by an effective staff team with a skill mix that benefits residents. Members of staff were gentle and soft spoken in their approach to each resident. In the dementia unit, it was particularly pleasing to observe the kind response from a member of staff to a resident who needed immediate help with personal care just before lunchtime. The individual was treated with respect and dignity. The service provides a homely, safe and stimulating environment for the residents to live in, and the surrounding grounds are spacious, pleasant and attractive. Social, recreational and therapeutic activities are provided daily and elicited favourable comments from the residents and relatives. Comments received included: "The home creates a good ambience. They arrange entertainment and creative activities." "They look after the residents. The activities are good." "The staff are very approachable and helpful. The surroundings are beautiful and the food is superb." "We get good service here. The place is very clean and nice." "The staff are considerate and nice." "They are very helpful and kind to me." "I am very happy here and would like to thank all the staff for making me feel so settled so quickly." "I am very happy and pleased to be here." "They care for the residents and treat them like family. Very helpful staff." "The home creates a very friendly atmosphere and every effort is made by the staff to ensure that your stay here meets all of your requirements." "The 24 hour pastoral care is superb. It`s a home from home." "The staff have always kept us informed about the care and service provided. At the present time all our needs are met." "We fully support the manager and her staff in implementing new ideas that make thehome more comfortable and relaxing. We feel we could not have picked a better place for our (relative)." "There is an excellent rapport between carers and residents and they show care and respect at all times. The food is excellent both in quality and variety. The laundry worker does an excellent job and clothes and bedding are always very clean. The care co-ordinator is lively and fun and arranges a wide variety of activities. Excellent work by all." What has improved since the last inspection? Since the last inspection, one of the communal rooms in the residential unit has been refurbished and is now used by residents and their visitors as a quiet room with pleasant decor and soft, soothing background music. The home has employed an additional activity co-ordinator so that there is now an activity co-ordinator for each unit to ensure that there is daily therapeutic and group exercise. What the care home could do better: There has been a positive move to improve the surroundings in the dementia unit. Work is in progress to create a quiet room in the unit and improve the colour scheme in sections of the unit, using contrasting colours to aid those with dementia from becoming disorientated and to aid them in finding their bedroom more easily. It would be good if the management took note of the following comment from some relatives: "The home could have more activities at weekends and I sometimes feel that the home is slightly stretched on staffing at night and weekends." Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashlyns Residential Home Chesham Road Berkhamsted Hertfordshire HP4 2ST     The quality rating for this care home is:   three star excellent 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: Yoke-Lan Jackson     Date: 2 2 0 6 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 27 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 27 Information about the care home Name of care home: Address: Ashlyns Residential Home Chesham Road Berkhamsted Hertfordshire HP4 2ST 01442870565 01442861601 ashlyns@bmcarehomes.co.uk 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) : Colley Care Limited (Trading as B & M Care) care home 58 Number of places (if applicable): Under 65 Over 65 19 38 0 dementia old age, not falling within any other category physical disability Additional conditions: 0 0 1 When the named service user in the PD category permanently leaves the care home for any reason the PD category will be removed and the number of places in the OP category would revert back to 39. Date of last inspection Brief description of the care home Ashlyns is a purpose built residential care home for 58 service users in the older people category. The home has a Dementia Unit (for 19 service users) and a Residential Unit (for 39 service users). The prover is Colley Care Limited, trading as B & M Care. The building, part of a large country estate, is situated on the outskirts of Berkhamsted, close to the A41. There are ample parking spaces nearby. The home has a front driveway and the main entrance to the building is security locked. All the bedrooms have en-suite facilities and some are double rooms. All bedrooms are accessible to wheelchair users. Care Homes for Older People Page 4 of 27 Brief description of the care home The Dementia Unit has 19 bedrooms, two lounges, a small nurses station, a kitchenette and a dining room. Overlooking the lounge is the sensory garden. The interior decor and furnishing are designed to provide a homely and comfortable atmosphere. Security locks are in place at both ends of the Dementia Unit for the safety of the service users. The corridor extends into the Residential Unit, with 39 bedrooms, a lounge, a laundry room, a main kitchen and two dining rooms. There are grounds all around the home and in the centre of the building is a courtyard that is well designed with an ornamental fountain, attractive potted and climbing plants and comfortable garden furniture. There is a large sun lounge, adjacent to an activity room and overlooking the back garden, which is accessible to wheelchairs. The home charges £738 to £890 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service Users Guide. A copy of these and the most recent CQC inspection report are available in 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: This service had a key inspection in July 2007 and an annual service review in July 2008. This unannounced key inspection was carried out on 22/06/2009. Both the registered home manager and the deputy manager were present. There are 58 people in residence. The inspection visit included a tour of the premises, lunchtime observation and observation of how the staff interacted with the residents in the dementia unit and during activity sessions in both units. Staff and residents were spoken to and key documents were examined. The inspection ended with a thorough discussion with the home manager. Care Homes for Older People Page 6 of 27 Survey questionnaires were sent to the residents and relatives and their responses and other information received by us were reviewed. This included the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete annually. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us with statistical data. What the care home does well: Ashlyns is very well managed by a stable and long-serving team of managers and core workers. Their consistency in providing excellent care and support has been very beneficial to the residents, particularly those suffering from dementia. These residents seemed alert, active, happy and content. There is a high level of one-to-one attention, conversation and stimulation given to them as observed on the day of the inspection. Residents felt well supported by an effective staff team with a skill mix that benefits residents. Members of staff were gentle and soft spoken in their approach to each resident. In the dementia unit, it was particularly pleasing to observe the kind response from a member of staff to a resident who needed immediate help with personal care just before lunchtime. The individual was treated with respect and dignity. The service provides a homely, safe and stimulating environment for the residents to live in, and the surrounding grounds are spacious, pleasant and attractive. Social, recreational and therapeutic activities are provided daily and elicited favourable comments from the residents and relatives. Comments received included: The home creates a good ambience. They arrange entertainment and creative activities. They look after the residents. The activities are good. The staff are very approachable and helpful. The surroundings are beautiful and the food is superb. We get good service here. The place is very clean and nice. The staff are considerate and nice. They are very helpful and kind to me. I am very happy here and would like to thank all the staff for making me feel so settled so quickly. I am very happy and pleased to be here. They care for the residents and treat them like family. Very helpful staff. The home creates a very friendly atmosphere and every effort is made by the staff to ensure that your stay here meets all of your requirements. The 24 hour pastoral care is superb. Its a home from home. The staff have always kept us informed about the care and service provided. At the present time all our needs are met. We fully support the manager and her staff in implementing new ideas that make the Care Homes for Older People Page 8 of 27 home more comfortable and relaxing. We feel we could not have picked a better place for our (relative). There is an excellent rapport between carers and residents and they show care and respect at all times. The food is excellent both in quality and variety. The laundry worker does an excellent job and clothes and bedding are always very clean. The care co-ordinator is lively and fun and arranges a wide variety of activities. Excellent work by all. 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 9 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 10 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. Prospective clients can be assured that a thorough pre-admission assessment will be carried out before they are admitted to ensure that the home can meet all their care needs. Evidence: The pre-admission documents for three new admissions were examined and they were found to be detailed and informative. The management had carried out a thorough assessment of each prospective clients personal, healthcare and social care needs. The three new admissions seemed settled in their new home. One of the new admissions was placed originally in the dementia unit and following a review of their care needs, staff felt that the resident would benefit more in the residential unit where they have been well settled since. In a recent survey by us some relatives commented: Care Homes for Older People Page 11 of 27 Evidence: My (relative) was very nervous and unsure when first arriving at Ashlyns but all the staff have made what could have been a very difficult time easy and worry free. They are all friendly and very welcoming. When (my relative) arrived at Ashlyns, (my relative) was depressed and very withdrawn and did not want to leave the bedroom or eat properly. The staff were amazing and supported and encouraged (my relative) and as a result (my relative) has gained confidence and their self esteem has increased dramatically. (My relatives) health and well being have improved immensely and (my relative) is fitter and happier then they have ever been for years. Care Homes for Older People Page 12 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 who use the service can be assured that they will be treated with respect and dignity and they will receive personal care and support in the way they prefer and require. They are safeguarded by the homes medication policy and procedure. Evidence: Each resident has a written care plan. The home uses the written format (known as BETTALs System) issued by the provider. The health, personal and social needs of the individual are set out in the care plan. However, it would benefit both staff and residents if specific conditions such as Parkinsons Disease and Diabetes are reflected in a more user friendly format to reflect the person-centred care provided. Since the inspection the management have improved this aspect in the written care plan. This ensures that those who are looking after the residents have the required information to deliver not only the personal and social care needs but also the healthcare needs of the people living in the home. The care needs of residents are reviewed monthly and when required. Both residents and their next of kin are involved. Care Homes for Older People Page 13 of 27 Evidence: During the site visit, it was noted that members of staff, in both the residential and dementia units, interacted well with the residents and readily assisted those residents who needed help. They seemed to have a good knowledge of the residents conditions and their likes and dislikes, and deliver care and support accordingly. Members of staff were gentle and soft spoken in their approach to each resident. It was particularly pleasing to observe the kind response from a member of staff to a resident who needed immediate help with personal care just before lunchtime. The individual was treated with respect and dignity. The resident seemed at ease to ask for assistance. All the residents have access to healthcare services if required. Each of the residents is registered with a general practitioner of their choice and residents have access to other healthcare professionals, including the district nurse, chiropodist and dentist according to their care needs. A trained member of staff administers the medication. All medicines are stored in the medication storage room. There is a controlled drug cupboard and the controlled drugs in use were accurately administered and recorded. All other medicines are stored in the drug trolleys. There are a number of residents who have been prescribed alendronic acid for osteoporosis. Appropriate measures are taken to ensure that on the day of administration of the drug, the individuals are not given calcium tablets because of a contraindication. This was as prescribed by the doctor. The assistant manager regularly audits the storage and administration of medication to ensure that staff follow the homes medication policy and procedures and that medication is administered in accordance with legislation. There have been no medication errors since the last inspection. However, there was a gap in one of the Medication Administrative Record (MAR) charts. The assistant manager had investigated and has taken appropriate action to retrain a member of staff who had given the medicine but had forgotten to sign the MAR chart and the incident was justified at the back of the MAR chart. It was noted that the medication storage room temperature was above 25 degrees centigrade. The maintenance man was immediately called and the air conditioning system was adjusted. The management have instructed the staff to record the room temperature three times a day to ensure the air conditioning system is working consistently. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be given the opportunity to make everyday choices and their preferences and requests will be respected. They will be encouraged to engage in communal activities and to maintain close links with their friends and families. A healthy diet is promoted which meets their needs and expectations. Evidence: The residents have a range of stimulating activities including daily exercise to music and reminiscence. In-house entertainment includes regular weekly visits by students from the local schools, including students from a public school, a state school and a nursery school. In the afternoon of the site visit, the school musical group was entertaining the residents with musical instruments with residents singing along. One of the residents has their own piano in the home and they are encouraged to play their own music pieces. Individual students made special requests to visit individuals in the home during their holiday period. One of the residents whose career was teaching has been encouraged to read to nursery school children in the nursery school building nearby. Sometimes these nursery children visit the home instead. Care Homes for Older People Page 15 of 27 Evidence: Residents have trips to places of interest. A resident said that they visited Dunstable Downs recently. Another resident commented, There are music exercises and we go on day trips. Outdoor activities include shopping for those who are able to go out, some accompanied by a member of staff or their family members. Some residents attend the local church service every Sunday accompanied by two members of staff. The dementia unit is full with 19 residents. It was noted that all except one resident participated in a reminiscence session organised by the activity co-ordinator. They seemed to enjoy themselves with smiles on their faces and some were conversing and responding to questions in a positive way. It was further noted that members of staff paid attention to individuals as they walk about in the communal areas and in the corridor. On the day of the site visit, it was noted that almost all the residents in the dementia unit were alert, responsive and eager to converse, with smiles on their faces. They live in a stimulating environment with familiar objects and continuity of staff to help them feel less disorientated. Members of staff give one-to-one interaction throughout the day as observed during the site visit. Residents quality of live is further enhanced through social interaction with family members and visitors on a regular basis. This included a dinner party (every eight weeks) served by waitresses for selected residents and their families. This special occasion is arranged for those dementia residents who are not able to go out to restaurants with their family members. Both managers and staff join in the party. Residents in the residential unit have regular meals with their families if they so wish. Meals are served in congenial surroundings. Lunchtime was observed to be unhurried. Members of staff were readily available to assist those residents who needed some help. The chef deals with the menu and has a one-to-one consultation with each resident. The meals provided are nutritious and wholesome and choices are given. Residents confirmed that they have a menu to choose from and that they are very pleased with the meals provided. A resident remarked, The food is good. No complaints. Another resident said, The food is very good. There is always an alternative dish. 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 who use the service can be assured that the service has a robust Complaints Policy and Procedure, and people can be assured that their complaints will be listened to, and that any concerns raised will be investigated and appropriate action taken. Evidence: A residents meeting is held regularly and there is a relatives meeting. The management deals with any issues raised promptly and effectively. There have been no safeguarding referrals for some years. Arrangements have been made for staff to have further training and a refresher course on the safeguarding procedure and issues on the protection of the vulnerable on 16/06/2009. The home follows the joint safeguarding procedure of the Hertfordshire County Council Adult Care Services. Members of staff understand the significance of the homes whistle-blowing procedure. The manager ensures that all members of staff are familiar with the procedure to follow. The service is not involved in the financial affairs of the residents. However, the manager assists a few residents with their personal allowances. Individual accounts are kept, together with receipts. Care Homes for Older People Page 17 of 27 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 who use the service can be assured that they live in a homely, comfortable, clean and safe environment, and that specialist equipment is provided to maximise their independence. Evidence: Residents live in a homely, safe and comfortable environment with access to all communal facilities. The surrounding grounds are spacious and attractive with healthy looking flowering plants and bushes and garden furniture in suitable locations around the building and the courtyard. The premises are clean, safe and well-maintained with security devices on exit doors. There is an ongoing maintenance programme. Residents have access to all communal areas. Since the last inspection, the residential unit has a pleasant quiet room with suitable decor and soothing background music. Work is in progress to construct a similar quiet room in the dementia unit and to redecorate sections of the dementia unit in contrasting colours to enhance the environment to aid those with dementia from getting disorientated and to install object of reference on each bedroom door to aid these residents find their own bedrooms more easily. Handrails will be repainted in a contrasting colour to the wall to aid those with poor eyesight. Aids such as zimmer frames, wheelchairs and hoists are serviced regularly to make them safe for the Care Homes for Older People Page 19 of 27 Evidence: residents. 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 who use the service can be assured that the home has an effective staff team who will support them, and can be confident that they will be safeguarded by the homes robust recruitment policy and procedure. Evidence: The residents are well supported by trained members of staff who have the experience and skills to care for them. The staffing level is well maintained. Residents are supported and protected by the homes recruitment and selection policy and procedures. Members of staff spoken to confirm that they started working only after the necessary security checks had been completed and clearance had been confirmed. Staff also confirmed that there is a period of induction and mandatory training that includes Food and Hygiene, Fire Safety, Moving and Handling and First Aid. All new staff have induction training that is in line with the Skills for Care guidelines. There is a rolling training programme that includes Care of the Dying provided by The Hospice of St Francis, Medication, Safeguarding of Vulnerable Adults, Infection Control, Parkinsons Disease and further training on dementia care. The home manager has recently completed a five day course on Leadership in Dementia Care and the deputy manager had attended further training on dementia Care Homes for Older People Page 21 of 27 Evidence: care with the Alzheimers Society. She has been given the responsibility of overseeing staff induction and training programme as well as being head of the dementia unit called The Willows. Both managers have NVQ4 The assistant manager is overseeing the residential unit and she has NVQ3. Two senior care workers have attained NVQ3. Seventeen members of care staff have attained NVQ2 qualifications and thirteen others are currently studying for NVQ2. 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. People who use the service can be assured that the service is run in their best interests and that they will be well supported and their health, safety and welfare will be promoted and protected. Evidence: The home is very well managed. The administration and management of the service and the care provided continue to be consistently well maintained. The registered home manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. She continues to find ways of improving the quality of care for the people using the service and is seeking to further improve dementia care and give these residents a better quality of life, having attended a five day course on Leadership in Dementia Care recently. The residents and their relatives seemed very pleased with the management style and Care Homes for Older People Page 23 of 27 Evidence: the quality of care provided. In a recent survey by us, a relative had this to say about the registered home manager: She is an excellent manager and expects high standards from her staff. She gives good attention to detail so that the standards remain high. My (relative) has never been happier in the home. Over the years there have been no safeguarding referrals made against the service and only compliments were received by us in a recent survey about the management and staff. Every member of staff has an annual appraisal and a monthly supervision and the registered home manager confirmed that all staff records are kept up to date. Records in relation to health and safety in the home are well maintained and show in particular that fire safety procedures are tested regularly and followed by all staff as demonstrated on the day of the site visit. All facilities are serviced and records of servicing are kept up to date. The rights and best interests of the residents are safeguarded by the record keeping policies and procedures of the home which have been updated to comply with current legislation. Staff handle confidential information in accordance with the Data Protection Act 1998. The home is not involved with the residents finances but the management assist some residents with their personal allowances. Proper accounting records are kept for each resident. The Registration Certificate and the Liability Insurance certificate are on display in the entrance hall. There is an annual quality assurance survey by the provider and this includes written questionnaire feedback from residents, relatives and others. There is a monthly providers report in compliance with regulations. The audit documents were readily available for inspection. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. Some of the sections lack detail. However, they contain relevant information which was included in this report. 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 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. 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