Care Home: Avon House

What the care home does well The home is well maintained so that people live in a comfortable and homely environment. The manager and staff are committed to providing good quality care in a relaxed atmosphere. Visitors spoken with said that they are always made welcome in the home and that the manager is always available to discuss any concerns. Staff are well trained and supported in their work. Fourteen of the nineteen staff have achieved a National Vocational Qualification (NVQ) in care at level two or above; this exceeds the required standard. The building is well maintained and improvements to the communal areas are due to begin in January. Comments that people made about the service include: `Avon House is well organised and the staff do a good job`, `Avon House is clean and well presented`, `cheerful staff, good food`, `always welcomes my sons when they visit me. Staff always friendly`, `keeps the home warm and friendly`, `respects and genuinely cares for individuals`, `a lot of care and attention, always helpful and always gives visitors the offer of a cup of tea or coffee` and `the registered manager is extremely supportive. Avon House prides itself in being a home which is happy`. What has improved since the last inspection? A number of rooms have been decorated and new furniture, bed coverings and memory foam pillows have been purchased to make people more comfortable. The storage arrangement for controlled medication now meets requirements. New furniture has been purchased for the dining room and lounge. What the care home could do better: The manager said that she would make sure that clear and detailed guidance would be provided for people who may present challenging behaviours so that staff know how to protect them and others in the home. The manager said that more individual time would be allocated for staff to spend with people as part of each person`s care plan. The recruitment procedure is due to be reviewed to make sure that a full employment history is obtained and records are kept to show that any gaps in employment have been explored before someone is offered a job. Key information such as the complaints policy, quality assurance documents and menu choices is due to be provided in a format that is easier for people to understand. Key inspection report Care homes for older people Name: Address: Avon House 40/42 Shakespeare Road Worthing West Sussex BN11 4AS     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: Annette Campbell-Currie     Date: 0 3 1 2 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: Avon House 40/42 Shakespeare Road Worthing West Sussex BN11 4AS 01903233257 01903531313 avonhouse@ntlbusiness.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cobham Care Ltd care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 26 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Date of last inspection Brief description of the care home Avon House is a home for older people with a past or present mental illness. It is registered to accommodate up to twenty-six residents. Two semi-detached houses are joined together with a passenger lift serving both floors. Accommodation is provided in twenty-four single and one double room. The home has a small rear garden. Avon House is situated in a residential area of Worthing close to local shops, the railway station and the seafront. The service is managed by Mrs Amanda OHagan and the registered provider is Cobham Care Ltd. The current fees for the home are from £419.25 to £650 per week. Care Homes for Older People Page 4 of 27 Over 65 0 26 0 2 0 1 2 0 0 9 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: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The previous key unannounced inspection was carried out on 2nd January 2009. The requirement regarding the need to have a lockable facility for controlled medication that meets current legislation has now been met. We (the Commission) carried out the site visit over six hours. Mrs OHagan, the registered manager, assisted with the inspection. The information and documents that we needed to make an assessment of the service were available. There were twentysix people staying in the home at the time of the visit and nineteen staff are employed to provide care. The manager completed an annual quality assurance assessment form (AQAA) before Care Homes for Older People Page 5 of 27 the inspection. The AQAA was detailed and provided us with a lot of information about the way the home is being managed and the improvements to the service that are planned. We sent out surveys to find out what people think about the home before we carried out the inspection. Fifteen people living in the home returned surveys; most people had been assisted by relatives or staff to complete the survey. Twelve staff and one health or social care professional also returned a survey. People were very positive about the care provided at Avon House and the information and comments have been used to help make an assessment of the service. During the site visit we spoke with two people living in the home, three visiting relatives and two members of staff. We saw the communal areas of the home, bath and shower facilities, the kitchen, laundry and five bedrooms. The following documents were read: the case records of three people living in the home, the recruitment records for two member of staff recruited in the past twelve months, the complaints policy, samples of policies and procedures, menus, staffing rotas, training and development plans and records, samples of medication records, medication storage facilities, quality assurance documents and development plans for the service. We also observed part of a handover session when the morning shift ended. The outcomes for people living in the home have been assessed in relation to nineteen of the thirty-eight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. 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 Care Homes for Older People Page 7 of 27 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. People have their needs assessed before a decision is made about them moving to the home. Evidence: There is a pre-assessment process that is carried out before a decision is made about someone moving to the home. The manager or a senior member of staff visit people at home to carry out the pre-admission assessment and information from relatives and other professionals who know the person is taken into account when making a decision about whether or not the home could provide for the persons needs. Mrs OHagan said that she encourages people to visit the home to find out whether or not they like it; if this is not possible then relatives are encouraged to visit and talk to the staff. People who may move to the home are invited to stay for the day when they visit so that they have an opportunity to have lunch and get to know the staff. Care Homes for Older People Page 10 of 27 Evidence: We read the case records for three people living in the home. The assessment form that is used by the home provides information about peoples immediate health and personal care needs. There was little information about each persons background or interests. Mrs OHagan said that it is often difficult to find out in detail about peoples wishes due to their memory difficulties and sometimes it is not possible to gain information from relatives. There was no space on the form to show that the person or their relative had been involved in the assessment process. If people are supported by social workers or care managers, the home receives assessments and care plans already carried out by them. Mrs OHagan explained the process to help support people when they move to the home; she said that a key worker is allocated and a senior member of staff is responsible for providing support when the person arrives. There was no evidence to show how this process is planned to make sure that the initial move to the home is as relaxed as possible; for example ensuring that staff are aware of the persons preferred daily routine and that personal items or photographs are in the persons room before they arrive. Mrs OHagan said that people are encouraged to move on week day mornings so that she is available for support. Intermediate care is not provided in the home however respite care is provided. 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. People have their health and personal care needs set out in a care plan that is kept under review. The medication policies and procedures protect people living in the home. People are treated with respect and their right to privacy is upheld. Evidence: A care plan is drawn up from the assessment when people move to the home. A new system for documenting care plans and risk assessments was introduced six months ago. Mrs OHagan said that staff have been given guidance about the way that the new documents should be used. She also said that due to peoples memory difficulties, it sometimes takes a while to gather all the information that is needed to make sure that sufficient information is included in the care plans. People who were supported to complete surveys said that they receive the care that they need. The staff spoken with and those who returned surveys said that they understand the needs of those who live in the home. We looked at the care plan documents for three people who have recently moved to the home. Peoples personal and healthcare needs were noted with guidance provided Care Homes for Older People Page 12 of 27 Evidence: to staff. There was information in the care plans about peoples backgrounds and interests, including information about the people who are important in their lives. Separate folders are being completed that include more detailed information about each persons life and the things that are important to them. Peoples spiritual needs and their wishes after their death were noted in the care plans that were seen. Relatives who were spoken with said that they are kept informed of any changes in their family members health and welfare. Risk assessments had been carried out for mobility needs, skin integrity and nutrition. Mrs OHagan said that the home is putting more emphasis on nutritional assessments so that staff understand the need to ensure that people are eating well. Mental health assessments had been carried out by staff at the home with information about the support that people need, for example: X has a good appetite and quite often forgets that she has eaten. When a cause for concern is noted, then guidance is provided in the care plan; for example: X can become confused or anxious, just needs patience and understanding. A record is kept of each persons contact with health or social care professionals. Mrs OHagan said that there is a good relationship with the local primary care team and GPs and district nurses respond well when people need their support. Feedback from surveys indicates that people receive the health care that they need. Notes had been made of each visit so that staff would know the instructions or guidance to follow. An optician visits people in the home when necessary and chiropody services are available at an additional cost. There is a handover session between each shift so that staff beginning their shift are informed of key events or information. The manager said that she would ensure that this meeting is held in private to protect confidentiality and that a clear process for recording information is in place. There are policies and procedures regarding medication practices. The storage facilities for medication including controlled medication now meets current legislation. Staff who administer medication have all attended training about medication issues. The training is kept updated so that staff have the knowledge and skills that they need. The records that were seen were up to date and in good order. Mrs OHagan said that the pharmacist has been very helpful and provides staff training, support and advice when required. The pharmacist also carries out an audit twice a year to make sure that everything is on order. Care Homes for Older People Page 13 of 27 Evidence: Care staff are provided with guidance about the way that personal care should be provided as part of their induction and training and those spoken with said that they understand how to protect peoples privacy and dignity. Staff were observed during the day to be treating people with respect and supporting them in a calm and sensitive manner. People were being well cared for and relatives spoken with said that they are happy with the way that staff provide care for their family member. 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. There is a programme of activities in the home. People are supported in their contact with relatives and friends. People are provided with nutritious meals that they enjoy. Evidence: Staff are gathering information about peoples interests, backgrounds and previous lifestyles. This information is being recorded with their case records so that staff will better understand peoples social and emotional needs. Entertainment is provided from time to time and people come to the home to provide exercise or music sessions. A piano has recently been purchased. Mrs OHagan said in the AQAA that a varied activity programme is provided in the home to meet individual need. In the afternoon one person was having a manicure, another person was taken for a walk as he was becoming agitated and a member of staff was planning to begin a singing session. Staff said that there is more time in the afternoon for activities and this is arranged on an ad hoc basis. Two people who returned surveys commented that it would be good for staff to spend more one to one time with people. Mrs OHagan said that she would look at the way that activities are planned so that staff have more guidance and that one to one time is allocated for each person to meet their individual needs and interests. Care Homes for Older People Page 15 of 27 Evidence: People are supported to maintain contact with their relatives and friends. Celebrations and special events are held from time to time and friends and relatives are invited. The relatives spoken with said that they are always made to feel welcome when they visit the home. People are given some choices in their daily lives; people can choose when they get up in the morning and when they retire to bed. The time for breakfast is flexible and during our visit some people had chosen to have a late breakfast. The menu for the day and for the week is available in the dining room. This has not yet been provided in picture format for people to better understand and make choices about the food they prefer to eat. A balanced and varied diet is provided and special dietary needs are catered for. The cook said that she uses fresh food as often as possible and that people are provided with home cooked food. The meal provided at lunch time was hot and appetizing with fresh meat and vegetables. Most people take their meals in the dining room although some people prefer to sit in the lounge area. Lunch time was a relaxed occasion and staff were supporting people in a sensitive manner. People are provided with hot food in the evening and the cook said she has been making home made soup as she feels this is more nutritious and people enjoy it. 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 can feel that their concerns and complaints would be listened to and acted upon. There are measures in place to help protect people from abuse or harm. Evidence: There is a complaints policy that is available to people in the home and their relatives. The complaints procedure is not yet provided in a format that would be easier for people who have a dementia to understand, Mrs OHagan said that she is in the process of re-designing the policy so that it meets the needs of people in the home. There is a system for recording complaints to show that they are investigated appropriately. The home has not received any formal complaints about the care provided in the past twelve months. Mrs OHagan said that she is in daily contact with everyone living in the home and keeps in touch with relatives so that any concerns or worries would be dealt with at an early stage. The home follows the West Sussex multi agency policy and procedure for safeguarding vulnerable adults. All staff have attended training in how to recognise adult abuse and also reporting procedures and this is updated every year. A safeguarding alert was raised with West Sussex Adult Services in March. This matter was investigated and measures were put in place to better protect people in the home. Feedback is now sought from staff on a regular basis to make sure that they understand how to protect people from harm. Two further alerts have been raised by the home and appropriately reported and investigated. Mrs OHagan said that she would ensure that detailed Care Homes for Older People Page 17 of 27 Evidence: records are kept when these situations arise and that she will also ensure that the Commission is kept informed. The staff spoken with and those who returned surveys indicated that this is the case and that they are aware of safeguarding procedures. Some people in the home may present challenging behaviours at times due to the condition of their mental health. There was some guidance to staff in care plans about triggers and behaviours to be aware of; however Mrs OHagan said that she would make sure that more detailed guidance about managing behaviours is provided for staff. All staff are booked to attend training in supporting people who have challenging behaviours. 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 live in an environment that is well maintained, comfortable and clean. Evidence: Avon House care home provides comfortable and homely accommodation. The manager said in the AQAA that all the equipment is serviced as required and that the ongoing programme of maintenance is monitored to make sure repairs are carried out in a timely manner. There is a member of staff responsible for maintenance who is employed full time. A number of bedrooms have been redecorated and bedding has been replaced. The manager has recently purchased memory foam pillows so that people will be more comfortable at night. We saw the communal areas, laundry, kitchen, bathroom and five bedrooms. There are plans to build a large conservatory at the back of the home. This will mean that people have better communal facilities and the dining room will also be extended. Mrs OHagan said that the work is due to begin in January and will be planned in a way that will not have too much impact on people living in the home. There is a garden at the back of the building that people can enjoy using in good weather. There are two domestic staff who are responsible for keeping the building clean. Feedback from the surveys showed that the home is usually clean and hygienic. There is also a member of staff are who is responsible for laundry duties. Staff have Care Homes for Older People Page 19 of 27 Evidence: attended training in infection control so that they understand how to prevent the risk of cross infection. 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. The recruitment procedure protects people living in the home. People are supported by sufficient numbers of staff who are well trained and competent. Evidence: The staffing rotas showed that there are four care staff on duty in the mornings and three in the afternoons. Mrs OHagan and the care manager are available for additional support. At night there are two members of staff on waking night duty. People who returned surveys and those spoken with during the day said that people receive the care that they need and staff were observed responding to the call bell without delay during the day. There is an induction procedure that covers the key policies and procedures that new staff need to know. There is also an opportunity for new staff to shadow more experienced staff so that they can get to know the needs of people in the home. All staff are then encouraged to register for the National Vocational Qualification (NVQ) in care at level two as soon as they begin work. Fourteen of the nineteen care staff have achieved the NVQ at level two or above. This exceeds the standard for staff qualifications. The manager said in the AQAA that all the required checks are carried out before someone begins work to make sure that people are protected. Mrs OHagan said that Care Homes for Older People Page 21 of 27 Evidence: prospective staff complete an application form and then attend for an interview. There is very little space on the form for people to complete a full employment history and there is no space for the inclusion of the contact details of the people who would provide a reference for them. Mrs OHagan said that any gaps in employment would be discussed with the candidate during the interview; however the interview process is not recorded so there is no record of this discussion. Two written references are obtained including one from the persons most recent employer. A POVA First check is carried out before people begin work and an Enhanced Criminal Record Bureau (CRB) check is also obtained. We looked at the records for two staff recently appointed to work at the home. An application form had been completed and POVA First or CRB checks had been carried out before the person began work. Two written references had been obtained. It was not clear that gaps in employment had been checked before people were offered a post. Staff who returned surveys indicated that the required checks had been carried out when they began work. There is an ongoing programme of training and certificates of attendance were included in the staff files that we saw. All staff have completed mandatory training and attendance is monitored so that the manager knows when updates are due. The staff spoken with and those who returned surveys said that they are provided with the training and support they need to do their job. 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 benefit from living in a home that is well run. Peoples views are sought and taken into account in the development of the service. There are measures in place to protect peoples finances. There are policies and procedures in place to protect the health, safety and welfare of people living in the home. Evidence: Mrs OHagan has worked at Avon House for fifteen years and has been the registered manager for six years. She has achieved the registered managers award (RMA) and is committed to her ongoing training and development. Mrs OHagan has recently attended management training in the Deprivation of Liberty Safeguarding Guidance. Mrs OHagan meets with the manager of the sister home regularly so that they can share training and support. There are systems in place to keep the quality of the service under review. Regulation 26 visits are carried out each month and a written report provided so that areas for improvement are highlighted and acted upon. The owners of the home meet with Mrs Care Homes for Older People Page 23 of 27 Evidence: OHagan once a week and minutes are kept to ensure that any agreed actions are carried out. Questionnaires are sent out to relatives of people living in the home every year. The returned forms are audited and Mrs OHagan responds to any issues that arise. A laundry assistant was recently employed following a number of comments that people made about their relatives clothes. The procedures for protecting peoples finances has recently been improved. Any items that people need are now paid for by the home and an invoice is sent to the relatives or solicitors who support people in managing their money. There are policies and procedures regarding health and safety matters to protect people living in the home and staff. There is a programme of mandatory training in health and safety topics so that staff understand how to keep people safe. Mrs OHagan said in the AQAA that all equipment is serviced as required and a fire risk assessment has been carried out in consultation with the fire officer. Window restrictors have now been fitted to windows on the first floor to prevent the risk of people falling. Incidents and accidents are recorded and monitored so that measures can be put in place to help protect people from harm. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!