Care Home: Barnham Manor

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What the care home does well Barnham Manor is a small care home that provides an individualised care service in a family atmosphere. There is a pleasant garden on level ground that is enjoyed by people living in the home in good weather. There are plans for major refurbishment and the owners are committed to providing a good service for people living there. People`s views about the home are sought and acted upon by Mr and Mrs Curpen. Everyone has an assessment of their needs before a decision is made about them moving to Barnham Manor and each person has a plan of their care. People are involved in making decisions about their daily lives. People say that they receive the health and social care that they need. There is a thorough recruitment procedure to help to protect people in the home. There is an induction and training programme for staff and the feedback from staff was positive in that they feel well trained and supported to do their job. Comments that people made about the service include:`I feel the owners of the home put a lot of their resources back into the home to make the resident`s lives more comfortable`, `They`re doing well as of now, staff work efficiently to meet the required care the patient`s need`, `I think the home is well run`, `The home makes sure all staff are trained to meet resident`s requirements` and `The home provides a good standard of care with attention to detail`. What has improved since the last inspection? Mrs Curpen said in the AQAA that a new sluice has been fitted, door guards have been fitted to all bedroom doors to protect people in the event of a fire. New televisions have been provided in the communal areas of the home, the main hallway has been redecorated and some beds have been replaced by new electric beds. There has been ongoing maintenance and improvements to the building including new carpets and redecoration to some rooms. The policies and procedures have been reviewed and the owners are committed to implementing the requirements of the Mental Capacity Act and to provide training for staff about the implications of the Act so that people living in the home are well supported. A `Friends of Barnham Manor` group has been set up to involve relatives and friends in the activities provided by the home. What the care home could do better: Mr Curpen said that he has been planning to improve the pre-assessment process to ensure that a more holistic approach is taken to people`s care from the outset. There was little information in the care plans that we saw about people`s backgrounds, interests and life experiences. This information should be used to inform the planning of an individual activity programme including time for staff to spend with individuals especially those who spend a lot of time in their room so that they do not become isolated. Key inspection report Care homes for older people Name: Address: Barnham Manor 150 Barnham Road Barnham Bognor Regis West Sussex PO22 0EH     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 7 0 9 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 26 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 26 Information about the care home Name of care home: Address: Barnham Manor 150 Barnham Road Barnham Bognor Regis West Sussex PO22 0EH 01243551190 01243551190 barnhammanorltd@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Barnham Manor Limited care home 23 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 who can be accommodated is: 23 The registered person may provide the following category/ies of service only: Care home with nursing - N to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Barnham Manor is a care home which is registered to accommodate up to twenty-three residents in the category (OP) old age, not falling within any other category. It provides personal and nursing care. Barnham Manor is a detached two storey property which has been extended and adapted for its current use. It provides accommodation in shared and single bedrooms located on the ground and first floors. A passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. An attractive garden, located to the rear of the home is available for residents to use. The property is in the village community of Barnham. The registered provider is Care Homes for Older People Page 4 of 26 Over 65 23 0 Brief description of the care home Barnham Manor Ltd. Mr Gary Curpen is the responsible individual for the service and Mrs Sivagamee Curpen is the registered manager, who is responsible for the day to day running of the home. Care Homes for Older People Page 5 of 26 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 October 2007 and an annual service review (ASR) was carried out on 30th September 2008. The current fees for the home are from £375 to £630 per week. We (the Commission) carried out the site visit over four and a half hours. Mr and Mrs Curpen both assisted with the inspection. The information and documents that we needed to make an assessment of the service were available. There were twenty people staying in the home at the time of the visit, not everyone in the home was requiring nursing care. Twelve staff were employed including five registered nurses. Care Homes for Older People Page 6 of 26 Mrs Curpen completed an annual quality assurance assessment form (AQAA) before 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. Fourteen people living in the home returned surveys; some people had been supported by relatives to fill them in. Ten staff and five health or social care professionals also returned surveys. The response was very positive about the care provided at Barnham Manor and the information and comments have been used to help make an assessment of the service. We spoke with four people living in the home and four members of staff including the cook. We saw the communal areas of the home, bath and shower facilities, the kitchen, laundry and six bedrooms. We read the following documents: the case records of four people living in the home, the recruitment records for three staff, 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 observed a medication round and part of a music activity session. The outcomes for people living in the home have been assessed in relation to twentytwo 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 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Mr Curpen said that he has been planning to improve the pre-assessment process to ensure that a more holistic approach is taken to peoples care from the outset. There was little information in the care plans that we saw about peoples backgrounds, interests and life experiences. This information should be used to inform the planning of an individual activity programme including time for staff to spend with individuals especially those who spend a lot of time in their room so that they do not become isolated. Care Homes for Older People Page 8 of 26 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 9 of 26 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 26 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 care 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. Mrs Curpen said that she usually visits people in their home or in hospital to carry out the assessment. When Mrs Curpen is not available one of the senior staff carries out the assessment. Information about the home is provided to help people to make a decision about whether or not to move to the home. Mrs Curpen said that if people have relatives they usually visit the home before a decision is made if the person themselves is not able to. The case records for three people were read. The assessment form that is used by the home provides basic information about peoples immediate health and personal care needs. Mr Curpen said that this form and process is under review to make sure that Care Homes for Older People Page 11 of 26 Evidence: comprehensive information is gathered about the person before they arrive at the home. If people are supported by social workers or care managers the home receives assessments and care plans already carried out by them. The pre-assessment process helps the home to make a decision about whether or not they could care for the persons needs. Mrs Curpen gave an example of a case where she felt the persons needs could not be met following the pre-assessment. The person and their relatives would be involved in the assessment process. Intermediate care is not provided in the home however respite care is provided. Care Homes for Older People Page 12 of 26 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 person centred care plan that is kept under review. The medication policies and procedures protect people in the home. People are treated with respect and their right to privacy upheld. Evidence: The home uses the Standex system for documenting care plans, risk assessments, reviews and daily records. The format includes some space to include details of all aspects of a persons needs and wishes. A care plan is drawn up from the assessment when people move to the home. The forms are completed with the person and if they are able to, they sign to say that they agree with what has been written about them. People spoken with and those who returned surveys said that they receive the care that they need. The staff spoken with said that they understand the needs of those who live in the home. We read the case records for four people including three people who have recently move to the home. The care plans included details about peoples health and personal care needs. There was a note on one persons records that a referral to the Care Homes for Older People Page 13 of 26 Evidence: physiotherapist had been made. Information provided to staff was clear, for example: make sure Xs nails, eyes and ears are kept clean at all times, give X reassurance at all times, explain all procedures/routines to alleviate any anxiety and when talking to X use simple and short sentences. Ask simple yes/no questions. Peoples wishes at the end of their life were not noted on the case records. The manager said that she would look at ways to open a discussion about this matter in a way that would not be distressing for people. There was little detail in the care plans that we saw about peoples backgrounds or interests in order to inform a person centred approach to care planning. The case records we read included comments about each persons mental capacity and their ability to make an informed choice about health and social care matters. The owners have attended training about the Mental Capacity Act and are aware of their responsibilities with regard to supporting people who do not have the capacity to make decisions and choices in their lives. Where a family member has lasting power of attorney for someone then this is documented. Risk assessments had been carried out for mobility needs, skin integrity and nutrition where this has giving cause for concern. When people are not taking sufficient fluids or nutrition then charts are kept in the persons room and monitored by the nurse in charge. No one was in need of this level of support at the time. Everyone has their weight checked each month and the manager monitors this so that any problems are identified at an early stage, for example there was a note on one persons records: appetite is fairly good, slight cause for concern at present. People are provided with pressure relieving beds and equipment if there is a concern that a person is at risk of pressure wounds. On one persons notes it was documented that staff should re-assess the Waterlow score weekly; records showed that this was being done. No one in the home at the time was in need of treatment for wound care which is an indication of good practice especially when caring for people in bed. The care plans and risk assessments had been reviewed monthly and changes noted if necessary. Mobility assessments had been carried out and guidance provided to staff: supervise X when he is mobilising. Give X reassurance at all times and give all instructions to X of how she is going to be transferred. The manager said that falls are documented and frequency monitored so that measures can be put in place if necessary. Guidance to staff included: make sure Xs room is free from clutter and make sure X wears proper footwear. Care Homes for Older People Page 14 of 26 Evidence: A record is kept of each persons contact with health or social care professionals. People said that they see their general practitioner (GP) in private when they visit. Notes had been made of each visit so that staff would know what instructions to follow. People who returned surveys said that they receive the healthcare that they need. The manager said that the home has a good relationship with the local primary care team and surveys returned by health professionals indicated that the home works well with them and uses healthcare services appropriately. There are policies and procedures regarding medication practices. The storage facilities for medication meet current requirements. The registered nurse on duty is responsible for administering medication and all nurses are supported to attend updated medication training each year to ensure that their knowledge and skills are up to date. No one in the home is able to be responsible for holding their own medication at present. We observed the administration of medication at lunch time. The records were up to date and in good order. The manager said that the pharmacy that supplies the home carries out an annual audit and provides advice and guidance if necessary. Care staff are provided with guidance about the way that personal care should be provided as part of their induction 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. Those spoken with said that they are happy with the way that staff provide their care. Care Homes for Older People Page 15 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are usually supported to have the lifestyle they choose and that suits them. People are supported in their contact with relatives and friends. People are provided with meals that they enjoy. Evidence: There is a programme of activities that includes at least three planned activities during the week; music, a quiz and reminiscence. People are encouraged to take part in the activity sessions although it was noted in some care plans that people did not like to be part of a group: X does not like to be in a crowd, likes her own company. There was very little information about peoples backgrounds or interests in their care plans so that a person centred approach could be taken to activity planning. There was no mention in care plans of individual time that staff might be able to spend with people, this is especially important for people who spend a lot of time in their room so that they do not become isolated. People are supported to maintain contact with their relatives and friends. Mr Curpen said that the home has been encouraging relatives to take a more active part in the care of their family member. Most people in the home at the moment have relatives who support them. Mr Curpen said that people have an opportunity to go out with Care Homes for Older People Page 16 of 26 Evidence: their families, however it was not clear that outings had been arranged by the home. In the AQAA it was stated that the home uses outside transport agencies for this purpose. A summer fete had been well attended by relatives and a Christmas pantomime and celebration is arranged every year. People are supported in their spiritual practice and the case records that we saw included details of peoples wishes in this respect: X is practicing Church of England, would like to have communion. Mrs Curpen said that a local vicar visits the home once a month for communion for those who wish to take part. People are able to make some choices in their daily routine. There is a four weekly menu that is seasonal. The meals are varied and Mr Curpen said that the home takes account of peoples preferences and feedback the home receives about the food. Special dietary needs are provided for and there is an emphasis on monitoring peoples nutritional needs for their health and wellbeing. There are two cooks who provide the main meal through the week and prepare supper for staff to distribute in the evening. People have some choice if they do not like the main meal. Those spoken with and most people who returned surveys said they are happy with the meals provided by the home, one person said that the meals are not very good. Staff in the home encourage people to take their meals in the dining room although some people choose to eat in their room. Lunch time was a relaxed occasion and staff were supporting people in a sensitive manner. Care Homes for Older People Page 17 of 26 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 feel their concerns and complaints would be listened to and acted upon. There are measures in place to help to protect people from abuse or harm. Evidence: There is a complaints policy that is given to everyone who moves to the home. There is a system for recording complaints to show that concerns and complaints are appropriately investigated. The home has not received any complaints in the past twelve months. Mr and Mrs Curpen are in the home most days and have regular contact with people living there. They both said that they deal with any concerns or worries that people may have at an early stage and address any issues that are raised. 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 this is updated every year. The staff spoken with and those who returned surveys indicated that this is the case and that they are aware of safeguarding procedures. Care Homes for Older People Page 18 of 26 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: Barnham Manor provides a homely and welcoming environment for people. Mrs Curpen said in the AQAA that the home meets with the requirements of the environmental health and fire departments. People are provided with the equipment that they need which is serviced as required. There is a call bell system in each persons room. Mr and Mrs Curpen have plans for a major upgrade and refurbishment of the building. The plans include increasing the size of some bedrooms and providing more en-suite facilities. Mr and Mrs Curpen are awaiting a decision from the local planning committee before work can begin. Mr Curpen said that there would be developing a plan for the building work to minimise the impact on the people living there. The home employs a cleaner to make sure that all areas of the home are kept clean. A new sluice has been provided and the laundry facilities are suitable for the home. Staff have attended infection control training and notices in areas of the home remind people to be vigilant regarding minimising the risk of cross infection. Hand gel is also available in the home for staff and visitors to use in order to further protect people from the risk of cross infection. Care Homes for Older People Page 19 of 26 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 manager said that the staffing numbers have been reduced recently because the home has vacancies and the dependency level of people living there at the moment is low. There are three care staff and a registered nurse on duty in the mornings, two care staff and a registered nurse in the afternoons and two waking night staff on duty during the night. People who returned surveys and those spoken with said that they are receiving the care that they need. There is an induction programme that meets the Skills for Care standards and all staff are then encouraged to study for the National Vocational Qualification (NVQ) in care at level two. Five of the seven care staff have achieved the NVQ at level two or above. One member of staff said that she is now studying for the NVQ at level three. One other member of staff is also studying for the NVQ at level three. The recruitment procedure is thorough and Mrs Curpen said in the AQAA that all the required checks are carried out before someone begins work to make sure that people are protected. Prospective staff complete an application form with a full employment history; Mr Curpen said that any gaps in employment would be discussed with them Care Homes for Older People Page 20 of 26 Evidence: during the interview. 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. The registration numbers for registered nurses is checked before they begin work and also when the registration expires. We read the records for three recently appointed members of staff including a registered nurse. Each person had completed an application form and the required checks had been carried out before they began work. Staff who returned surveys also indicated that the recruitment process is thorough. There is an ongoing programme of training and certificates of attendance were included in the staff files that we saw. Some training is provided by outside trainers and the home has purchased a selection of DVDs for key topics for staff to refresh their knowledge. All staff have attended mandatory training and registered nurses are supported to maintain and develop their skills. 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 21 of 26 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 and of staff. Evidence: Mr and Mrs Curpen both run the home and are available on a daily basis. Mrs Curpen is the registered manager is also a registered nurse. She said that she provides hands on care on a regular basis because she likes to make sure that good care is being provided. She also said that she steps back at times so that the other nurses in the home have the opportunity to take responsibility for decision making. Mrs Curpen is committed to her own ongoing training and development and has recently attended training in palliative care and The Mental Capacity Act. Peoples views about the service are sought informally on a regular basis. There is also an annual quality assurance process and people living in the home and relatives are Care Homes for Older People Page 22 of 26 Evidence: given a questionnaire to complete. Samples of completed forms were on file and Mr Curpen said that any comments are followed up, he gave examples of this. He also said that staff and people living in the home would be kept informed about the planned changes to the home and their views would be included in future planning. Family members or solicitors support people with their finances. It was noted in case records when relatives have lasting power of attorney for the person. The home supports people to manage small amounts of money. There is a procedure for this that protects people. The money is stored securely; receipts and a total of money spent is also kept. We saw a sample of the records that were in order. Policies and procedures are kept under review to make sure that people are fully protected and staff are aware of health and safety procedures to be followed. Mrs Curpen said in the AQAA that equipment in the home is serviced as required and that health and safety measures are in place to protect people. All staff have attended mandatory training in health and safety topics and we saw the records to show this is the case. Incidents are recorded and monitored in order to minimise any risks to people in the home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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 26 of 26 - 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!