Care Home: Blenheim Lodge

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What the care home does well Blenheim Lodge provides people with a comfortable, homely and well maintained environment. The home is conveniently located close to the sea front, local amenities and park. People benefit from a staff team who are appropriately trained, well supported and supervised. The home ensure that staffing levels are appropriate to the needs of the people living there. People benefit from a stable staff team. The home have not had to use agency staff. Systems are in place to provide people with opportunities to express their views and procedures are in place to ensure that people are kept well informed about aspects of life at the home and of any staff changes. People who are thinking about moving to the home are provided with the information they need to enable them to make an informed decision about living there. The home ensures that people are fully assessed before a placement is offered. They also liaise with other health care professionals as appropriate. This is to ensure that the home is able to meet the needs and aspirations of people thinking about using the service. People are involved in their care planning process and are encouraged to express their preferences. Care plans are well maintained. Staff were very aware of the needs, rights and privacy of people using the service. People using the service were positive about the care they received and commented on the kindness of staff. Care records demonstrated that the home ensures that peoples` health care needs are met. The home ensures that people know how to make a complaint. People using the service told us that they would feel confident in raising concerns if they had any. Staff demonstrated a good awareness of whistle blowing and protection of vulnerable adults procedures. Staff also told us that they would not hesitate in raising concerns if they had any. Procedures are in place to ensure the health and safety of persons at the home. What has improved since the last inspection? The home have addressed the four statutory requirements raised at the last inspection. These related to the registration of a manager, quality assurance procedures and staff induction and supervision. What the care home could do better: No statutory requirements were raised at this inspection. Key inspection report Care homes for older people Name: Address: Blenheim Lodge North Road Minehead Somerset TA24 5QB     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: kathy McCluskey     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 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 29 Information about the care home Name of care home: Address: Blenheim Lodge North Road Minehead Somerset TA24 5QB 01643703588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: linda@blenheimlodge2.wanadoo.co.uk WEST SOMERSET HOME (BLENHEIM LODGE) Limited care home 30 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 30. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Blenheim Lodge is registered with the Care Quality Commission to provide personal care for up to 30 people over the age of 65 years. The home is not registered to provide nursing care nor is it registered to provide care to people with a primary diagnoses of dementia or other mental health related issues. Blenheim Lodge is situated close to the town and seafront in Minehead. Blenheim gardens are nearby and enjoyed by many people residing at the home. Accommodation is provided over two floors. A passenger lift is available. A call bell system is provided and grab rails have been installed in communal hallways. Assisted Care Homes for Older People Page 4 of 29 Over 65 30 0 Brief description of the care home bathing facilities are available. The registered provider is West Somerset Home (Blenheim Lodge) Ltd. A Board of Governors who serve voluntarily, administer the home as a Charitable Trust. Nicola Hudson has been appointed as manager in May 2008 and is in the process of submitting an application to the Commission to be registered manager. We were informed that the homes current fee levels are between £450 and £525 per week. Personal items, toiletries, newspapers and hairdressing are not included in the fees. Care Homes for Older People Page 5 of 29 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: This unannounced key inspection was conducted over one day (6.5hrs) by regulation inspector Kathy McCluskey. The home submitted its Annual Quality Assurance Assessment (AQAA) to the Commission within agreed timescales. The AQAA is a self assessment which focuses how well outcomes are being met for people using the service. It also provides us with some numerical information. Extracts from the AQAA have been included in this report as appropriate. The acting manager was available throughout this inspection. We were given unrestricted access to all parts of the home and all records required for this inspection were made available to us. We were informed that 25 people were currently using the service which included one person using the homes respite facility. During this inspection we were able to meet with a number of people using the service and staff Care Homes for Older People Page 6 of 29 members. Comments have been included in this report as appropriate. It should be noted that the term we used throughout this report refers to we the Commission. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 29 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 29 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 29 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 who are thinking about using the service are provided with information and a trial period to enable them to make an informed decision about moving to the home. The home has procedures in place to ensure that people are appropriately assessed before a placement is offered. People are provided with a contract which provides them with information about the fees to be charged, services offered and a statement as to the terms and conditions of occupancy. The contract also needs to include the room number to be occupied. Evidence: Within the last year the Commission approved an application from the home to decrease their registered numbers from 34 to 30. The third floor of the home is no longer used for resident accommodation. Within the maximum numbers of 30, 2 beds are used for respite stays. Care Homes for Older People Page 11 of 29 Evidence: The home have updated their Statement of Purpose and Service User Guide to reflect these changes. These documents provide people with information about the home and the services offered. We examined care plans for people who had recently moved to the home and we were able to see evidence that people were fully assessed before a placement was offered. Care plans also contained assessments from other health care professionals. One person using the service told us that they had used the respite facility before making a decision to move to the home on a permanent basis. They also told us that they had been provided with information about the home and the services offered. We were able to see that people had been provided with a contract which identified the fees to be charged, services offered and a statement of the terms and conditions of occupancy. The homes contract needs to be updated to include details of the room number to be occupied. This was discussed with the registered manager at the time of the inspection. The homes completed AQAA told us that people who are thinking about using the service are given the opportunity to test drive the home so that they are able to make an informed decision about moving there; Before any resident comes to Blenheim Lodge they and/or their family are shown around the home and all questions they have are answered, They are encouraged to try the home for an initial period before making their mind up. Care Homes for Older People Page 12 of 29 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. The homes care planning procedures ensure that peoples assessed needs can be met by staff in line with peoples needs/wishes and preferences. The home ensure that people have access to a range of health care professionals so that their health care needs can be met. Appropriate procedures are in place for the safe management and administration of peoples medication. People are treated with respect and their right to privacy is upheld. This could be further improved if action was taken to block the small windows currently fitted in bedroom doors. Evidence: We examined three care plans at this inspection and all were found to be well maintained and up to date. We were able to see evidence that people were involved in the care planning and review process. Care plans contained information about peoples Care Homes for Older People Page 13 of 29 Evidence: social history and preferences and this helps staff to deliver a more person centred approach to care. Risk assessments were in place relating to moving and handling needs, reducing the risk of pressure sores, maintaining a safe environment and nutrition. We were able to see that care plans had been raised where their was an assessed need. Staff record detailed and appropriate information about people on a daily basis in their plan of care. Care plans contained evidence that people have access to a range of health care professionals. Records are maintained for each persons contact with a health care professional. The home monitors peoples weights on a monthly basis so that any concerns can be identified. We spoke to a number of people using the service and they were very positive about the care they received. People confirmed that call bells were responded to promptly by staff both during the day and at night. People commented on the kindness of staff. They told us that they felt safe at the home and that they were treated with respect. We observed staff interactions with people using the service to be kind and respectful. Staff addressed people in their preferred form of address and were observed knocking on peoples doors before entering. The atmosphere in the home appeared relaxed and interactions were unhurried. We spoke with four members of staff and no concerns were raised about the ability to meet the assessed needs of people using the service. Staff told us that they had received appropriate training and support. Staff stated that people using the service received very good care. We examined the homes procedures for the management and administration of peoples medication. Medicines are securely stored in peoples bedrooms. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). All available MAR charts were examined and these were found to be fully completed. Appropriate procedures were being followed for the recording of the receipt of medicines into the home and for medicines returned to the pharmacy. No excess stocks of medicines were noted. The home follows safe procedures for the management and administration of controlled drugs. Medicines are only administered by senior staff on duty who have completed an NVQ Level 3 in care and up to date medication training. As previously mentioned, people using the service told us that staff treated them with Care Homes for Older People Page 14 of 29 Evidence: respect and that their privacy was upheld. All bedrooms are for single occupancy and people choose when they want to spend time in the privacy of their rooms. Doors are fitted with a lock which can be overridden by staff in the event of an emergency. We noted that bedroom doors are fitted with a small window which, although are fitted with a piece of netting, does have an impact on peoples privacy. This was discussed with the acting manager who acknowledged this and confirmed that appropriate action would be taken to address this. Care Homes for Older People Page 15 of 29 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. The home is currently devising an activities programme which will provide people with a range of opportunities both within the home and local community. People are supported to exercise choice about their lives and visitors to the home are welcomed in line with peoples wishes. People are offered a wholesome and varied menu in line with their preferences and choices. Evidence: We were informed that, due to recent staff changes, a new activity programme was currently in the process of being developed by the homes care manager. We were able to see documented evidence that the home were currently in the process of seeking peoples views and preferences as to the range of activities offered. Information about peoples social history and interests are recorded in their plan of care. The plan is for the care manager to provide activities 4-5 hours a day over a five day period. The care manager stated that hours would be flexible to provide cover for Care Homes for Older People Page 16 of 29 Evidence: evening trips to the pub or local facilities and trips out. We were told that currently people are offered flexercise on a Monday, A discussion group is being planned for Tuesdays, Thursdays include a visiting hairdresser and newspaper reading group. Monthly trips out and regular outside entertainers are in the process of being organised. Regular church services take place at the home. This was noted to be well attended during this inspection. People told us that they were satisfied with the activities on offer. The home also has a good supply of books, puzzles and games. The completed AQAA told us that visitors are welcome at the home at any reasonable time in line with peoples preferences. People can choose whether to see their visitors in one of the communal areas or in the privacy of their own bedrooms. In line with fire safety regulations, all visitors to the home are required to sign the visitors book when arriving and on leaving the home. People can choose where to spend their day and people told us that their preferences were respected with regard to what time they got up in the morning or go to bed at night. All meals are freshly prepared and served by the homes designated catering staff. The home has a well equipped kitchen and the home have been awarded a 5 star excellent standard by the Environmental Health Department for their food hygiene standards. We examined menus and choices appeared wholesome and varied. People choose from three options for each meal and hot options are available at teatime/supper. People confirmed that snacks were available and that drinks were plentiful. The home has a large dining room which is comfortably furnished. During this inspection we were able to see lunch being served. Tables had been attractively laid with condiments, napkins and refreshments available. The menu for the day was clearly displayed for people. People were served the lunch of their choice and meals appeared appetising and plentiful. The lunch time experience appeared relaxed and unhurried. People spoken with were positive about the meals and choices available. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an appropriate complaints procedure in place and people feel confident in raising concerns. Procedures are in place to reduce the risk of harm or abuse to the people using the service. Evidence: The home have produced a complaints procedure which is clearly displayed in the reception area of the home. Copies of the policy are also contained within the resident handbook which is made available to each person using the service. During this inspection people told us that they would feel confident in raising concerns if they had any. No concerns were raised with us during this inspection. The home maintains appropriate records relating to all concerns received. We were able to see evidence that concerns had been appropriately investigated in line with the homes procedures. The Commission have not received any concerns about the service in the last twelve months. Staff spoken with demonstrated a good awareness of the whistle blowing procedures the protection of vulnerable adults procedures. Staff also stated that they would not hesitate in raising concerns should they arise. Staff have received training in the protection of vulnerable adults and in the Care Homes for Older People Page 18 of 29 Evidence: deprivation of liberties. The home have a range of policies in place to reduce the risk of the harm or abuse to the people using the service. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and well maintained environment for the people living there. People have their own bedrooms which they can personalise. The standard of cleanliness is good and the home has procedures in place to reduce the risk of the spread of infection. Evidence: Blenheim Lodge provides a comfortable and homely environment for up to 30 people who require assistance to meet their personal care needs. The home is well maintained and an on-going programme of routine maintenance and redecoration is in place. People can choose from a number of communal areas. Gardens are limited but the home have made each area a pleasant area for people to enjoy. A range of fresh vegetables are currently being grown on a patio area. There is some parking to the front of the property and on street parking is also available. The home is located just off the sea front. Blenheim gardens are located just opposite the home and all local amenities are within a very short walk. Care Homes for Older People Page 20 of 29 Evidence: Each person has their own bedroom which they can personalise. Bedrooms seen at this inspection appeared comfortably furnished and decorated to a good standard. All bedrooms have the provision of an en-suite toilet and wash hand basin. Some bedrooms are fitted with a bath or shower. Communal bathrooms consist of two assisted baths and a shower. A call bell system is installed throughout the home and hand rails and ramps are appropriately sited to assist people to mobilise. The acting manager confirmed that the home has a good supply of moving and handling equipment and pressure relieving equipment. Additional specialist equipment would be accessed as required. The home has a shaft lift which gives access to the first floor. Procedures are in place to reduce the risk of the spread of infection. Liquid soap and paper hand towels are appropriately sited and staff have access to protective clothing. The laundry was found to be clean and well organised. We were informed that only peoples personal laundry was done at the home and that sheets were sent to an external company. The standard of cleanliness throughout the home was noted to be very good and there were no malodours. Designated laundry and domestic staff are employed. Care Homes for Older People Page 21 of 29 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 home ensures that staffing levels are appropriate to the needs of people using the service. People benefit from a team of staff who have been appropriately trained. The homes procedures for staff recruitment are generally good. Evidence: We were informed that 25 people were currently using the service which includes one person receiving respite care and that staffing levels were as follows; During the morning, 5 carers, 4 in the afternoon and 2 waking night staff. Senior staff are on each shift all of which have an NVQ 3 or equivalent. The acting manager informed us that staffing levels would be increased as required to meet the dependency levels of people using the service. No concerns were raised with us about staffing levels during this inspection. The acting manager and care manager work in addition to the care hours shown. The home also employs catering, domestic, laundry, administrative and maintenance staff. Care Homes for Older People Page 22 of 29 Evidence: The homes completed AQAA told us that of the 23 permanent care staff employed, 16 have achieved an NVQ Level 2 in care or above. This equates to 70 which exceeds the recommended 50 of the National Minimum Standards. All newly appointed staff undertake a period of induction which follows the Skills for Care Common Induction Standards. We examined three staff recruitment files at this inspection. We were able to see evidence that satisfactory references had been obtained before the applicant was offered employment. Some staff had commenced employment on a POVAFirst pending a full CRB. The acting manager was able to confirm that staff did not work unsupervised during this period. It has been recommended that risk assessments are completed which clearly identify the restrictions imposed on the employee during this period and details how the employee will be supervised. This should be signed by the employer and the employee. We have also recommended that the home reviews the application for employment form so that staff are prompted to provide at least 10 years employment history and that start and end dates of employment are provided. This will allow for any gaps in employment to be identified and discussed. Systems are in place to ensure that all staff receive up to date mandatory and specialised training. The home also has an E-Learning computer programme on which staff are completing training in dementia, protection of vulnerable adults, deprivation of liberties and the mental capacity act. Staff training records made available to us confirmed that staff had received recent training in first aid, moving and handling, fire safety, care planning, POVA, mental capacity act and dementia. Regular in-house training sessions also take place. Staff spoken with during this inspection were positive about the training opportunities available. Care Homes for Older People Page 23 of 29 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. The acting manager is in the process of submitting an application to the Commission to be registered manager of the home. Quality assurance procedures are in place which seek the views of people using the service. The views of other stakeholders should also be sought. People are protected by the homes procedures for the management of their finances. People benefit from a staff team who are appropriately supported and supervised. The home follows appropriate procedures to ensure the health and safety of persons at the home. Evidence: The acting manager is in the process of submitting an application to the Commission to be registered manager. the acting manager has already achieved an NVQ level 4 in Care Homes for Older People Page 24 of 29 Evidence: care and has completed the registered managers award. The acting manager is supported by a care manager. The home has systems in place to monitor the quality of the service provided. Regular quality assurance questionnaires are sent to people using the service to seek their views about life at the home and of the care they receive. Recently completed questionnaires were seen and results were positive. The home should ensure that questionnaires are dated. It has been recommended that the home also consider seeking the views of relatives and health care professionals. Regular meetings are held for people using the service and staff. Minutes are maintained. The home are also producing a monthly newsletter for people. The most recent newsletter completed in June contained information for people about the importance of fluids during the hot weather, information about newly appointed staff and information on how to make a complaint. There were also requests for ideas for trips out. As part of the homes quality assurance procedures and in line with the Care Homes Regulations 2001, monthly visits are conducted by a company representative and a report is produced and maintained at the home. The homes procedures for the management of peoples money reduces the risk of abuse. As requested, the home assists people to manage small amounts of personal monies. Records of all transactions are maintained and are confirmed by two signatures, one of which is the individual using the service. Receipts are obtained and transactions and balances are regularly audited. We were able to see evidence that staff are appropriately supported and supervised. This was also confirmed by staff spoken with. Staff records examined contained documented evidence of formal supervisions and annual appraisals. We toured the premises and examined a range of records relating to health and safety procedures. These were found to be up to date. The home maintains detailed information relating to all accidents in the home. Regular analysis of the accidents ensures that any traits are identified and we were also able to see evidence that, as appropriate, action had been taken to reduce the risk of recurrence. The majority of the staff team at the home have completed training in first aid. as required by the Care Homes Regulations 2001, the home inform the Commission of all significant events at the home. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 2 2 10 The homes contract with people using the service should be updated to include the room number to be occupied. To ensure the privacy of people using the service, the home should consider blocking in the small windows currently fitted to bedroom doors. Any agreed action should be discussed with the fire officer where fire doors are fitted. The home should ensure that the application for employment form is updated to prompt applicants to provide a 10 year employment history to include start and end dates as this will allow the home to explore the reason for any gaps in employment. To ensure better protection for the people using the service the home should ensure that risk assessments are completed for any staff member commencing employment on a POVAFirst pending a full CRB. This should detail the restrictions imposed on the employee during this period and should detail how the employee will be supervised at all times. This should be signed by the employer and employee. The home should consider making their quality assurance Page 27 of 29 3 29 4 29 5 33 Care Homes for Older People 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 questionnaires available to relatives and health care professionals to seek their views on the quality of the service provided. Care Homes for Older People Page 28 of 29 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 29 of 29 - 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. 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