Care Home: Bowood Court Nursing & Residential Home

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What the care home does well Bowood Court provides a safe purpose built environment for people to live in which is spacious so people have a choice of areas where they can spend their time or see their visitors. It is conveniently located within walking distance of Redditch town centre. We were told by relatives and residents that they had been provided with sufficient information about the home to assist them make an informed choice prior to moving in. The manager encourages people to visit the home before making up their minds. All people are assessed before moving into the home to ensure that the home can meet their health and physical needs safely. People are able to bring their own belongings into their bedrooms to help them make and feel it is theirs. Residents told us that they have their health and personal care needs provided in a polite and courteous way, and their preferences about their care is respected. The staff told us that the home is committed to them receiving training, and that they have the skills and knowledge to meet the care needs of the residents. The information we received in our surveys and when we spoke to people was complementary about the staff and the facilities available at the home. Comments included: `Staff are pleasant and caring` `standards are very good` `staff are all kind and hard working` What has improved since the last inspection? Since the last key inspection a new manager commenced and this has provided stability for the staff, who now feel supported which has has a positive effect for the people living in the home. Further progress has been made with the care plans, and further training is being arranged to help the nurses provide more person centred records about people living in the home. Some improvements with the catering provision and listening to the people`s opinions about the food. What the care home could do better: The service could review the activities for the more Dependant people and those suffering with dementia, and look at making the environment more suitable for their needs. Further develop the care plans for people so that they are more person centred. Ensure that the televisions have good picture quality for the residents to watch in the lounges. Key inspection report Care homes for older people Name: Address: Bowood Court Nursing & Residential Home Hewell Road Enfield Redditch Worcestershire B97 6AT     The quality rating for this care home is:   one star adequate 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: User doesnt belongs to any group     Date: 0 7 1 0 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 28 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 28 Information about the care home Name of care home: Address: Bowood Court Nursing & Residential Home Hewell Road Enfield Redditch Worcestershire B97 6AT 0152765115 0152766645 bowoodcourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd care home 59 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may accomodate no more than 27 people who require nursing care. The maximum number of service users who can be accommodated is: 59 The registered person may provide the following category of service only: Care Home with Nursing (Code 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) 59 Dementia (DE) 7 Physical Disability (PD) 59 Date of last inspection Brief description of the care home Bowood court is a purpose built home offering accommodation to 59 people in both shared and single bedrooms all with en suite facilities. Accommodation is on two floors with a lift to assist people using the service to access all areas of the home. The home Care Homes for Older People Page 4 of 28 Over 65 0 59 0 7 0 59 0 4 1 1 2 0 0 8 Brief description of the care home provides a range of aids and equipment to assist them in meeting the needs of people using the service. Communal areas are available with lounges and dining facilities on both floors so people have a choice of where they wish to spend their day. The home has a small garden area. A limited range of activities are provided for the people living at the home and the home and assist people to maintain links with the local community. Bowood Court in conveniently located near Redditch town centre, so accessible for visitors using public transport. Off road car parking facilities are available for visitors travelling by car. Information regarding the home is available in the Statement of Purpose, The Service Users Guide and Inspection reports. These documents are available on request from the home. Southern Cross Health Care Ltd owns the home. The acting manager is Jennifer Woodward who is going through the registration process with the Commission. Information about the fees are not included in the Service User Guide, for up to date information about the fees please contact the home direct as the fees are based on individual needs and assessments. Additional costs for hairdressing, chiropody, newspapers are requested when the service is used. Care Homes for Older People Page 5 of 28 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: one star adequate 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for the people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. We visited the service during the day on the 9th October 2009 the last Key inspection was the 4th November 2008 . We spent time observing daily life, and we met with people and relatives who use the service. We spoke to staff and the manager who was present throughout the inspection. We looked at care files and records completed by the service which must be kept by the home to show that it is being run properly. Before we visited the service we looked at the information we had about the service since the last inspection. This included the last key inspection report , notifications of Care Homes for Older People Page 6 of 28 incidents sent to us by the service, surveys sent to us by people using the service and the Annual Quality Assessment. The Annual Quality Assessment is completed by the manager and should tell us how well the home think they are performing and should give us some information about the home, staff and people who live there, improvements and plans for improvement which we would take into consideration. Care Homes for Older People Page 7 of 28 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 8 of 28 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 28 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 28 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. There is sufficient information available for people to decide whether Bowood Court is right for them. There are opportunities for people to visit the home before making up their minds. The home carries out assessments of peoples needs before they move in, so that staff can provide the care that is needed. Evidence: The home provides written information in the form of a Service User Guide to help people decide whether they wish to live at Bowood Court Nursing home. A resident told us that they had received the information and had a trial visit prior to moving into the home. We saw copies of the Service Users Guide in the reception area of the home, and in the residents bedrooms. The home has the ability to have the documents translated and made available in other formats including large print, and audio. This assists people with sensory problems to understand the information more easilly. Care Homes for Older People Page 11 of 28 Evidence: We looked at the pre admission assessments for three people who had recently moved into the home. The assessments provided sufficient information for the service to decide whether they would be able to meet the persons needs if they chose to move into the home. People using the service and relatives confirmed that the manager had visited and assessed their relative prior to them being admitted to the home. One resident told us that they had a trail visit to help them make their mind up about the home, and commented: very happy here with the home the staff are lovely We received two completed surveys from people using the service who confirmed that they had received enough information about the service and a quote included: the home is outstanding The AQAA received from the home told us that: they encourage potential clients and families to visit the home and have a look round in the first instance. They send out brochures to interested parties who contact them. A copy of their Inspection report, Statement of Purpose and Service User Guide, relevant information is displayed in the reception area of the home to assist clients and their families to make an informed choice about the home. They involve the multi disciplinary team, relatives and our own documentation to gain all the information to complete a full and accurate assessment to meet the clients needs. They also have a web site to give potential clients and families additional information. All clients admitted to the home are on a four week trial period and a review is carried out during this time scale. Care Homes for Older People Page 12 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made to care plans and recording so staff have enough information to meet peoples care needs. People are treated with dignity and respect but the service is not personalised to peoples individual preferences. Evidence: The last key inspection rated these standards as adequate. From the last key inspection the service have appointed a new manager who recognised that the quality of the care records could be improved in being more person centred. The manager is in the process of arranging training for all the nurses to assist them in improving the overall quality of peoples care records. The first training was arranged for the week after the inspection. The AQAA received from the home advised us that the care documentation had improved, and audits were being completed to ensure that the improvements continue. The care records for three people were reviewed and we completed a short observational framework assessment. It was found that the care records showed little Care Homes for Older People Page 13 of 28 Evidence: evidence of being person centred for the individual and included basic information for staff to follow. There was little information within the plans about peoples likes, dislikes, hobbies and interests which assists the staff in getting to know the residents. It is important that the service gathers this personalised information about people using the service so that staff can provide the best support for that person. For example one person had lost weight and the assessment recorded that this should trigger the person to be weighed weekly, however this had not been followed. This person was weighed during the inspection and their weight had increased within the month and staff were aware of the causes for the weight loss. Some risk assessments appeared not to have been updated within the last 12 months, the staff confirmed that their had been no changes to the assessment, however it is recommended that assessments are reviewed at least annually. In some assessments changes had been made, but the changes had not been dated or signed by the person updating the record. The home has been working with the local authoritys care services quality team to improve some areas of their service. This has included staff attending training sessions including Dignity in Care. The quality officer who carried out this training tells us that the training was well received and staff were open and honest about some of the care practices they had used and had good recognition and awareness of changes they could make. The short observational assessment showed that the management for people with dementia type illnesss was variable. Not all staff demonstrated following good practice in responding to individuals needs. For example one person was shouting out and three members of staff attempted to calm them down. Only the third member of staff clearly understood what the person wanted. Another person was holding a cup of tea and a staff member asked if they had finished but failed to wait for response before removing the drink. A person was asked if they wished to have the television on to which they responded no, however the television was turned on two minutes later. The home has good procedures in place for the management of medication. Medication is stored safely, and accurate record keeping enables the home to know which medications have been given and at what times. We looked at three peoples medication records and they had been completed by the nurse who administered the medication. The manager completes a monthly audit of the medication system and these records were looked at and support that the nurses are adhering to the homes medication policy. Care Homes for Older People Page 14 of 28 Evidence: Peoples privacy was seen to be maintained by the staff, they were knocking on doors before entering bedrooms and speaking to people courteously. Residents and relatives confirmed that all staff respect their privacy and dignity. comments from the surveys included staff meet the individual needs of the residents well, dignity and privacy are always maintained. Staff told us that hey were provided with sufficient information about the residents care needs to enable them to look after them. They also confirmed that they were given time to look at the residents care records for additional information about the individual. A good range of specialist equipment is available to assist the staff in meeting the health and personal care needs of the people. A good range of pressure relieving equipment which is recorded in the health care needs assessment. Staff told us that the home has sufficient pressure relieving equipment in place for residents prone to skin pressure damage. The manager confirmed that no person had any skin damage caused by pressure at the time of this inspection. Care Homes for Older People Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provide activities suitable for some of the people living in the home, the service should review the activities for people with dementia and more complex needs. People are able to keep in touch with family, friends and representatives. They have nutritious and attractive meals and snacks, at a time and place to suit them. Evidence: The last key inspection rated these standards as adequate, the AQAA received from the home advised us how the home had progressed in relation to these standards in the last 12 months. This included: Revising the menus following feedback from residents and providing books in the dining rooms so peoples opinions can be recorded about the meals and reported back to the catering staff. Increased the number of personnel involved in activities and provide more male staff to meet the ratio of male to female residents. The home provides a varied well balanced menu for the residents and caters for cultural and dietary needs. Currently, meals are based on a four-week menu with a choice of two dishes at both the lunchtime meal and afternoon tea. The menus are sent round daily and people can have alternatives if they wish to for example Care Homes for Older People Page 16 of 28 Evidence: omelettes or cheese on toast. We observed evidence that drinks are provided throughout the day. We saw the lunch being served to the residents in the dining rooms, this was in a relaxed manner. The food appeared appetising, and the people told us that they were enjoying their meal. Some peoples comments implied that the quality of food was variable, but generally improved since the last inspection. From discussing the overall outcome with the catering staff it was confirmed that they do the best they can with the food budget allocation.The most recent environmental health officers visit rated the kitchen as four star which is very good. The comments received the food included: the food always looks nice the food has definitely improved From observation and discussion with people living at the home and staff the home provide activities which are generally more suitable for the less Dependant people living in the home. At the time of the inspection a group activity was taking place on the first floor and the people involved appeared to be enjoying the activity. However people on the ground floor were sitting with the television on which had poor picture quality. As part of the observation one person was asked if they wished to watch the television to which they responded no but it was turned on. The manager confirmed that at the moment the home is allocated 25 hours for activities and they have just been authorised for an additional 10 hours which should help with developing the service. Pictures were displayed around the home of some of the activities which the residents had participated in. A monthly church service is held and people can receive Holy Communion if they choose to. The hairdresser visits the home once a week and the people told us that they were pleased with her. There is an open visiting policy, which means that people can see their friends and relatives as they choose and maintain relationships that are important to them. We saw visitors coming and going throughout the day. There is provision for them to make drinks whilst visiting the home. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust. Effective complaints procedure, and they are protected from abuse, and have their rights protected. Evidence: People using the service and relatives told us they were aware of the complaints procedure, including how to complain to the Care Quality Commission by way of information provided by the home, e.g. the Service Users Guide and notices displayed in the homes reception area. Records demonstrated complaints are investigated by the manager, discussed with the owner and responded to within given timescales. Review of the current accident book showed no occurrences, or trends, in the nature and type of reported accidents, which caused us concern. The homes thorough approach to the prevention and management of incidents, such as falls, was evident through crosschecking with the individual documentation. These showed people recorded as having had falls, had all been risk assessed with regard to their mobility and potential for falling. The home operates an open door policy to allow residents and visitors to voice their concerns at any time. Residents and relatives confirmed to us they would have no hesitation in raising concerns they might have. Policies and Procedures on whistle blowing and advocacy information is available on Care Homes for Older People Page 18 of 28 Evidence: display for all everyone, and all staff receive abuse training during their induction. We had discussions with four staff, all of whom were able to describe the action they should take if they were in receipt of a complaint, or observed abuse of a resident. Training records confirmed they had all received relevant adult protection training. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well maintained and comfortable environment. Evidence: Bowood Court is a purpose built home set in attractive gardens in close walking distance to the town centre of Redditch. The home provides 59 single en suite bedrooms, communal lounges and dining areas. Specialist bathing facilities and a passenger lift to assist people with mobility difficulties to access all areas of the home. The last key inspection recommended that the home review the storage facilities as their was lots of clutter around. The manager confirmed that all excess equipment and unused clutter had been removed from the home. We were informed that some communal areas are in need of being redecorated and refurbished and plans were in hand to commence this. It is recommended that the home look at ways to assist people with short term memory problems to find their way around the home more easilly. The corridors are wide and spacious and allow people with mobility problems to move around with any equipment they are assessed as needing. Care Homes for Older People Page 20 of 28 Evidence: The home has a good range of equipment in place to assist staff in changing individuals position. A lifting hoist has been provided on the first floor. We looked at the bedrooms of the people being case tracked and found these were personalised with items that reflected the individuals choices and preferences. The home has a good maintenance program in place and monitor the hot water temperatures weekly, checks are made of the window restrictors to ensure that they are working correctly. An area as been developed for people to sit outside, and volunteers from a local college are helping with the gardening. All areas of the home were clean and tidy, no odours were evident in any part of the home at the time of the inspection. Care Homes for Older People Page 21 of 28 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. Residents can be confident staff numbers on duty, and skill-mix, are sufficient to meet their assessed care needs, and that recruitment and employment practices are consistent with safeguarding them from abuse. Evidence: On the day of the inspection the home was accommodating 56 residents 25 of these were assessed as requiring 24 nursing care. We looked at the recent duty rosters which showed that the staffing levels and skill mix were proportionate for the size of the home. Staff told us that they felt that the staffing levels were sufficient and that they had enough time to spend with individuals to ensure that their health and personal care needs were met. All staff spoken with demonstrated a good understanding of the residents and their assessed needs. The home has a bank of nurses to call on when they have a shortfall, so they would rarely use agency staff. We looked at three staff files and these showed that the home was following their recruitment procedure and completing the appropriate checks on the applicants. This assists in ensuring that the right people are selected to work with vulnerable people. The staff told us that they had gone through the recruitment process and induction training prior to commencing duties. Staff told us about the providers commitment to Care Homes for Older People Page 22 of 28 Evidence: ongoing training which includes moving and handling, fire safety, dementia, adult abuse and first aid. The home have exceeded the standard of having more than 50 of care staff with NVQ level two qualification in care, with a further 14 completing NVQ level 3 in care. Care Homes for Older People Page 23 of 28 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 living at Bowood Court can be confident that the management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a competent manager. Evidence: The manager commenced in post eight months ago and has made improvements in many areas and is clearly committed to moving the home forward. All staff and residents were positive about the manager and how approachable and supportive she had been towards them. The manager is looking to commence the Registered Managers Award and the diploma for Dementia. The deputy manager has an NVQ level 3 in team management and is supportive to the manager and the staff team. The home has a system in place, for monitoring the views of people using the service, and completes monthly checks on a number of areas including accidents, medication and food. Care Homes for Older People Page 24 of 28 Evidence: Copies of the audits and last questionnaire results had been collated and were available in the home. This gives the home an insight into how the home is performing and assists in monitoring that the staff are following correct procedures. The system for monies held in the home for the people is robust, which assists in ensuring that it can be held safely for people who live there. The home employs a maintenance person who assists in ensuring that equipment is serviced, tests and maintenance in respect of health and safety for utilities, appliances and equipment such as electricity, fire, emergency lighting and hoists are well maintained and this should ensure they are safe to use. Staff confirmed that they receive regular supervision which they find helpful and a record of this is maintained on the computer. The AQAA received from the home included:the home manager has created an open door policy and holds three monthly residents and relatives meetings, the home has a friendly atmosphere.Managers surgeries are planned and are available on a weekly basis, this is advertised on both floors. It was recommended that some policies and procedures were in need of updating as they had not been reviewed since 2006. Care Homes for Older People Page 25 of 28 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 28 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 7 To assist staff in how to support all residents. Care plans should provide personalised information as well as health care needs so that all aspects of peoples well being is considered. More training for staff to assist them in understanding the needs of people with dementia and short term memory problems. It is recommended that the home review activities for people with dementia type illnesss. It is recommended that the catering budget is reviewed to ensure that people have good quality food. It is recommended that as part of the refurbishment and upgrade thourght is given to assist people to find their way around the home who have short term memory problems. 2 7 3 4 5 12 15 19 Care Homes for Older People Page 27 of 28 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). 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