Care Home: Brookvale Care Home

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What the care home does well People have access to information about the home so that they can make an informed choice about whether to move in. People`s needs are assessed before a service is offered so that they can be confident that their individual needs will be met. People are treated with respect and staff have a good understanding of promoting dignity so that people feel valued. Positive comments received from people who live in the home indicate that the staff team are friendly, respectful and understanding of people`s individual needs. Menus are well planned and a range of food is offered that people enjoy. There are two activity co ordinators that assist people to take part in things they enjoy as part of a meaningful lifestyle. Staff receive training and professional development opportunities so that they are equipped to meet the needs of people who live in the home. The service has policies and procedures in place to listen and respond to people`s concerns and complaints and to safeguard them from risk of harm. The home is being well managed for the benefit of the people who use it. What has improved since the last inspection? Care plans and risk assessments that describe how people need and like to be cared for are completed in greater detail so that individuals` needs are clearly stated. Records of complaints are maintained so that there is information about the way complaints are investigated and the action that has been taken in response to concerns raised. There have been a number of physical improvements to the home so that people live in a more pleasant environment. What the care home could do better: Medication records are not always fully completed to show that medicines have been given as prescribed. Key inspection report Care homes for older people Name: Address: Brookvale Care Home 111 Warwick Road Olton Solihull West Midlands B92 7HP     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: Julie Preston     Date: 1 4 0 5 2 0 1 0 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 30 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Brookvale Care Home 111 Warwick Road Olton Solihull West Midlands B92 7HP 01217069097 01217060467 tracey.arms@heartofenglandcare.org.uk www.heartofenglandcare.org.uk Heart Of England Care Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Tracey Belinda Arms Type of registration: Number of places registered: care home 61 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 61 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 61, Mental disorder, excluding learning disability or dementia (MD) 61 Date of last inspection Brief description of the care home Brookvale Care Home is situated in Olton and accommodates up to 61 people with mild to moderate cognitive deficits and dementia. The home does not offer nursing care. The home is over three floors, people in the home have access to all areas and there are suitable facilities available. Care Homes for Older People Page 4 of 30 Over 65 0 0 61 61 1 0 0 7 2 0 0 9 Brief description of the care home The home is close to local amenities, and local bus services. The home receives visits from the local church, and residents may participate in religious services if they wish. People are advised to discuss fees with the manager when considering the home. Extra charges are required for personal and additional services. Further information can be acquired from the home. Care Homes for Older People Page 5 of 30 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 focus of inspections undertaken by the Care Quality Commission is upon outcomes for people and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, national minimum standards and focuses on aspects of service provision that need further development. Before we visited the home we looked at their Annual Quality Assurance Assessment (AQAA) which provides information about the way that the service are meeting standards and identifies how they plan to maintain and improve outcomes for people. We also reviewed information about complaints and notifications regarding the protection of vulnerable adults. Our visit took place over one day and was unannounced. We were able to meet managers from the home and a number of staff who work with the people who use its services. We spoke to three people about their experience of living in the home and Care Homes for Older People Page 6 of 30 two relatives also. Three people were case tracked. Case tracking involves talking to people about the care they receive, looking at their records and talking to the staff who support them. This helps us focus on outcomes for people who use the service. We looked at staff training and supervision records, policies and records relating to health and safety, quality assurance and medicines management. We interviewed four members of staff to get information about the training they receive and how they are supported to meet peoples needs. There were no immediate requirements made as a result of our visit. This means that there was nothing that needed to be done urgently to ensure people remained safe and well. Care Homes for Older People Page 7 of 30 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Older People Page 8 of 30 order line 0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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 are provided with accessible information about services and facilities and are offered opportunities to visit the home, before moving in so that they can be confident that the home is suitable for them. There are assessment systems in place to make sure that individual needs can be met, before a placement is offered. Evidence: The home makes a statement of purpose and service user guide available to people (and their families) before they move in. These documents provide important information about the services and facilities available at Brookvale to help people determine whether the home is suitable for them. Information about services and facilities is also available in DVD format, to assist people who may have difficulty reading and to present visual images of the layout of the home. The DVD features comments from visitors and staff about the ethos of care and the range of activities Care Homes for Older People Page 11 of 30 Evidence: that are on offer as part of peoples day to day lifestyles. We looked at three peoples records as part of our case tracking process. Each persons needs had been assessed by staff from the home prior to them being offered a placement. There were also assessments made by health and social care professionals which determined that the home was able to meet the needs of the people they had referred. The pre admission assessments linked to care plans, which specify how people need and like to be cared for. Brookvale provides both long and short term (respite) placements. The records showed that people (and their relatives) had been given opportunities to visit the home at varying times before deciding to move in. A relative told us that this was important as it offered him a chance to get a feel of the home and talk to staff and some of the people who live there before making a decision. Care Homes for Older People Page 12 of 30 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. Care plans are in place that contain sufficient detail to assist staff to meet the needs of the people using the service. People have access to health care professionals and are cared for in a respectful manner. Medicines are being generally well managed so that people receive their medication as prescribed. Evidence: We looked at three sets of care records for the people we case tracked. Care plans and risk assessments contain important information about the way in which people need and like to be cared for. The records we looked at stated areas of individual need and the support that staff must offer to ensure those needs are met. In some cases information did not fully describe how people should be offered care. For example, continence care plans referred to offering regular toileting but did not contain details of how frequently this should occur for people to ensure they remain comfortable. Another care plan Care Homes for Older People Page 13 of 30 Evidence: described a person as demonstrating patterns of behaviour that are challenging, however there was no further information to explain how to manage this safely. Staff members had recorded that they try to calm the person when agitated, but there was no evidence that an agreed strategy had been implemented so that the individual received a consistent approach. Records were in place within the files looked at, including for falls, pressure areas, weight, bathing, nutrition and nutritional screening. The home keeps a record of individuals dependency scores which may vary as a result of changes to physical and/or mental health. Senior staff told us (and records showed) that these are reviewed on a monthly basis to maintain accurate and up to date information about peoples health care needs. Completed risk assessments for tissue viability in relation to the development of pressure sores (a break in the skin due to pressure, which reduces the blood supply to the area) and risk assessments for moving and handling (transferring a person from one place to another) were in place. This information helps to minimise any risk in these areas. Peoples ongoing health care needs were being met with evidence of visits to or visits by the GP, District Nurse, optician and chiropodist being identified in the care files looked at. The care and senior staff spoken to at this visit demonstrated effective knowledge of peoples needs and were able to describe the action they would take should there be concerns about peoples health. Staff members had also signed care records to indicate that they had read them. This should ensure that people are provided with consistent care that meets their needs. Observation of care practice and discussion with staff and visitors demonstrated that people who live in the home are treated with respect and their privacy respected. We looked at medicines storage and systems of administration to check that medication was being safely managed. The pharmacist supplies most of the medicines in a monitored dosage system where each medicine is dispensed in a blister pack from which to administer it on a daily basis. The homes medication policy states that only senior staff manage medicines. We saw records that showed staff had received training in the safe handling of medicines. Solihull Primary Care Trust conduct a six monthly audit of medicines management in Care Homes for Older People Page 14 of 30 Evidence: the home. The most recent report in January 2010 congratulated the staff team on their high standards. We reviewed medication records for the people we case tracked. The majority were correctly completed and through observation, discussion and examination of records it was demonstrated that the staff generally order, store, administer, record and dispose of medication in accordance with current clinical practice. However there were some shortfalls. In some cases people take tablets as required. The medication record we looked at stated that the person should be offered one or two tablets, however it was not possible to determine how many tablets had been given as this had not been recorded. Staff had used a code on a medication record but did not identify what the code meant. On two occasions there were gaps in a medication record and although the medicines in stock were accurate it was evident that some staff had not signed to confirm that medication had been given as prescribed. Care Homes for Older People Page 15 of 30 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 supported to maintain a meaningful lifestyle that reflects their personal tastes. Visitors are encouraged so that people do not lose relationships that are important to them. Menus are well planned and people enjoy their meals and mealtimes. Evidence: Brookvale employs two activities co ordinators who take responsibility for planning and implementing a programme of events that people have asked for. This information is gathered from a number of sources including individuals and their families and from residents meetings held at the home. Life history information is kept in individuals files which describes social and leisure pursuits that people are interested in. Some people have newspapers and magazines delivered each day so that they can keep in touch with current affairs and subjects they enjoy. Areas of the home had been decorated with murals and collage that people had made. A visitor told us that her relative had really enjoyed this experience. Care Homes for Older People Page 16 of 30 Evidence: There is a designated activity room which contains period furniture and reminiscence equipment. We were told that people watch black and white movies in this room, or spend time doing arts and crafts or chatting. One person told us I like a glass of sherry in this very comfortable room. There are plans to create an outdoor aviary so that people can sit and watch the birds during good weather. Brookvale has an open visiting policy and we were told by several visitors that they were always made to feel welcome whenever they called in. A relative told us that the staff team keep him updated by telephone should he be unable to visit. Another relative commented the staff are very friendly and always have time to talk to me. Observations made and discussion with people who live in the home showed that they have opportunities to make choices and decisions about their day to day lifestyles such as when to get up and go to bed, what to eat and where to spend their time. A five weekly menu is rotated based on choices made by people who live in the home. Menus are discussed as part of regular residents meetings. The home employs a head chef and four assistants who work solely in the kitchens and do not have responsibility for additional care tasks. The head chef has several years experience in the catering field and is a qualified chef, also holding an advanced certificate in food hygiene. The head chef and her team work to standard operational procedures when opening and closing the kitchen so that food safety and infection control is not compromised. Spot checks are conducted in the small kitchen areas on each floor of the home to make sure that the areas are clean and that food is being stored safely. We observed lunch on each floor during our visit. People were offered discreet support to eat their food where this was required; staff sat with them and chatted throughout the meal. A choice of two dishes is available at each meal and we were told that should people prefer an alternative, this would be catered for whenever possible. The home provide soft and pureed diets as well as menus that are suitable for people with diabetes and food allergies. People told us that they enjoyed the standard of food at the home and in particular the Sunday roasts. It was evident from spending time in the home that mealtimes are a social occasion for the people who live there. People were offered appropriate support to eat and the Care Homes for Older People Page 17 of 30 Evidence: meal was unhurried and relaxed. Care Homes for Older People Page 18 of 30 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. There are policies and procedures in place to respond to complaints and safeguard the welfare of vulnerable people. Evidence: The home has a complaints procedure which is made available to the people who live there and to their relatives. A complaints log is maintained showing the action taken following a complaint and a copy of the correspondence informing the complainant of the outcome. We spoke to two visitors who confirmed that they had received a copy of the complaints procedure. Both stated they were confident that the staff team would take concerns seriously and take prompt action to address them. The home runs regular residents meetings, which create another arena for concerns and complaints to be discussed. Two safeguarding referrals have been made since our last visit to Solihull Care Trust (who take the lead in investigating safeguarding concerns). There were records which detailed the events that had occurred and it was evident that the management team had followed the homes policies and procedures for protecting vulnerable people. Heart of England Care employ an in house trainer who takes responsibility for Care Homes for Older People Page 19 of 30 Evidence: arranging and providing safeguarding training, which is offered as part of staff induction. The staff files we looked at showed that all were up to date with training in this area. Staff members spoken to at this visit were able to demonstrate understanding of their role in protecting vulnerable people. From discussion with senior staff and observation of individual records it was evident that the service is supported by a Community Psychiatric Nurse who assessed people for capacity. This is a requirement under the Mental Capacity Act and determines if someone can make their own decisions in various areas of their life. Care Homes for Older People Page 20 of 30 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 is clean, warm and well furnished so people live in a comfortable and pleasant environment that meets their needs. Evidence: Brookvale is situated in the Olton area of Solihull close to public transport links and local shopping amenities. There is space for visitor parking at the front of the home. The service has three floors and can accommodate up to 61 people. Two floors accommodate women only, with the middle floor accommodating men. This decision was made in consultation with people who live in the home and their relatives. At this visit the home was clean and free from unpleasant odour; a designated team of domestic staff take responsibility for the day to day cleaning of the home. We spoke to three domestic staff who confirmed that they have access to sufficient cleaning materials and personal protective equipment in order to reduce the risk of spread of infection for peoples health and safety. We looked at the bedrooms of people case tracked. All were clean, warm and comfortably furnished. Some people had bought furniture and other personal items with them when they moved in; a member of staff commented that this helped people feel more at home. Bedrooms contained secure storage for peoples belongings and Care Homes for Older People Page 21 of 30 Evidence: door keys are offered where it is assessed that individuals can manage to have them. There is an ongoing maintenance and development programme. The home has a new conservatory; new windows have been fitted throughout and a number of rooms have been redecorated. Shared space on each floor consists of a lounge and kitchenette/dining area with a range of bathrooms that offer bathing and showering facilities. Shower curtains had not been fitted within any of the shower rooms, which does not promote peoples dignity when they receive personal care. Upon looking around the building we noted two issues that could compromise the health and well being of people who live in the home. The floor covering between the kitchen and dining room on the ground floor was torn and damaged; which could present a trip hazard. This was immediately addressed by the homes handyman who made arrangements for repairs to be made. An Environmental Health report from February 2010 identified that covered pedal operated bins had not been provided in the kitchen areas, which could present a food safety and hygiene risk. This remained the same at our visit. We spoke to three people who live in the home to ask their opinion of the standard of their accommodation. We were told, Its very nice here, I have everything I need and Very comfortable, absolutely no complaints. From discussion with staff and observation of training records it was evident that training in infection control and health and safety had been provided. A quality audit made by Solihull Care Trust in January 2010 scored the home as achieving 96 compliance in the area of infection prevention and control. Care Homes for Older People Page 22 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a team of well trained staff who know them well and understand their needs. Recruitment and selection procedures are robust for the ongoing protection of people who live in the home. Evidence: Brookvale employs a range of staff so that people have specific responsibility for the day to day running of the home. There are designated catering and domestic staff, an administrator, activity co ordinators, laundry and maintenance staff as well as care workers, senior day and night staff, deputy manager and registered manager. We spoke directly or over the telephone to representatives from each staff group. Each person demonstrated clear understanding of their role and in all cases commented on the variety of training opportunities available to them to assist them to do their jobs effectively. The rota showed that senior staff are on duty throughout the day and during the night. Senior staff take responsibility for supervising care and are a point of contact for other staff should they require advice and guidance. The Annual Quality Assurance Assessment stated that all staff, including the catering Care Homes for Older People Page 23 of 30 Evidence: and domestic teams have completed or are working towards National Vocational Qualifications at Level 2 within their specific area of employment. Senior staff have completed or are working towards Level 3 in Health and Social Care and have attained accredited training in the safe handling of medicines. From discussion with staff, observation of records and from information provided in the homes AQAA, it was evident that a range of training opportunities are provided. All staff have completed training in dementia care awareness, with some staff undertaking a comprehensive 12 week course that is assessed by independent trainers. Records showed that new staff had completed moving and handling, first aid, health and safety, infection control and fire safety training within the first few weeks of employment. Training which is specific to the needs of people living in the home such as pressure care, continence awareness and palliative care is provided on a regular basis. We looked at recruitment records for two new members of staff. The records showed that checks had been made of the persons suitability to work within the home, prior to appointment. This contributes to the ongoing safety and protection of people that live at Brookvale. Relatives told us that the staff team keep them updated with regard to any changes they need to know about. One relative said, The staff here are marvelous, incredibly friendly. Another commented, I have no concerns at all, everyone knows exactly what they are doing. Care Homes for Older People Page 24 of 30 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 home is being managed so that peoples views are respected and their health and safety promoted and protected. Evidence: The home has a registered manager who has considerable experience of managing care services. The registered manager is a mental health nurse, holds the Registered Managers Award and a certificate of customer relations. The deputy manager is working towards a National Vocational Qualification at Level 4 in health and social care. The registered manager was not able to be present at our visit, so the deputy manager and senior staff assisted us during the day. This group were confident in answering our questions and finding the information we required; they demonstrated effective knowledge of their roles and the arrangements for the day to day running of the home. Care Homes for Older People Page 25 of 30 Evidence: The manager returned the Annual Quality Assurance Assessment when requested. This contained information about the improvements made, what they do well and where further improvements are needed. This told us that the management team are aware of the action they need to take to ensure that the home continues to be run in the best interests of the people who live there. The home operates a range of quality assurance systems such as care plan and risk assessment reviews, health and safety audits, medicines audits and unannounced spot checks during the night. There were no records of the spot checks that had been made by representatives of the management team, which made it difficult to establish how action had been taken to address any concerns raised. Heart of England Care (the provider) visit the home on a monthly basis in order to comment on the standard of service being provided. We saw copies of reports made following these visits and information of the steps taken by the management team to rectify any issues that had been identified. Surveys are conducted by the home twice a year; people who live in the home and their relatives are encouraged to express their views about the standard of care and service provided. A senior member of staff told us that individual responses were made should there be negative comments, so that action could be taken to put things right. The home takes responsibility for managing money for some people who live there. We spent time with the administrator who showed us how monies are audited and the safeguards in place to make sure that people are not placed at risk of financial abuse. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The fire alarm system had been tested and serviced on a regular basis to make sure that it was working properly. Moving and handling equipment had been checked for safety and serviced on a regular basis. There were no records to show that the nurse call system was tested to ensure it remained in good working order. We were told that the call system was not being tested. This could lead to a delay in responding to any faults and may place people at risk of being unable to summon help if the system fails. Care Homes for Older People Page 26 of 30 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 27 of 30 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 1 19 12 Shower curtains must be fitted in all bathrooms. So that peoples privacy and dignity is promoted and protected. 11/07/2010 2 26 13 Covered pedal operated bins 11/07/2010 must be provided in kitchen areas. So that staff do not handle waste and for the ongoing protection of people who live in the home. 3 38 13 The nurse call system must be tested and a record of each test maintained within the home. To ensure that the system remains in working order so that people can summon assistance should they need to. 11/07/2010 Care Homes for Older People Page 28 of 30 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 Care plans should be reviewed to make sure that the support people need within their daily lives is clealry stated for their ongoing health nad protection. Codes used on medication records should include a description of what has taken place so that people receive their medicines as prescribed. Medication Administration recording should be reviewed so that the number of tablets taken are clearly recorded. This will enable peoples medication records to be robustly audited for their ongoing protection. Consideration should be given to recording the spot checks undertaken by members of the management team so that action can be taken to address any concerns identified as a result of the checks. 2 9 3 9 4 38 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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