Care Home: Brownlands Nursing Home

What the care home does well The people spoken to tell us that they like living at the home. It was said that the staff are very nice and work hard. One person said `I am getting on well, and they look after me` and `staff are very nice`. We were told that the meals are `very nice` and `plenty of it` and `we have choices`. The people told us that they like their bedrooms and the rooms seen were individualised to meet the needs of that person. Relatives spoken to say that the home tells them of any thing that is happening with their relative and the staff are very caring. The home undertakes people`s needs assessments to make sure they are able to meet the person`s needs. Relatives and the people are invited to visit the home and meet the staff and the people. The staff spoken to say that they enjoy working at the home and it was said `I like working with the residents`. They say that they work very hard to meet the needs of the people `to make sure that all the people are looked after well`. The staff also said that they are getting the relevant training to help them meet the people`s needs. They were observed talking and listening to the people in a respectful manner. What has improved since the last inspection? An activity organiser has been appointed to carry out activities five days a week. The dining area was refurbished and new furniture was purchased. The medication room was better organised and a bigger medication cabinet was purchased. The home had bought a new hoist to meet the needs of the people. What the care home could do better: Ensure all the people`s rooms are free from offensive odours. This is to ensure that the environment is fresh and clean for the people. Provide staff supervision on a regular basis to monitor how they are meeting the needs of the people. Ensure that all the trolleys with bedding are kept in a suitable place. This is to ensure that the corridors are kept clear for moving hoists and pushing people in wheelchairs. Replace the carpet in some areas of the corridor. This is so the people live in a pleasant environment. Ensure that all the information that is required when employing staff is undertaken to protect the people from any harm. Carry out a survey questionnaire that takes into account the views of the people and their relatives, and staff and other professionals involved with the home to find out their views in how the home is meeting the needs of the people. Ensure the times the people want to get up in the mornings is recorded in their care plan to make sure their needs are met. Ensure the people who want their stockings or socks put on in the mornings is recorded in their care plans to meet their needs. Ensure all the extractor fans are working properly in the bathrooms to meet the needs of the people. Key inspection report Care homes for older people Name: Address: Brownlands Nursing Home 34 London Road Daventry Northants NN11 4BZ     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: Ansuya Chudasama     Date: 2 7 1 1 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: Brownlands Nursing Home 34 London Road Daventry Northants NN11 4BZ 01327876985 01327706091 peter_hargrave@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kentbrim Limited care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: A maximum of 31 residents in the category of OP (elderly persons) over the age of 65 years may be admitted to the home. No more residents may be admitted to the home when 31 residents in the category of OP are already accommodated in the home. One named service user under 65 years may be accommodated in the home. Date of last inspection Brief description of the care home Brownlands is a care home providing nursing care and personal care for up to 31 elderly service users within the category of old age. The home is situated in a residential area of Daventry, on the main London Road. The building is a large, converted Victorian house and provides spacious and homely accommodation, with communal areas, and a mixture of single and shared rooms. Fees range from £373.76 to £790.00 further details on the fee structure can be Care Homes for Older People Page 4 of 29 Over 65 31 0 1 3 0 3 2 0 0 9 Brief description of the care home obtained through contacting the home direct. 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: 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: This inspection was carried out in accordance with the Care quality Commission (CQC) policy and methodologies which require review of key standards for the provision of a care home for older people that takes account of the peoples views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. The report refers to we this is because the report is written on behalf of the Quality Care Commission. We last inspected this service on the 11th of February 09. The home completed an Annual Quality Assurance Assessment (AQAA) which is a selfassessment tool that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Care Homes for Older People Page 6 of 29 During this inspection we tracked the care of four people who use this service. This involved reading their care records and also talking to them wherever possible to obtain their views on the service. We also spoke to some of the other people who live in the home and relatives who were visiting the home. Documentation relating to staff recruitment, training, supervision, medication administration, complaints and health and safety were also examined. We had the opportunity to talk to some of the staff who were on duty and a tour of the home was also conducted. The Statement of purpose says the fees charged for people funded by Northants County Council are £373.76 per week and this is dependant on the personal income of the person. The people who are self funding, the fees are £630.00 to £790-00 per week and dependent on the size of the room. Continuing Health care funding is charged at £611.00 per week and this is funded by the Primary Care Trust. The Statement of Purpose, the complaints procedure and the inspection report are all displayed in the home for the people and visitors to view. 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: Ensure all the peoples rooms are free from offensive odours. This is to ensure that the environment is fresh and clean for the people. Provide staff supervision on a regular basis to monitor how they are meeting the needs of the people. Ensure that all the trolleys with bedding are kept in a suitable place. This is to ensure that the corridors are kept clear for moving hoists and pushing people in wheelchairs. Replace the carpet in some areas of the corridor. This is so the people live in a pleasant environment. Ensure that all the information that is required when employing staff is undertaken to protect the people from any harm. Carry out a survey questionnaire that takes into account the views of the people and their relatives, and staff and other professionals involved with the home to find out Care Homes for Older People Page 8 of 29 their views in how the home is meeting the needs of the people. Ensure the times the people want to get up in the mornings is recorded in their care plan to make sure their needs are met. Ensure the people who want their stockings or socks put on in the mornings is recorded in their care plans to meet their needs. Ensure all the extractor fans are working properly in the bathrooms to meet the needs of the people. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. Peoples needs are assessed prior to admission to ensure the home can meet their needs. Evidence: The people spoken to tell us that their family had chosen this home for them to live in. One person told us that they had known about the place before coming to live at the home. It was said that they were happy at the home. The manager stated that they encourage the people to bring in their personal items to make their room feel homely. The AQAA says that the people are given a copy of the statement of purpose, which gives information about the home. Relatives spoken to stated that they were given information about the home when they visited the place. It was also said that their family member had a contract with the home. This tells them of their rights and responsibilities whilst staying at the home. Care Homes for Older People Page 11 of 29 Evidence: The AQAA says that all potential service users are fully assessed normally by the manager, and always by a trained nurse. The peoples files looked at showed that there were admission details of the person being admitted to the home. 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 peoples health care needs are being met by the home. Evidence: We looked at four peoples care plans and discussed the peoples care needs with some staff on duty. The staff spoken to told us how they met the care needs of some of the people. We were told that the manager writes the care plans and they review the plans. However information read in the reviews showed that the changes in peoples needs were not always being updated in the care plan. The care plans we saw clearly set out peoples support needs and preferences in receiving personal care. We observed that a few of the women did not have their stockings or socks on. We spoke to two people and they informed us that they would like their stockings on. The manager informed us that they would make sure that the ladies who wanted to have their stockings or socks on in the mornings would be supported by staff and the information would be recorded in their plans. Concerns were raised to CQC about some people being washed and dressed at 6 Care Homes for Older People Page 13 of 29 Evidence: oclock in the morning and then being put back to bed again. The people were then brought downstairs for breakfast when the morning staff came on shift. This was discussed with the manager and we were told that some of the people wanted to get up early. The peoples care records looked at did not have any information recorded about what time the people wanted to get up or information about people who were being got up at 6 oclock in the morning. The daily notes recorded by staff did not record the time the people were being got up. The manager stated that they will ensure that the information about the times the people want to get up will be recorded in their care plans and this would be discussed with their relatives. We observed staff interaction and noticed that they talked to people in a respectful manner and were careful to preserve their dignity. One person spoken to said I do every thing for my self and staff help me to wash my back and they shut the door when they do this. Another person who had recently been admitted to the home told us I am getting on well and they look after me and staff are very good. The people told us that if they did not feel well, they would tell the staff. Relatives spoken to said that they were happy with the care that was provided at the home. Evidence in the care records showed that the people are offered support for their physical and emotional health needs. There were records of general practitioner, and hospital appointments, and people have access to the opticians, dentists, tissue viability nurse, and other health care professionals. The home was using the Liverpool Care Pathway for caring for people who are very ill. The nurses at the home gave out medication and evidence showed that they have all received the accredited training in administering medication. We had received information telling us when the home had made medication errors and this was reported to the relevant people. The AQAA says that the medication policy has been renewed, and a new controlled medication cupboard was purchased for staff to have easier access to medication. The home put in an action plan and monitoring systems in place to ensure medication errors did not happen again. The records and medication checked was satisfactory. Care Homes for Older People Page 14 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 people are provided healthy meals with choices at meal times to ensure their dietary needs are met. Evidence: We observed staff talking to the people and encouraging them to eat in a kind manner at tea time. Positive comments were received from the people about the food that was offered to them. One person told us that the food is good and plenty of it. Another person said the food is very nice and we can choose from two options and if we dont like what is on the menu, we can have something else to eat. The staff were observed asking the people what they wanted to eat. Discussion with staff showed that they had good understanding of the peoples likes and dislikes of food and this information was recorded in their. Relatives spoken to told us that the food was nice at the home. The AQAA says relatives are encouraged to have meals with their relatives. The people told us that they liked their bedroom, and each persons bedroom seen was individualised to their taste. Care Homes for Older People Page 15 of 29 Evidence: Most of the people in the home maintain contact with their relatives. The relatives were encouraged to visit the home and some people visited the home every day. The relatives were also invited to any functions that the home had and we were told that families were invited to the homes Christmas sitting down meal. The home has an activity organiser and they work five days a week from 9AM to 3PM. This role was still being further explored to find out the activities the people in the home enjoyed doing. A copy of the activities being carried out is displayed where the people and their relatives can view this. Some of the activities include, playing bingo, snakes and ladder, doing chair exercises and manicures, beanbag throwing, and having outside entertainers come and sing, and play music. On the day of the inspection the home had a singer and all the people in the lounge were observed enjoying the music. Care Homes for Older People Page 16 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. Concerns raised are listened to and acted upon by management to ensure the peoples needs are met. Evidence: The home has a complaints policy, and the procedures for making a complaint is recorded in the Statement of Purpose. We are told that a copy is given to the person or their relative. The AQAA says the complaints procedure is in the entrance hall for all to access. We observed that this document was displayed in the home where the people and visitors can view this. Some of the people spoken to were capable of informing staff if they were not happy. One person said if staff asked you how you are, but its up to you to tell them if you are not happy. Other people said that they had no complaints to make. Relatives spoken to told us that if they had any concerns, they would speak to the manager or staff. The AQAA says the home had received one complaint from a family member. This was discussed with the manager and evidence showed that the complaint was dealt with appropriately. The staff spoken to informed us that they had completed the safe guarding of vulnerable adults procedures training. They had good understanding of this and understood the peoples behaviours to know if they were unhappy or not feeling well. Care Homes for Older People Page 17 of 29 Evidence: The home has not made any referrals to the safe guarding team of social services. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent investments has greatly improved the appearance of the home and therefore creating a more comfortable environment for the people living at the home. Evidence: A tour of the home showed that the place was generally clean. The blinds in the lounge in some areas were broken. Some of the people in the home had difficulty opening their eyes and they were observed to be agitated and distressed when being moved around. This was discussed with the manager and we were told that they were going to get the blinds replaced. We were told after the inspection by the manager that the blinds were not being replaced but the owner had repaired them and the problem had been resolved. We observed that the lounge was crowded, and most of the entrances were being blocked by small tables or stools. A person was observed sitting in the middle of the room and there fore made it difficult for staff using the hoist to pass by. The manager stated that the lounge requires redecoration and the corridors require new carpet. We were informed after the inspection that the lounge area had been better organised by removing some of the items that were not needed in the room to provide more room for the people and staff to move around safely. The AQAA says for our plans for the next 12 months is that the owner of the home is looking to extend the home and the lounge area is to be widened, decorated and carpeted. However the manager did not have a date of when this work was going to Care Homes for Older People Page 19 of 29 Evidence: start. The dining room had been refurbished and new chairs and tables had been purchased. We were told that the room looked very pleasant. We observed that the room was very crowded because there were 14 people in wheelchairs and six people sitting in chairs. There were also lots of empty chairs that were not used in the room. The manager informed us after the inspection that they now transfer most of the people from the wheelchairs to sit on the dining room chairs. The other chairs, which were not used, were removed from the room to create more space and it was said this was much better. The bedrooms seen were individualised to the people and those spoken to tell us that they like their rooms. One bedroom that we looked at did not smell very pleasant. We were told that the carpet was being cleaned. The AQAA says a new equipment has been purchased to keep enviroment clean and odour free including a sanitising machine. The shower floor in room 30 needed looking at because the water was not draining properly. The manager stated that this would be looked at by the maintenance person. The extractor fan in one bathroom was not working. One bathroom on the ground floor had very bad odour and the whole room needed redecorating and the floor was worn out. The manager informed us after the inspection that the flooring in this room had been re done and a new shower was fitted. It was said that the work being done in the room was still on going. The manager informed us that they had bought a new hoist for the home to meet the needs of the people. We were informed by the manager that the occupational therapist was visiting the home this week to undertake an assessment of bedrooms and some of the communal areas. This was to find out if the peoples needs were being met properly when transferring people on and off the bed, wheelchairs, and chairs. A trolley with sheets and bedding was kept on different floors. However this was seen as a hazard in some areas because it was in the way of the wheelchairs and hoists being pushed through to the toilet and peoples room. The manager stated that they would find a cupboard where these items could be stored. We were told that the home had a small van donated by a service user who passed away at the home. This vehicle was to be used for the people in the home but it was said that the owner was using this vehicle for their own use. This was discussed with the manager and it was said that they would speak to the owner about this. It was Care Homes for Older People Page 20 of 29 Evidence: also said that the vehicle would be used more for taking people out in the community. The garden was pleasant and we were told that the people like to sit outside in the garden in the summer months. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment procedures are not fully robust and therefore places people at risk. Evidence: The staff recruitment files were looked at in detail and the information looked at was not well organised. Evidence showed that the home was not obtaining all the relevant information required to safe guard the people in the home. We issued an immediate requirement by asking the home to tell us how they were going to improve their recruitment procedures. We received information from the manager telling us that they had recruited a new administrator for 30 hours per week to help the manager with the admin tasks. It was also said that they had reviewed all the staff files and had all the information required in their files and the office was better organised. The AQAA says the home has 7 care staff with NVQ level 2 training or above. The training records showed that 8 more staff had commenced this training. The manager informed us that all new staff would be doing NVQ training when they start employment. All new staff had started doing the skills for care induction training. We were told that the home did not have enough staff on duty to meet the needs of the people. The manager informed us after the inspection that the care hours had been increased in the morning shifts. However they had a full time vacancy for a Care Homes for Older People Page 22 of 29 Evidence: Registered General Nurse (RGN) and the position had been advertised. The RGNs hours were being worked by bank nurses, permanent staff and the manager. It was also said that two bank nurses were being employed to help out when needed. The staff spoken to said that they enjoy working at the home, and with the people. They like working with the other staff and found them helpful and supportive. They said that they did training to help them meet the peoples needs. The staff say they get support from the manager and from senior staff on duty. The staff training records showed that dementia and infection control by distance learning was still on going. The manager said that they had done the Mental Capacity Act training and they were going to do this training with staff using the training video. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management has improved the systems to ensure that the health and safety of people living at the home are met. Evidence: The manager of the home is qualified and has many years experience of running a home. She has good understanding of the areas that need improving in the home. The AQAA says employ an administrator to take some of the managers work load to ensure all paperwork is up to date. We were informed by the manager after the inspection that an administrator was employed and staff recruitment files and other information was better managed in the office. It was said that this gave the manager more time to do things they needed to do in the home. The staff say that the manager is supportive and gives advice when needed. We were told by families spoken to that the staff were very caring and if they had any concerns, they would speak to the manager. Care Homes for Older People Page 24 of 29 Evidence: The manager informed us of the training that they have undertaken to keep up with their skills and knowledge. The managers certificate for manual handling assessors certificate had expired and they were doing the City and Guilds training on manual handling assessors course on the 25th of February 09. The home has not undertaken a service users survey since the last inspection. We were told by the manager that they were going to carry out a questionnaire survey with the people and with the relatives, and visitors to find out their views on how the home was meeting the needs of the people. We were told that this was going to be undertaken in February 2010. The Manager told us that she talks to the relatives and the people in the home to get their views of the care received by the home. The manager had also booked a relatives meeting at the home for January 2010. Staff spoken to and evidence showed that not all the staff were receiving supervision on a regular basis. The AQAA says the supervision sessions with staff have been commenced and are now regular and 2 senior carers have been employed and are taking on supervisory tasks. The manager was also not receiving regular supervision on a monthly basis to find out how they were managing the home. We were told that they were going to speak to the proprietor about this. The accident and incident records show that these were being recorded appropriately. The manager managed the finances of the people and records were maintained satisfactory. The fire alarm system was being tested on a weekly basis. The emergency lighting was done on a monthly basis. The staff told us that they had fire drill practice so they know what to do if there was a fire. The premises electrical circuits had not been reviewed since last year. An immediate requirement was issued by asking the home when this was going to be done. We received confirmation that this had been carried out on the 7th of December 09. 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 1 7 15 Care plans must be updated when there is a change in the persons well being. This is so that the staff have relevant and correct guidance to meet the persons needs. 26/02/2010 2 29 7 The homes recruitment procedures must be robust. This is to ensure the people living in the home are protected from any harm. 28/01/2010 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 19 Provide CQC an action plan to state when the extention to the lounge area is going to take place to meet the needs of the people. Ensure that all the trolleys with bedding are kept in a suitable place. This is to ensure that the corridors are kept 2 19 Care Homes for Older People Page 27 of 29 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 clear for moving hoists and pushing people in wheelchairs. 3 33 Carry out a survey questionnaire that takes into account the views of the people and their relatives, and staff and other professionals involved with the home to find out their views in how the home is meeting the needs of the people. Ensure all staff receive regular supervision to monitor how they are meeting the needs of the people. 4 36 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. 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