Care Home: Burnworthy House

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What the care home does well Each person who lives in the home we spoke with, and those who wrote to us, said they liked living in the home and always receive the care and support they need. There are many positive comments from people which are included in this report. The social and health care professionals we spoke with, and those who wrote to us, said the home meets individuals` health care needs and respects their privacy and dignity. Some professionals were particularly complimentary about this home and their comments are included in this report. The staff we spoke with, and those who wrote to us, said they enjoy working at the home, are well supported in their roles and are provided with the training they need to enable them to support people properly. The home has a welcoming and inviting entrance hall with photographs and posters displayed to interest the visitors and people who live in the home. People continue to be very happy with the quality and variety of meals. There is a very homely atmosphere; staff were seen to offer care and support in a respectful and professional way. What has improved since the last inspection? All areas of the home were clean and tidy. The people who live in the home we spoke with, and those who wrote to us, said the home is always kept fresh and clean. Recruitment records for new staff have now been improved; none of the records we saw had any information missing. Thorough checks are carried out to ensure staff are suitable to work in the home. Blood sugar monitoring by care staff is now `sharp safe` in line with good practice guidance. This protects staff from the risk of `needle stick` injury. Care plans and risk assessments are now up to date and none of the plans we saw had any information missing. This ensures that all staff have the information they need to offer appropriate care and support to people. What the care home could do better: The Registered Person must ensure that the remaining staff are provided with fire safety training and that regular fire drills are carried out. This would ensure people would know what to do in the event of a fire and help to keep them safe. The Registered Person should consider improving the recording of supervision frequencies for staff to show that they are being given enough support to provide good quality care to people who live in the home. Key inspection report Care homes for older people Name: Address: Burnworthy House South Street South Petherton Somerset TA13 5AD     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: David Smith     Date: 0 1 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Burnworthy House South Street South Petherton Somerset TA13 5AD 01460240116 01460241729 claire.smith@somersetcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset Care Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Burnworthy House is operated by Somerset Care Limited, a not for profit organisation; the home provides care and support for up to 37 older people. It is situated in South Petherton, close to the shops and other amenities in this large, south Somerset village. The house is set in its own grounds and has a car parking area at the front of the building. The home is arranged over two floors and there is a lift for people who are not able to manage stairs. There are 31 single and three double bedrooms, many with en-suite facilities. Double rooms are used as doubles exclusively for married couples or close relatives who choose to share; the Manager told us it has been a number of years since couples or relatives shared a room. There are five communal rooms, including lounge and dining areas, and people also have access to the gardens at the rear of the property. The home offers both long and short term stays. There are regular activities during the Care Homes for Older People Page 4 of 28 Over 65 37 0 Brief description of the care home day attended by people living at the home and those who live elsewhere. Day to day management of the home is under the direction of the Manager and her Deputy; both have many years experience working in the care sector. The home has a number of locally based volunteers who visit on a regular basis. It is clearly a part of the local community and people are encouraged and supported to maintain links with families and friends. 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: 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 last Key Inspection of this service was completed on 14/08/07. This was an unannounced visit to the home to enable us to complete a Key Inspection of this service. We spent approximately seven hours in the home on the day of our visit. The inspection was carried out by one inspector, but the term we is used in this report. This is because the report, and the judgements within it, are made on behalf of the Care Quality Commission (CQC). The pre-inspection planning involved reviewing the report of the last Key Inspection completed in August 2007 and the Annual Service Review carried out in August 2008. We looked at the last Annual Quality Assurance Assessment (AQAA) that was sent to us by the home; this is a self-assessment that focuses on how well outcomes are being Care Homes for Older People Page 6 of 28 met for people living at Burnworthy House. It also gave us some numerical information about the service. We also looked at the service history, which details all other contact with, or about, the home. We sent surveys to some of the individuals living in the home, to a number of social and health care professionals who support the home and staff members as part of this Key Inspection; 21 were completed and returned. The views of each person who wrote to us have been included in this report. A significant amount of time was spent speaking with people who are living in the home or those who are on a short stay. We joined a number of people for lunch in one of the dining areas, where we were free to speak with them and observe staff interacting and supporting people who live in the home. We gathered additional information for this report by speaking with the Manager, a social care professional who visits regularly and some members of staff who were working on the day of our visit. We looked at a number of records within the home such as individuals care records, risk assessments, medication administration, staff records, complaints and compliments and some health and safety procedures. We viewed all communal areas of the home, the grounds and some of the bedrooms used by the people who live here. 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 following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 28 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. Individuals are given the information they need about the home to enable them to make an informed choice about whether to use this service. People are confident the home can support them as their needs are thoroughly assessed before they are given the opportunity to move in. Evidence: The home has a Statement of Purpose and people are also given a guide to the service. The people living in the home we spoke with and those who wrote to us said they did have enough information to decide if it was the right place for them to live. The home ensures comprehensive assessments are carried out for each person interested in moving to the home to determine whether Burnworthy House could meet their needs. These include what personal or medical care people may need, their hobbies and interests, how they communicate, how mobile they are and family Care Homes for Older People Page 11 of 28 Evidence: involvement. Any potential risks to each person are also identified. If any assessments or reports have been completed by other social or health care professionals, copies are obtained and used as part of the assessment process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are met. Each person has a plan of care that they, and people close to them, has been involved in making. Peoples right to privacy is respected and they are supported with their medicines in a safe way. Evidence: The home now uses a computerised care planning system: this has been in use for approximately one year. One member of staff we spoke with has led the development of these computerised plans and told us that staff have had training in using the new system. They felt most staff members are now confident using the new system and that it generally works very well. Care plans are developed with each persons involvement where possible, but this very much depends on the level of the persons skills, ability and awareness. We looked at four peoples plans in detail; these contain clear guidance for staff in relation to the care and support each person needs with their health and personal care. Care Homes for Older People Page 13 of 28 Evidence: They also contain health care risk assessments such as assessments for the likelihood of a pressure sore developing, for the prevention of falls, how to move and transfer safely and nutritional assessments. Each of these assessments is regularly updated and takes into account the daily records for each person; for example if an individual has a fall this information is used in the review process. The staff members we spoke with or who wrote to us said they are always provided with up to date information about the support needs of the people who live in the home. People we spoke with and those who wrote to us said they do receive the care and support they need and staff are available when they need them. One person said staff are always around; you can call for them if you need help with anything, you never have to wait. Other comments were the staff have been quite wonderful to me since I came here and there are always helpful and cheerful staff around to help you. Everyone we spoke with felt that their privacy was respected. We saw that people were able to choose to spend time in their own rooms or in communal areas; staff knew them well and always addressed them using their names. Staff always knocked on peoples doors and waited for a response before entering rooms. The social and health care professionals we spoke with and those who wrote to us said peoples health care needs are met and properly monitored; they told us the home seeks their advice and acts on this to ensure each persons differing needs are met and to improve their well being. They feel peoples privacy and dignity is respected; one professional said the staff at Burnworthy provide great care for the residents, genuine affection and interest in their well being and another said the residents I have placed here have always been happy and feel well supported. The home uses a monitored dosage system of medication administration and this is well managed. All medicines are stored securely in one room of the home; a medicine fridge is available. Some medicines require additional secure storage and this is provided together with a register to record their use. The home uses a trolley when medicines are dispensed. This ensures that all medicines are dispensed and the given to the person immediately to reduce the risk of errors or people not taking their medicines at the right time. The trolley is then stored securely when not in use. The medication administration records are well kept and two staff sign the records, which is good practice. Care Homes for Older People Page 14 of 28 Evidence: Medicines are only dispensed by senior members of the staff team who have had appropriate training. One senior member of staff we spoke with said the medication round can take between 30 minutes and an hour depending on the time of day; they felt the current medication system worked well and also explained how they support people, who may become confused or anxious at times, to take their medicines. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and they make choices about their lives. People are part of their local community. They have a choice of a wide range of activities and trips and are supported to keep in touch with family and friends. People have healthy, well presented meals which they choose. Evidence: The people living at the home we spoke with, and those who wrote to us, said they are happy living at Burnworthy House. They are able to choose how to spend their time; staff always respect their wishes. One person said I always choose what I wish to do; you can choose what time you get up and go to bed and what things you want to take part in. I enjoy just sitting and talking with my friends here. People said there are always activities arranged in the home which they can choose to take part in. One person said we have a regular tea dance which I really enjoy; we also go on longer trips out to places like West Bay. There is always lots going on. Another person told us you can choose what you want to do; a member of staff took me out in the garden yesterday which I enjoyed and they play dominoes with me. Care Homes for Older People Page 16 of 28 Evidence: Three members of the staff team now share the roles as activity co-ordinators; they link with people in and out of the home, the Manager and other staff to ensure a varied programme of activities for people within the home and in the wider community. The Manager said this works well as each of these three staff have different skills and their input has helped to ensure that everyone, including the less able people, are involved in the activities programme. There are weekly music sessions, flexercise, a library round, a visiting pet dog and individual and group discussions. For people who practice a religion there is a regular service held by an inter-denominational Church Group and there is a monthly Communion service. The home has help from a group of local volunteers; there has been an increase in volunteer numbers; as a consequence the opportunity for input from them at the home has increased to three times a week to offer support for people and help at social events held at the home. The social and health care professionals we spoke with, and those who wrote to us, said the home supported each person to live the life they choose. One professional said people here really are an important part of the local community. There are lots of volunteers and the home is well known in the village; people are made to feel part of it even if they are not local people. Each person is supported to maintain contact with their families and friends. Visitors to the home are welcome and relatives are kept up to date about important issues. During our visit many people received visitors; those spoken with said they are always made welcome and were happy with the care and support provided to their relative. We were kindly given the opportunity to have lunch with a number of people who live in the home. Tables were laid in the dining room and people congregated for lunch at about 12.45pm. People knew they had a choice of meals and drinks; these are also displayed on a notice board. Seconds were offered as well as a choice of deserts; staff checked to make sure people had what they wanted or needed. One person said the food is excellent and another said the food is lovely, you always have a choice. There was a very relaxed, informal atmosphere during lunch; it was an enjoyable social occasion. Staff supported people who need help at mealtimes in a sensitive and professional way; people chatted between themselves and with staff. There was a good rapport between people who live in the home and the staff team. 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. 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. People are safeguarded from abuse and neglect and action is taken to follow up any allegations. Evidence: The home has clear policies and procedures on how to recognise and report abuse, making a complaint and whistle blowing, which staff can use in confidence to raise any issue or concern they have regarding poor practice. The people who live in the home we spoke with, and those who wrote to us, said they know they are able to complain if they are unhappy about any aspect of the home. One person said I have no problem telling them what I think and another person told us I dont have any problems here; if I did I would speak to the staff. The staff we spoke with and those who wrote to us are clear about the important role they have to ensure people are happy with their service and remain safe; they know what to do if an individual, family member or a friend is concerned about any aspect of the care and support they provide. Social and health care professionals who wrote to us said they do know who to speak to if they have any concerns regarding the care and support provided at the home; they feel their views would be listened to and Care Homes for Older People Page 18 of 28 Evidence: taken seriously. The home has had two complaints since our last visit; both have been looked into in line with the homes policy. As a result of one investigation, and to ensure best practice at all times, the company has put together a training package for use across the organisations many homes. This includes pressure sore risk assessment training for the non nursing staff. We also looked at compliments the home has had; there are a number of complimentary cards and letters where people have said they are very happy with the care and support provided by the home. Staff are provided with training in how to recognise and report abuse (currently known as Safeguarding Vulnerable Adults) and are subject to enhanced Criminal Record Bureau disclosures (CRBs), before they start work in the home. The home maintains thorough records of each accident, incident or other significant event which occurs in the home. We are always notified of significant events together with any other concerns regarding individuals who live in the home. 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. Burnworthy House provides a homely, clean and comfortable environment for people to live in. Evidence: Burnworthy House is situated in South Petherton, close to the shops and other amenities in this large, south Somerset village. It is set in its own grounds and has a car parking area at the front of the building. The home is arranged over two floors and there is a lift for people who are not able to manage stairs. There are 31 single and three double bedrooms, many have en-suite facilities. Double rooms are used as doubles exclusively for married couples or close relatives who choose to share; the Manager told us it has been a number of years since couples or relatives shared a room. There are five communal rooms, including lounge and dining areas, and people also have access to the gardens at the rear of the property. The last AQAA states that the environment has been upgraded and re-decorated. Ensuite facilities have been upgraded in two bedrooms with the addition each of a shower facility. The Manager told us that the barriers to further development of the service are due to the constraints of the building, for example the number of bedrooms that are not en-suite; longer term this may be addressed. Care Homes for Older People Page 20 of 28 Evidence: The people who live in the home we spoke with, and those who wrote to us said the home is always kept fresh and clean; they are encouraged to bring in personal items, pictures and photographs to help make their rooms personal to them and more homely. One person said my room is delightful and the garden is beautiful to gaze at and walk in and another said I have everything I need in my room; they have recently bought new chairs for the lounge which I like and the new TV [which has a flat screen and is wall mounted] is much easier to see. Building work was in progress when we last visited; some areas of the home were not as clean as they should have been and this was brought to the attention of the Manager at the time. All areas of the home we saw during this visit were clean and tidy; the bedrooms we saw did contain many personal items and they appeared homely. The garden area and the grounds were well tended. The home employs domestic staff who are responsible for keeping the home clean. Infection control is well managed; staff have access to personal protective clothing such as gloves and aprons, there are hand wash facilities available around the home and staff wear tabards when serving at meal times. 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. People have safe and appropriate support provided by a competent and well trained staff team. Thorough checks are carried out on new staff to ensure they are suitable to work in the home. Evidence: The home currently employs 46 members of staff; 34 members of the team are classed as permanent care staff and 24 of these have attained a National Vocational Qualification (NVQ): this is commended. On the day of our visit there were sufficient staff working to make sure people were well cared for and supported. Those staff we observed supporting and interacting with people who live in the home had a good understanding of peoples needs and how to communicate effectively with them. Staff have a very good rapport with individuals and always had time for them; there was a relaxed, homely atmosphere. The people who live in the home we spoke with, and those who wrote to us, said they are treated well by staff; they are available when they need them and they listen to them and act on what they say. One person told us the staff are always helpful; other comments were the staff are always helpful and cheerful; I am very happy to Care Homes for Older People Page 22 of 28 Evidence: be here and all of the staff are staff are wonderful. The social and health care professionals we spoke with, and those who wrote to us, said the staff have the right skills and experience to support people. One said the staff provide a very caring and supportive environment for people to live in and another said staff at the home are always very helpful and approachable. Staff members told us they are happy working in the home and they are always given up to date information about the people they support. They feel there is generally a very homely atmosphere, they are listened to and their views are taken seriously and acted upon. They said there are generally enough staff to meet peoples needs and the way information is shared, between care staff and the managers, works well. When asked what the home does well comments from staff included: we all work well as a team, we are a very friendly and hardworking team, I find this is a very good place to work, we are given good training and kept up to date and this is a friendly and happy environment to work in. When asked what could be done better four staff members said at times the home seemed to be short staffed, when staff are ill for example. One person explained we cover our shifts very well but maybe the employment of more relief staff would be helpful. New staff complete a thorough induction training programme; all staff are then provided with mandatory courses such as health and safety, how to move and handle people safely and infection control. Staff are also given training in specific areas such as medication administration, pressure area training and safeguarding vulnerable adults. The staff we spoke with and those who wrote to us are happy with the level of training they receive. They are provided with training they feel helps them understand and meet peoples needs, keeps them up to date on new ways of working and gives them enough knowledge about healthcare and medication. The home has a robust recruitment process. The personnel records of staff who have recently joined the team contain copies of their application form, documents proving their identity and eligibility to work in the UK, a health declaration, two satisfactory references and an Enhanced CRB. 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 have confidence in Burnworthy House because it is well managed. The environment is generally safe for people and staff because health and safety practices are carried out. Evidence: The home is managed by Mrs Claire Smith; she is suitably qualified, has many years experience in the care sector and has managed Burnworthy House for 22 years. She is supported by one Deputy Manager and senior members of the staff team who are on duty to offer support and guidance to less experienced staff. Mrs Smith will be retiring in approximately three weeks; the new manager is currently managing another of the organisations homes and has worked at Burnworthy House before. Mrs Smith has open door policy and knows people who live in the home, their friends and relatives and staff members well. During our visit people came into the office for help or advice and the Manager also spoke with people in communal parts of the Care Homes for Older People Page 24 of 28 Evidence: home; she was seen to be very in touch with the day to day running as well as all the management of the home. Every person we spoke with and who wrote to us said they found the Manager very approachable and they were happy to speak with her, or her Deputy, about any issue. People said they were always listened to and that any problems were resolved. One person said we have a very supportive Manager and Deputy and another said I found I was given lots of support, the Manager does listen. The home have a system in place to ensure a Quality Assurance review is carried out; questionnaires are sent out to monitor the quality of the care and support provided by the staff team. The last AQAA confirms that in the most recent survey of people living at the home consistent customer satisfaction is shown. Peoples records are stored securely. People told us they can have small amounts of money held for them; this is recorded and receipts are obtained when money is spent. Access to peoples money is appropriately restricted to certain staff within the home. Staff are provided with supervision sessions and an annual appraisal. Staff meetings are also held regularly to support staff in their work. We did note that the way the frequency of supervision meetings, or other meetings held to support staff in their professional development, is recorded could be improved. The current records suggest that staff have only been supervised once or twice this year; if some staff meetings or induction is part of the homes supervision process these should be recorded as such. This was discussed with the Manager during our visit. The home is well maintained and there are systems in place to ensure the health and safety of people living and working at the home. The last AQAA confirmed that appropriate safety checks have been carried out on the electrical wiring in the home, portable electrical appliances, the heating system, gas appliances, hoists and the homes lift. We looked at the fire log book. This shows there is a current Fire Risk Assessment in place; regular checks are carried out on the fire alarm system and other fire fighting equipment. We did note that the last fire drill recorded in the log book was on 26/03/08, however when the Manager checked further the most recent drill was held on 18/03/09; none were held between these dates and therefore the frequency of fire drills must be improved. Staff are also provided with fire safety training; 11 staff still need to complete this course. 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 1 38 10 The Registered Person must ensure that the remaining staff are provided with fire safety training and that regular fire drills are carried out. This would ensure people would know what to do in the event of a fire and help to keep them safe. 01/11/2009 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 36 The Registered Person should consider improving the recording of supervision frequencies for staff to show that they are being given enough support to provide good quality care to people who live in the home. 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. 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