Care Home: Canwick Court Care Home

What the care home does well There are good assessments and care plans in place to make sure that people`s needs and wishes are identified and met in the way they want them to be. Residents and relatives are able to say what they think about the service they receive and feel able to do so. Staff treat people with respect and dignity. They are well trained and have a good understanding of people`s needs and wishes. They encourage people to make their own choices and decisions and help residents to be as independent as possible. There are good systems in place to make sure that people are protected, including the training of staff, risk assessments, policies and procedures and people who visit the home tell us their relatives are safe living there. There is a range of activities and a part of the lounge has been made into an activities corner. Family and friends are made welcome when they visit the home. What has improved since the last inspection? The providers improvement plan tells us that all those requirements made in the last inspection in February 2009 have been addressed. The acting manager confirmed that there is a new management team and that training for staff and staff supervision is now undertaken. She commented that people`s files are updated with risk assessments and care plans, which are reviewed monthly. Surgeries have been introduced for people who wish to discuss their care plans and other issues relating to their care and general welfare. There has been an increase in signs, which are dementia friendly including pictures, colour and wording that residents can easily understand. This is now being introduced to all parts of the home. Also new furniture has been purchased and the acting manager stated that as people are admitted, new bedroom furniture and bedding will be purchased. Murals have been painted in lounges and corridors and new dining chairs have been bought. During the last inspection we said that risks assessments and better care plans should refer to new laws about decision making. Both of these things have now been done. What the care home could do better: Although we found lots of improvements have been made to the service people receive, we said that there are still things that the home must do to make things better. Some care plans identified mental health issues for residents and what decisions they were unable to make. Care plans also need to identify those decisions that residents can make relating to their daily living and record this in their care plans. We also made suggestions to help make things better. We said that care plans relating to ensuring people privacy and dignity should be personalised to meet their individual wishes. This will ensure that their privacy and dignity is fully maintained. Key inspection report Care homes for older people Name: Address: Canwick Court Care Home 78 South Park Lincoln Lincs LN5 8ES     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: Douglas Tunmore     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Canwick Court Care Home 78 South Park Lincoln Lincs LN5 8ES 01522544595 01522544230 canwickcourt@guardiancarehomes.com www.guardiancarehomes.co.uk Guardian Care Homes (UK) Limited care home 31 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The home is registered to provide personal care only for service users of both sexes whose primary needs fall within the following categories:- Dementia - over 65 years of age (DE)(E) The maximum number of service users to be accommodated is 31. Date of last inspection Brief description of the care home Canwick Court Care Home is registered to provide personal care for 31 people over the age of 65 years. The home has an acting manager in place who is not registered. The home is situated to the south of Lincoln city and is served by a bus route and is within walking distance of the town centre. The property is a large detached Victorian building laid out over 4 floors. The top floor is for staff and an administration area. The first floor comprises of resident bedrooms Care Homes for Older People Page 4 of 28 Over 65 31 0 2 7 0 2 2 0 0 9 Brief description of the care home and the ground floor has bedrooms and communal areas. The lower ground floor has the main kitchen and the residential care unit, which can accommodate 9 residents. This unit is called Heathlands and has its own entrance. We were told that the current fees for a weeks stay at the service range from three hundred and fifty one pounds to five hundred and forty five pounds depending on the level of care required. Extras charged for include chiropody, hairdressing toiletries and newspapers. The providers Survice Users guide and the last inspection report is available from the acting manager. 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 quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced key visit carried out over one day during the month of June 2009. This inspection focused on key standards, which have the potential to affect the health, safety and welfare of people who use the service. From 1 April 2009 the duties of The Commission for Social Care Inspection (CSCI) has been taken over by the Care Quality Commission (CQC), the new independent regulator of all health and social care in England. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). We took into account previous information held by us, including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Care Homes for Older People Page 6 of 28 Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA) and their improvement plan telling us what progress they have made since their last inspection. The main method used to carry out the inspection is called case tracking; this includes following the care of a sample of two people through their records and assessing their care. We spoke with the regional manager, the acting manager, observed two residents who were being case tracked and spoke to one carer and the cook. We also spoke to a visitor who confirmed she attended weekly to see her relative. At the time of this inspection there were two people living in the home. 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: Although we found lots of improvements have been made to the service people receive, we said that there are still things that the home must do to make things better. Some care plans identified mental health issues for residents and what decisions they were unable to make. Care plans also need to identify those decisions that residents can make relating to their daily living and record this in their care plans. We also made suggestions to help make things better. We said that care plans relating to ensuring people privacy and dignity should be personalised to meet their individual wishes. This will ensure that their privacy and dignity is fully maintained. Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. Evidence: We were told that, Care Plans are centred around the initial pre-admission assessment and the wishes of the client and their family; next of kin are documented and implemented throughout. Daily records pay close attention to their physical and psychological well being, their dietary intake, their weight and their personal hygiene. We looked at the files of two people who live in this home. The files show us that the provider does not admit residents without a care needs assessment being undertaken. The regional manager commented that either the acting manager or a trained senior staff member goes out to visit people before they come to live at this home, so that they can find out what their needs are and how they want to be looked after. Care Homes for Older People Page 11 of 28 Evidence: Prospective residents are also written to by the home confirming whether they can meet the residents care needs or not. A visitor told us that, I came to view the place before my relative was admitted and found it very homely. At that time a manager visited and carried out an assessment of my mothers needs. It was all a very positive experience with information taken about my mothers needs and we were given a service users guide. We looked at care plans and found that in some cases assessments were also available to the home from health care professionals as well as social workers detailing the needs of those residents. The acting manager confirmed that trial visits are available and prospective residents can stay for a meal if they so wish. We received the providers improvement plan telling us that there is now a check list and monthly audits to ensure that admission forms fully address any significant or specialist areas of care for people. The home does not provide intermediate care. 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. The health and welfare needs of people living in the home are fully met. Medication procedures keep people safe. Evidence: We are informed that, Documentation is thorough and robust in all areas. Mental Capacity and Best Interests are addressed. Outside agencies such as Chiropody and Opticians visit the home regularly. District Nurses (DN), community psychiatric nurse and doctors visit the home upon request. Tissue Viability is monitored and appropriate equipment sourced following referral to DNs where necessary. Assessments are carried out by DNs following referral for any issues surrounding continence. Nutritional assessment is carried out and weights recorded regularly. Dietary intake is also recorded. We said that care plans must reflect issues relating to risk of residents in relation to managing weight loss or risk of pressure sores. This must be introduced to ensure the general health and welfare of residents. At this visit Care plans showed that this has been done with regular checks on peoples weight and what they have eaten during Care Homes for Older People Page 13 of 28 Evidence: the day. The providers improvement plan showed that at any risk of a pressure sore the community nurse would be contacted. We said that night care checks must show when residents had been changed, when incontinent or found wandering. This visit found in residents files that night checks are undertaken and a record is kept of the care and support given to a resident. We also said that care plans must reflect person centred care planning. This must be introduced so as to ensure that residents are actively involved in their care plans. At this visit we saw that the care plans had improved and reflected the care provided and those who act on a residents behalf. A relative who is also Deputy Guardian of a resident told us I have been through the care plans and every time I visit they inform me of my mothers care. We also said that care plans of residents must record the care required by those residents who were put to bed at an inappropriate time of day. The regional manager confirmed that no resident would be put to bed during the day without other health care professional advice being sought. We said that the privacy and dignity of residents must be maintained and a record kept showing residents wishes regarding this issue. Care plans showed that dignity and privacy has been recorded and how this was to be undertaken. However, this was recorded the same in both files. Residents or their relatives and friends must be consulted regarding their personal views on how a residents privacy is to be managed. The providers improvement plan shows us that staff training has been undertaken on privacy and dignity. The acting manager told us that this is an ongoing development for staff and for care planning. The improvement plan showed us that care planning training for all staff is ongoing, night checks are undertaken with records kept and care planning reflected the person centred approach to looking after people with dementia. Monthly audits are carried out on the above by the regional manager or acting manager to ensure that standards of care are maintained. During this visit people were seen to be treated with dignity and respect by the carers. At this visit a carer confirmed that she has undertaken the homes induction training as well as care planning and had training relating to the new laws about decision making for residents. A relative told us that, my mother gets very good care, she communicates in a very Care Homes for Older People Page 14 of 28 Evidence: positive way with her carers, nothing is to much trouble for them. Files seen also confirmed that health care professionals visit the home when required by the residents. The pharmacist visited the home on the 3rd March 2009 and recorded that storage and administration records of medication is carried out and everything was in order. Medication sheets were seen by the inspector and it was found that an accurate record of medication was kept of medication given on that day. We watched staff giving medication and saw that they did this in a safe way. For example they locked the medicine trolley up whenever they moved away from it. The acting manager confirmed that no residents self-medicates at this time. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a range of activities and a menu to suit their needs and wishes. Evidence: We are informed that, Menus are displayed each day and refreshments are offered between meals. Clients are given a calm and relaxed environment to eat their meals at their own pace and staff offer encouragement and assistance where required. Clients can eat their meals in their own rooms if desired. Meals are well presented and look and smell appealing. The visitors signing in book showed that people visit their relatives at various times of the day and evening. A visitor said that she is always made welcome, as soon as you get in they ask do you want a drink. The visitor also confirmed that her mother will not do activities. However, we go into the garden and walk around and have a cup of tea. On the day of the visit the hairdresser was styling the two residents hair. The current programme contains activities such as, games in the garden, reminisces, quizzes, newspaper discussion, movement to music, arts and crafts and songs of praise for one resident on a Sunday. Baking was taking place in the afternoon of the visit. Care Homes for Older People Page 16 of 28 Evidence: Observations made on the day of the visit were that people were seen to drift in and out of any activity as they so wished. Care plans showed that there was a detailed history of the life of people and what they liked to do as well as their likes and dislikes. Relatives have added to this care plan confirming that flower arranging had been a favourite pastime of one resident. There was a copy of the activities undertaken and if they enjoyed them in the care plan as well as important events such as birthdays. An area in the lounge dining room is used as the activities corner and games, postures and newspapers were on display. There is no activities organiser at the present time. A visitor commented that my mother is kept clean and tidy and staff give her the opportunity to do things for herself and then prompts are given to her and further support. I get on with the staff and visit three times a week. A new cook has been employed since the last inspection, he confirmed that he was experience and qualified to undertake his tasks. He told us that menus are developed on a monthly basis and that there is a choice of meals for residents. A visitor told us that the meals are good and the new cook is very good, the food looks appetising and choices are given to my mother, she is very happy here. Observations made of the lunch period was that staff were supportive to people when they were eating and the setting was calm and relaxed, allowing time for residents to enjoy this social occasion. 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. Clear policies and a responsive and caring staff team protect people in this home. Evidence: e were told that,All staff are POVA checked before commencing employment and have enhanced CRB. Staff have access to policies which relate to abuse and safeguarding and the home also carries a Whistle blowing policy. Manager has an open door policy to encourage staff, clients and visitors to freely discuss any concerns or issues they have. There is a complaints procedure in place within the home which deals with complaints quickly and efficiently. The complaints procedure is also set out in the Service User Guide and the Statement of Purpose which is available to all visitors and clients. A visitor told us that she feels her mother is safe in this home. She commented that If I made a complaint now it would be instantly looked into. The provider has an up to date copy of Lincolnshire County Councils revised safeguarding adults protocol. The provider has amended the homes service users guide and statement of purpose relating to the change of name of this home. All residents have a copy of this document, which informs them how to make a complaint and is given to them when they come to live in this home. The complaints procedure is displayed in the reception area of this home. Care Homes for Older People Page 18 of 28 Evidence: One carer spoken with had a good knowledge of the types of abuse that might occur and she was clear of the action to take should she need to report any concerns. She told us that she had undertaken adult protection training. The providers improvement plan showed that training had been undertaken by care staff. We were told that there had been thirteen safeguarding investigations and three complaints. We were told by the local authorities Adult Social Care team that most issues have been resolved, however, investigations may continue regarding staff who have left this home. The provider has responded in the right way to these allegations and has co-operated with investigations. During this visit no resident, relative or member of staff made negative comments about the care on offer at this home or that they had any concerns. 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. Residents benefit from a comfortable, warm and clean environment that meets their individual needs. Evidence: We were told that, comfort and safety of the clients is paramount at all times. Thorough and robust risk assessments are carried out on all areas of the building. A maintenance plan is in place that addresses all areas for improvement and decoration. A sensory garden has been introduced and the garden is now secure for clients. The gardens are maintained and attractive. We found the home to be clean, tidy and free from obstructions to mobility, the decor and furnishings were well maintained. Hoists, a specialist bath and specialist mattresses are available for the use of people. Call bells are in reach of people in those areas in which they live. The acting manager confirmed that there is a new handyman who undertakes general maintenance of the home. She stated that since the last inspection improvements to the home have been made with murals painted in lounges and corridors. Furniture has been replaced and new lighting fitted in the main dinning room. She also told us that when people come to live at the home then new throw-overs will be ordered and all furnishings will be replaced. Care Homes for Older People Page 20 of 28 Evidence: We were told by a carer that since the new management team started they have made positive changes, the home looks a lot better, cleaner and nice and inviting. A visitor commented, my mother likes it here she potters about like its her own home. 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 benefit from a well trained staff team, who are available in such numbers to fully meet their needs. Evidence: Staff duty rotas clearly show the people who are on duty each day and staff told us that there are enough of them to meet peoples needs. A visitor said that there are always staff around for me to speak to about my mothers care. Observations made and this visit were that there was ample staff to meet the needs of two residents living in the home. This included the acting care manager, the visiting regional manager, two carers, a domestic worker, cook and handyman. The acting manager told us that there are two carers on duty day and night. We were told by a carer that there are enough staff on duty to meet the needs of people in the home. She confirmed that there is a key worker system and she is responsible for the care of a resident. She stated that she discusses with people how they want their care to be delivered. She also told us that she has undertaken training relating to the care of elderly residents and that the provider is giving us a lot of training. The acting manager commented that there are eight carers and five have a nationally recognised qualification for the care of older people. She confirmed that training is Care Homes for Older People Page 22 of 28 Evidence: ongoing for all staff and the Skills For Care introduction to work training package is to be introduced for all workers in the home. The providers improvement plan confirmed this and and showed us that staff do training courses such as fire safety, risk assessing, care plan training, dementia training, privacy and dignity training, nutrition, first aid and moving and handling. A previous inspection in 2009 showed us that personnel files contained satisfactory CRB, POVA, Criminal Record Bureau Checks and Protection Of Vulnerable Adults checks, which have been received prior to their employment and staff have been given copies of the General Social Care Council code of conduct. The acting manager confirmed that two new staff have been recruited, a cook and handyman, both she said had undertaken all the checks required as per the companies policy and procedures. 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. The home is managed in the best interests of the people who live there and systems are in place to promote their health, safety and welfare. Evidence: We were informed that, the acting manager is currently going through the procedure of registering as the manager of Canwick Court Care Home. She has almost 4 yrs experience of managing a care home and was previously the registered manager of a home for 22 residents with dementia. She has NVQ (National Vocational Qualification ) 3, Registered Managers Award and NVQ 4. She also has a certificate in Dementia Management. Since the last visit the management team has been changed and now has an acting manager and a regional manager. We were told by the acting manager that her application has been sent to the commission so as to undertake a fit person interview to become the registered manager of this home. Care Homes for Older People Page 24 of 28 Evidence: One carer stated that the acting manager is very supportive, she has a presence on the shop floor and chats to people. She also said that I feel we are moving in the right direction and when the home is full it will be a better place. The regional manager told us that supervision and appraisals are undertaken with all staff. Records tell us that supervision is undertaken by a senior manager to ensure that all staff receive guidance and support in carryout their duties. We were told that a complete audit of peoples valuables has been undertaken to ensure that there is a record. The providers improvement plan showed that this has been undertaken. The last inspection visit in 2009 showed that an accurate record of peoples monies was kept. Records at this visit confirmed that the regional manager visits and checks finances on a monthly basis. Residents meetings are held with dates given on the notice board. Further surveys need to be sent out to all those people who visit the home so that the provider can assess their views on how the home is run. We identified that there are a range of policies and procedures available in the home relating to the health and safety of residents. These documents also showed dates when equipment was serviced and fire alarm checked to ensure the safety of residents and staff. A carer confirmed that she had undertaken fire safety training and knew what to do in the event of a fire. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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