Care Home: Chiltern Retirement Home

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Ashcroft Hollow Nursing Home

What the care home does well This is a small home that capitalises upon the close, positive and friendly relationships that can be established in a home this size. There is a very homely and relaxed atmosphere. Staff have detailed knowledge of the needs of the people they support and there is an open dialogue between them. Training opportunities are available to staff and they have a pro-active approach to health care issues. Early referrals are made to health care professionals if there are any concerns. The home have an excellent record of working closely with the District Nursing Service and successfully provide a home for life even where people may have high healthcare dependency needs. People in the home and visitors seen all made very positive comments about the care provided, they spoke highly of the commitment of the staff team and had no complaints or negative comments to make. No complaints have been received by the home or by us in the past few years. What has improved since the last inspection? Social histories are now obtained for all. The quality and quantity of these may vary, but they provide a useful knowledge base for staff in meeting peoples needs and particularly their social and recreational interests and needs. Progress has been made in the provision of activities. A member of staff leading on activities has made a difference, but unfortunately she is on maternity leave and a replacement needed. Other staff continue to provide a range of activities and we saw evidence of this during this inspection. Staff training in the areas of Dementia Care and Safeguarding has been provided as required in the last report. We saw further planned dates for this training that would include recently appointed members of staff. The required 50% of care staff qualified to NVQ standards has been met since the last inspection. Now 13 of the 15 care staff have completed training to NVQ2 standards and some studying NVQ3 and 4. There has been replacement of some bedroom carpets and furniture and the dining room has been refurbished including new furniture, carpets and redecoration. This has improve the presentation of the dining room and provides a comfortable, attractive setting. What the care home could do better: All exit doors must be alarmed to ensure the security of all people using the service and a safe garden area would allow people to sit, wander or use this area safely particularly during the summer months. A risk assessment must be completed for a person with memory loss who has a propensity to wander and possibly leave the building. Contracts for people funding their own care should be provided in a timely way after admission, so that they are aware of their individual rights. The Statement of Purpose/Service Users Guide needs some updating to ensure people have all the relevant information before making a judgment about the suitability of the home for them. All creams in use in the home should be prescribed/labelled to ensure they are used as directed. They must be securely stored and records must clearly indicate how they must be applied, when and where. Some people self-administer creams and staff must be able to monitor their correct usage. This will ensure people have the treatment as prescribed and needed to maintain their health. Aspects of the complaints procedure need updating and a copy should be readily available in the home for visitors. Fire doors must not be propped open. Some people prefer to have their bedroom door open during the day, this should be supported with appropriate self-closing devices fitted to those doors to protect people in the event of fire. Key inspection report Care homes for older people Name: Address: Chiltern Retirement Home 23 Kingsfield Oval Basford Stoke-on-Trent Staffordshire ST4 6HN     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: Peter Dawson     Date: 2 8 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: Chiltern Retirement Home 23 Kingsfield Oval Basford Stoke-on-Trent Staffordshire ST4 6HN 01782711186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chiltern Residential Homes Limited care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1) The registered person may provide personal care and accommodation without nursing for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any category 14 [OP 14]. Dementia over 65 years of age 4 [DE(E) 4]. Physical Disability over 65 years of age 4 [PD(E) 4] 2) The maximum number of service users to be accommodated is 14. Date of last inspection Brief description of the care home Chiltern House is situated in a pleasant residential area close to Newcastle and is easily accessible by public transport. The home has category to admit up to 14 people over the age of 65 years, some of Care Homes for Older People Page 4 of 28 0 0 0 Over 65 4 14 4 Brief description of the care home whom may have dementia care needs or physical disabilities. There are 10 single and 2 shared bedrooms, seven have en-suite facilities. There is an assisted bathroom and separate shower room with walk in shower, both located on the ground floor. There are bedrooms on the ground and first floor, with access to the first floor via the stairs or stair lift. The environment is well maintained and standards are good. The home changed ownership in February 2007 and a new Registered Manager appointed in July 2007. The transition was smooth and successful. There has been some refurbishment of the home by the new owners and building of a planned extension due to start in Autumn 2009. 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 on 1st October 2007. An Annual Service Review of the service was completed on 30th September 2008 and confirmed that good services continued to be provided for people using this service. This unannounced Key Inspection was carried out by one inspector on one day from 08:30 - 16:00. The service completed and returned to us the AQAA (Annual Quality Assurance Assessment) prior to the inspection. This is a legally required self-assessment that every service has to complete annually. It contains information about what the service think they do well, what progress they have made over the past year, what they think they could do better and their plans for improving the service over the next year. The information given was comprehensive with supporting evidence of the statements Care Homes for Older People Page 6 of 28 made. We found at the inspection that the service operated to the level described. Some information from the AQAA is included in this report. During the inspection most people were seen and the majority spoken with either together or separately. It was possible to speak to small groups in the lounge areas and we saw and spoke with two visiting relatives throughout the day. Comments from people using the service, and visitors seen are included in the body of this report. The views expressed showed that people were satisfied with the high standards of service provided at Chiltern House. There were 13 people in residence at the time of this inspection - the maximum number is 14 but one shared room is used as a single. We were able to inspect the communal areas of the home and a sample of bedrooms on both floors. We inspected documentation relating the inspection process. These included care plans, risk assessments, staff files, medication records, staff rosters and complaints and accident records. The Registered Manager was present during the inspection and we were able to speak with a Senior Carer and other care and support staff during the day . At the end of our inspection a summary feedback was given to the Manager outlining our findings. The basis used for the assessment of the service was the National Minimum Standards for Older People. 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: All exit doors must be alarmed to ensure the security of all people using the service and a safe garden area would allow people to sit, wander or use this area safely particularly during the summer months. A risk assessment must be completed for a person with memory loss who has a propensity to wander and possibly leave the building. Care Homes for Older People Page 8 of 28 Contracts for people funding their own care should be provided in a timely way after admission, so that they are aware of their individual rights. The Statement of Purpose/Service Users Guide needs some updating to ensure people have all the relevant information before making a judgment about the suitability of the home for them. All creams in use in the home should be prescribed/labelled to ensure they are used as directed. They must be securely stored and records must clearly indicate how they must be applied, when and where. Some people self-administer creams and staff must be able to monitor their correct usage. This will ensure people have the treatment as prescribed and needed to maintain their health. Aspects of the complaints procedure need updating and a copy should be readily available in the home for visitors. Fire doors must not be propped open. Some people prefer to have their bedroom door open during the day, this should be supported with appropriate self-closing devices fitted to those doors to protect people in the event of fire. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre admission procedures are good. Written information for people about the service could be improved to ensure people have the maximum amount of information to make a decision about the suitability of the home for them. Evidence: The Statement of Purpose & Service Users Guide require updating. The copy available was dated March 2007. Services provided have changed and contact details for other agencies have also changed, together with aspects of registration. Copies should be readily available to all visitors and people visiting to assess the suitability of the home and must contain correct and current information. The current fees should also be included in the Statement of Purpose, to inform people of the charges for the services outlined. We asked to see a contract for a person funding his own care. This person has been Care Homes for Older People Page 11 of 28 Evidence: resident for 3 months. We were told that the contract had been completed and was to be printed and signed. The home needs to speed up this process. It is important that new people using the service have a contract from the point of admission so that they know what they will have to pay and their rights under the contract. People are always invited to visit the home prior to admission. We spoke to a person recently admitted who said that he had visited prior to his admission for a day and had lunch at the home. He said that this gave him the opportunity to make an informed decision about the suitability of the home for him. Pre admission assessments are carried out to ensure that peoples needs can be met. We also saw multi-disciplinary assessments co-ordinated by Social Workers that had been made available prior to the persons admission. 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 personal care needs of people are known and met. Improved procedures for recording the use of creams in the home will ensure people have the treatment prescribed for them. Evidence: We looked at several care plans for people recently admitted and some who had been resident for some time. Plans were based upon assessment of need. Information was detailed including health and personal care needs and risk assessments. Additionally each person had a 24 hour support plan - summarising the routines and inputs, on an hourly basis, needed to support them over the 24 hour period. The home have a good record of early referred to health care professionals where concerns about health care are identified. This has been confirmed by District Nurses seen on previous inspections. One person has been cared for in bed for the past 5 years. District Nurses having commented upon the exceptional care provided for this person. She was seen during this inspection in her room. An adjustable bed, pressure relieving mattress, oxygen, hoist and screens (shared bedroom) were present and Care Homes for Older People Page 13 of 28 Evidence: background music playing. Her diet and fluid intake is monitored closely, staff feed her and interact very positively with her on their regular checks in her room. The District Nurses are not presently visiting her but available immediately if staff have any concerns. Her longevity and quality of life is attributable to the high standards of care provided by staff at Chiltern House. We looked at the care provided for a recently admitted person who is registered as a blind person and has some complex health care needs, including a recent hospital admission. Daily recording of blood sugar levels (diabetic) were seen and monitored closely with advice from the Nursing Service, with instructions about actions to take when sugar levels rise. There has been previous staff training in diabetic care, but it is suggested that further training to update and include new staff would be advisable. We discussed the need for more social opportunities for this person. Staff are aware of this and trying to balance individual choices with the need to meet the social care needs of the person. A requirement of the last report to provide social histories for people has been actioned. Families generally provide information/complete these. Some were very brief others more informative. Staff may need to take the initiative where there are shortfalls in information. We did see a Life Story Book completed with the family for a person that included lots of photographs and information about the persons past life. This is used as a needed positive reminiscence tool for this person. This was initiated by the Activities Coordinator who is presently on maternity leave. A person admitted 4 days prior to this inspection who has dementia care needs and assessed with the need to wander within the home had tried to leave through a patio door. The garden area is not fenced and leads directly onto the road. The home need to complete a risk assessment in relation to that incident to address and reduce the risks involved. We looked at the medication system in the home. Generally all oral medication was recorded on MAR (Medication Administration Records) sheets accurately, had been appropriately received, stored, administered and disposed of correctly. This did not apply to creams administered in the home. We found creams in peoples bedrooms that had no prescription labels and their application was unclear/not known. Some creams were removed from rooms during the inspection and it is important that where possible creams are prescribed and their use recorded (whether prescribed or not) in care plans, MAR sheets or on other forms. It is important that staff are aware of the prescribers instructions and when, how and where they must be applied. Some Care Homes for Older People Page 14 of 28 Evidence: people self-administer creams and staff must be able to monitor their correct usage. This will ensure people have the treatment as prescribed and needed. 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. Chosen lifestyles are supported with a range of activities to meet peoples needs. Evidence: An Activities Co-ordinator has been leading on activities but is now on maternity leave until April 2010. The AQAA states Due to the Activities Co-ordinator being on maternity leave we need to appoint another and resume activities In relation to the next 12 months the AQAA stated We need to give more choice with activities that people do Staff are continuing to provide activities for people where possible. On the day of this inspection 3 people were involved in preparing and baking cakes. They have done this before and said that they enjoy it. There are other activities, people said that they have played bingo and been involved in other games recently. Activities are recorded as they are taken and also recorded in peoples individual records. Social histories are completed, usually by relatives, some contain detailed information, others brief information about the persons past life, family, history, employment, hobbies etc. One relative has completed a history book for her mother with many photographs and narrative this helps to stimulate memory and provides Care Homes for Older People Page 16 of 28 Evidence: points for reminiscence and discussion. There are plans to extend this to other people using the service. A person recently admitted who is registered blind has been encouraged to socialise but limits the opportunities himself. We established that he does not really know many fellow residents. He engages easily with people and needs the stimulation of interactions. The home are attempting to provide him with more opportunities to interact with other people in the home and make new friends. He has several areas of interest. He chooses to spend large parts of the day in his bedroom where he has high definition radio. He has been offered, but declined the talking book service. We saw most people having breakfast in the dining room at the start of the inspection, but people arrived later for breakfast, having made choices about waking/retiring times. There were other indications of flexibility for chosen lifestyles. A person transferred from anther home a year ago said that she had settled very well into the home and was very positive about the home, staff and the support she had received. She was going out for the day with her daughter who also said that the care her mother receives at Chiltern is excellent and I have not concerns at all. Catering staff took over the food preparation duties from care staff some time ago and there is a daily presence in the kitchen. We saw and discussed the daily menus with people, one said that the food is excellent - we can have whatever we want. A varied and nutritional diet was seen and the home-made food sampled during the inspection was to a high standard. Peoples views are sought about the choice and quality of food provided. 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. A readily available and updated complaints procedure will ensure people know how to make a complaint. Evidence: The complaints procedure is being revised to state that complaints will be dealt with within 30 days and not 60 days. A copy of the complaints procedure is in the dining room of the home, but a copy should be placed in the reception or other area that visitors have access to. No complaints have been received by the home or by us in the past year. A requirement of the last inspection report to provide training for staff in Safeguarding has been actioned. There have been staff changes in the past year and apart from recent appointments staff have received Safeguarding training as required. We saw planned courses for staff in November/December this year to update their training in this area. No safeguarding referrals have been made in relation to this service since the last inspection. Care Homes for Older People Page 18 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 adequate 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 maintained environment shortly to be extended to provide needed additional facilities. Safety of the building should be reviewed to ensure people are safe. Evidence: There has been some replacement of bedroom carpets and the dining room has been refurbished including new furniture, carpets and redecoration. The presentation of the dining room is much improved providing a pleasant, comfortable dining facility. Plans have been approved to extend the building at the rear and to build a further floor on the single storey ground floor extension. Work is due to commence soon. This will extend/resite the kitchen, laundry, office and communal space. Six additional bedrooms will be provided above the single storey extension. There will be limited bedroom access for people during the day whilst the work is carried out and sound-proofing reportedly being provided to minimise noise in the existing ground floor bedrooms. We are concerned that this is managed well by the home to ensure the minimum disruption to people throughout the day and particularly to those who access their bedrooms during the day. Some carpets in corridors and communal areas are worn and need replacement. We Care Homes for Older People Page 19 of 28 Evidence: were told that these are due to be replaced as part of the extension and other work to be carried out soon. There are plans to erect a fenced area allowing safe access from the existing patio area of the home. A recently admitted person with a propensity to wander has attempted to leave via the patio area. A secure area is important to allow people to safely sit or wander outside the home. This persons bedroom is located in a corridor area where there is a fire exit door that also accesses that area. There was no alarm on the door to alert staff in the event of someone leaving the building. A requirement is made in this report to ensure that all external doors are alarmed in the interests of safety. An alarm was, in fact fitted to this door later in the inspection day. Inspection of the building showed high standards of hygiene throughout with good infection control measures and practice in place. there were some items in the shower room cupboard that should be removed. They included dressings and other items previously, but no longer used by the Nursing Service. Care Homes for Older People Page 20 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. Staff skills and training ensure that peoples needs are known and met. Evidence: There are 2 carers on duty througout the day plus either the Manager or Deputy Manager. This applies over 7 days. The night staffing levels have changed recently. Previously there was one waking night care and one person sleeping in and on call for part of the week. There are now 2 waking night carers always on duty. A requirement was made at the last inspection to provide training for staff in dementia care. This has been done for all with the exception of recently appointed staff who will undertake the training in the next few weeks. More training is required in Fire Safety, dementia care and mental health awareness. Courses are being presently arranged as well as a course in Nutrition in the Elderly. The target of 50 of care staff trained to NVQ standards has been met since the last inspection. 13 out of 15 care staff have now completed training to NVQ2 standards and some studying NVQ3 and 4. Catering staff have also commenced NVQ training. We looked at a sample of staff files and found that all required checks, references and documents had been obtained for each person prior to employment. This ensures that Care Homes for Older People Page 21 of 28 Evidence: people using the service are protected from potential harm by the staff supporting them. Care Homes for Older People Page 22 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 well run and managed in the interests of the people using the service. Some aspects of safety could be improved to ensure people are safe. Evidence: The Manager was approved by us in July 2007 as the Registered Manager. She had the necessary experience to the run the home. She will complete the NVQ4 in care and Management in December this year. The owners visit the home weekly and are in constant contact and readily available at all times for consultation. The Manager reports an excellent relationship with the providers, there is good two-way dialogue. Providers regularly provide email contact, although no reports under Regulation 26 are left in the home. Staff supervision has improved, the AQAA states in the next 12 months we will try to keep on top of supervisions and appraisals. both were seen in some staff records examined. Care Homes for Older People Page 23 of 28 Evidence: There are no meetings for people in the home although dialogue is established easily and is ongoing in this smaller home. People have opportunities for access to all staff, manager and providers. Three issues were identified during the inspection in relation to safety. One is outlined earlier in this report requiring all external doors to be alarmed. In relation to a person admitted days prior to the inspection who wanders within the home, staff were alerted that she wished to go into the garden area and able to ensure that she did not leave. It is important to carry out a risk assessment in relation to this and the steps that can be taken to reduce or eliminate the risks. We saw a bedroom door being propped open for a person who spends considerable time in his bedroom during the day. It is important to ensure that he has this preferred option but a self-closing device should be fitted to his bedroom door to ensure safety in the event of fire. Care Homes for Older People Page 24 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 25 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 19 13 All exernal doors must be alarmed. This will ensure the safety of all people using the service. 30/10/2009 2 38 23 Fire doors should not be propped open People would not be protected in the event of a fire. 31/10/2009 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 1 The Statement of Purpose/Service Users Guide should be updated to ensure people have current information on which to make their decision about the suitability of the home. Contracts for people funding their own care should be available at the point of admission. This will ensure they are aware of their individual rights. Creams must be safely stored. Instructions for their use must be clearly documented and records kept of when they are applied. Page 26 of 28 2 2 3 9 Care Homes for Older People 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 4 5 16 38 The complaints procedure should be updated and readily available in the home for visitors. Carry out a risk assessment for person who may wish to leave the building. This will ensure her safety. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!