Care Home: Cholwell House

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What the care home does well Cholwell provides a high standard of care to its residents, who appear to be happy with the service they receive and are content with their daily lives. Staff have a good awareness of individuals needs and treat the residents in a warm and respectful manner. Meals are well presented and menus offer a healthy well balanced diet for all residents who benefit from a tailored menu. The home is comfortable and provides a safe, peaceful and well maintained environment for the residents. The outdoor surroundings provides great pleasure and enjoyment to them. Staff are well trained and supported. The home is well organised and managed by an effective, stable management team that promotes the views and interests of the residents. What has improved since the last inspection? A new manager has taken post. What the care home could do better: Continue to improve the quality of night care plans and introduce the Gold Standard end of life documentation. Maintain and monitor the mixer valves on hot water outlets to ensure they present no scalding risk. Submit a landlord gas safety certificate Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cholwell House Cholwell House Temple Cloud Bath & N E Somerset BS39 5DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrew Pollard     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Cholwell House Cholwell House Temple Cloud Bath & N E Somerset BS39 5DJ 01761452885 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cholwell House Nursing Home Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 51 Number of places (if applicable): Under 65 Over 65 51 51 dementia old age, not falling within any other category Additional conditions: 51 0 Manager must be a RN on parts 1 or 12 of the NMC register. May accommodate 51 persons aged 50 years and over. Staffing Notice dated 20/04/1998 and NCSC letters re: revised staffing levels dated 27/08/02, 03/03/03 and CSCI letter 08/04/05 apply Date of last inspection Brief description of the care home Cholwell House is registered for 51 residents requiring personal or nursing care. In general the home operates a maximum occupancy of 46 thus reducing the proportion of double rooms. The home is situated in a rural position and can be accessed by car or bus. The home is in part a converted older property with recently built extensions. The home provides single and double rooms on three floors. There is a choice of communal areas including a large conservatory. There is an internal link corridor to the Care Homes for Older People Page 4 of 29 Brief description of the care home new extension of 11 rooms with en-suite facilities and its own pleasant communal space. There is lift access to all parts of the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration Leadership and management Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection visit conducted as part of the annual inspection process. Prior to the visit the inspector spent some time examining documentation accumulated since the previous inspection, including notified incidents and the reports conducted by the Registered Providers. The Annual Quality assurance Assessment has also been reviewed after the site visit. The inspector sent questionnaires to residents in the home prior to the inspection and 11 were completed and returned. Surveys were also given to staff and visiting health and social care professionals, none were returned. Information from these has been Care Homes for Older People Page 6 of 29 peterchart collated and is detailed throughout the report. The inspector spent time throughout the visit in discussions with a relative, residents, the registered manager and the homes administrators. Residents care plans and care files were examined. Records and files relating to the day to day running and management of the home were examined. The inspector toured the premises. Feedback was given as the visit progressed on the outcome of the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Leadership and management () Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective clients and their families are given relevant information in written or verbal form about the home. Contracts and terms and conditions of services are provided to all residents or their families. The assessment procedure is clear and a thorough assessment of prospective residents needs is carried out. Evidence: The resident guide and statement of purpose is made available to prospective residents and their families. Alternative formats can be accommodated if need be. A full revision of these documents is to be conducted in the coming months. All residents and relatives stated in their surveys that they and their families had received information about the home prior to admission. The range of fees is between 400 pounds and 551 pounds with a single supplement of 15 pounds, it was suggested that this should be Incorporated with the general fee unless a shared room rate is less than the single rate. Care Homes for Older People Page 10 of 29 Evidence: The pre admission assessments were fully completed and informative. The manager or a senior nurse meets with prospective residents prior to admission. The prospective resident and family are involved in the assessment and all information is used to determine the suitability of the placement. Residents have contracts and terms and conditions, which are signed on admission. The majority of residents continue to be admitted through Social Services or via the Primary Care Trust who provide detailed assessment and enhanced care plan documentation prior to admission. The Local Authority have a block bed contract for twenty beds. The information gathered pre admission provides evidence of the residents disabilities and state of health prior to admission. A detailed assessment of the residents care needs are established over the initial few days and regularly reviewed. This information forms the basis of the Care Plan. All residents have Waterlow, handling and other relevant assessments. Residents records showed that the persons physical, mental and social needs had been taken account of. It is intended that assessments will be reviewed at least annually and care plan rewritten including the risk assessments and where possible this will involve the resident and their family, named nurse and key worker. The Standex dependency rating is used and reviewed monthly. The majority of residents are in the high dependency banding. The value of repeating monthly dependency assessments was discussed as it may not be necessary for all residents when a quarterly assessment tied to the care plan evaluations may be adequate. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans detail residents care needs and are clearly written and give clear directions to staff other than night care plans. The staff provide appropriate personal care to maintain residents health, well being and dignity. Proper arrangements are in place for residents to access primary health care services. The staff properly store, administer and record medication on behalf of residents. Evidence: The named nurse and key worker system remains in place. It is intended that all residents will have a thumbnail biography written by the family and care staff if possible. The standex system of documentation is used, the assessments and directions of the care were detailed and clearly presented. Needs were assessed using a model based on the Activities of Daily Living. There was evidence of regular review, updating of documentation and relative and resident involvement where practical. It was suggested that residents or in the main relative be asked to endorse the care plans Care Homes for Older People Page 12 of 29 Evidence: and reviews. Daily records are made for all residents. It was suggested that the standex system be used to record bathing rather than duplicate the record in a separate book. Residents have end of life plans which are to be enhanced by the roll out of the Gold Standard approach and documentation. The local Primary Care trust and GP will be providing training in support of this change. The night care plans are basic and need to be more person centred, the manager is aware of this issue and will be working with the night staff to improve them. Further enhancement of care documentation for the benefit of residents is likely as the manager and other staff will be attending training related to the practical implementation of the Mental Capacity Act and the manager is attending a Deprivation of Liberty Act workshop in the coming weeks. There were individual risk assessments including moving and handling, nutrition and Waterlow assessments to assess the risk of developing pressure sores. The Stirling index of classification is used. Specialist equipment being used for individual service users i.e. alternating pressure relief mattresses and seat cushions had been related to the risk assessments. Use of bed rails are regularly reviewed to ensure their use remains necessary. Monthly dependency levels are recorded for all residents along with key observations where indicated. All admissions are referred for a dental review, if an individual does not have an existing dentist the Community Dentist visits the home to carry out routine examinations. Health call visit regularly to carry out eyesight checks. The chiropodist visits every 6 to 8 weeks. The local GP from the Timsbury practice Dr Howell has all of the residents on his list and visits every week. A Consultant Psychiatrist chairs a residents review meeting each month. Nurses have delegated responsibility for certain clinical issues in the home such as medication, continence, and end of life. The responsibility for the medication has been delegated to one of the Registered Nurses and the records indicated that staff adhere to the appropriate procedures and practices in the home. The receipt, administration, disposal and controlled drug records were up to date and in order. The GP practice is a dispensing practice and currently also receive unwanted medication for disposal. Care Homes for Older People Page 13 of 29 Evidence: None of the current residents wish to or are able to self medicate at present . Comments made form returned survey include, My mother is well cared for and they make a great fuss of her and I cannot fault Cholewll there is care and concern from every member of staff, it has a very good atmosphere. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of social and recreational activities is arranged that seek to enhance the quality of life for the residents. Residents families are involved and informed of issues related to their relatives and residents are able to maintain close contact with families and friends. The food is of a high standard and provides a balanced diet for residents. Evidence: Mr and Mrs Thompson, the proprietors visit the home on a regular basis to maintain contact with residents and visitors. The home operates an open door policy for visitors. Residents are able to see visitors in the privacy of their rooms if they wish and there are several semi-private seating areas around the home. Feedback from the visitors spoken to and surveys confirmed that the staff are easy to talk to and helpful. Survey comments included, I am always made to feel welcome, everyone is friendly to visitors and It’s a nice place to go, and Staff are welcoming and friendly. Care Homes for Older People Page 15 of 29 Evidence: The dining room was light, relatively spacious and the tables were attractively laid with tablecloths and napkins. The 4 week menu offers traditional meals and those with a more unusual source, choice is available, however due to mental incapacity meals are often provided to residents based on known likes and dislikes. The menus are designed with consideration given to colour, presentation, taste and texture for the benefit of the residents. Staff were seen to be assisting residents to eat in an unhurried and respectful manner. The residents who were able to express an opinion stated they enjoyed their meals and felt they received the food they liked. The meal on the day of inspection was well cooked and tasty. The main meal times are set, however, staff can access beverages and snacks 24 hrs a day for those who would like them. Surveys indicated that the standard of food was good. At present there are no residents with particular cultural needs. There is one person employed to co ordinate social activities and one part time vacancy, which it is hoped to fill soon to enhance the quality of life for the residents. In addition it is hoped to recruit a carer to work a 10 AM to 2 PM shift to assist with meals and activities, to date this has proved difficult. The aim is to develop more diversional, tactile and sensory based activities and keep more detailed records of resident engagement to assess which activities are most relevant. Visiting entertainers continue to come to the home periodically. The manager is considering adopting a more formal dementia care model and is seeking information about training a practitioner to develop such. A weekly timetable is on display on the notice board. Recreational activities included sing-along, bingo, crafts, games, quizzes and gentle movement. A range of visiting entertainers perform in the home. Trips out in the community minibus have not taken place due to the increasing dependency and frailty of the current residents. A number of residents go out with their families. Resident and family meetings take place regularly and records of outcomes are kept. There are celebrations for various events and festivals to which families and friends can be invited. Links have been established with a local school who visit the home for special events. The Christmas arrangements included a party to which relatives were invited, carol singing and Mrs Thompson bought each resident a gift. A monthly ecumenical service is held in the home run by local clergy. At present there are no residents with other faith backgrounds or particular cultural needs. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust and comprehensive policies in place to protect residents investigate complaints or manage allegations of abuse. There are good arrangements in place for staff training and awareness of Protection Of Vulnerable Adults matters. Evidence: There is a complaint procedure on public display in the home. Information on how to make a complaint and to whom such a complaint should be addressed is included in the residents guide. Only one minor complaint has been received since the last inspection. The action taken by the manager was appropriate and the person concerned was happy with the outcome. Resident surveys indicated that people knew who to speak to if they were not happy and that they were aware of the homes policies should they need to make a complaint. Comments included, There is always someone you can speak to and I would always speak to the manager. All staff have received training on safe guarding vulnerable adults, and have an update annually. The Local Authority adult protection procedure document is available. The deputy manager has completed an investigators training course run by the Local Authority. One incident arose last year and Social Services considered that the home managed the case properly. A number of staff are undertaking the National Vocational Care Homes for Older People Page 17 of 29 Evidence: Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. The General Social Care Council code of practice has been distributed to the care staff. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of furnishing and decor is good to the benefit of residents. The home provides a safe and well maintained environment for the residents. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the residents needs. Specialist equipment is in place for the residents safety and well being. The standard of cleanliness is high. Evidence: The home is in part an older property converted and adapted to care for older people, with a purpose built extensions. The home offers a total of 51 beds although at present only using 46 to reduce double occupancy. A further review of remaining double rooms is to take place later this year. The home provides care over three floors. There are two passenger lifts and a stair lift, which together give level access to all parts of the home. The home is in good order and well maintained and is fit for its purpose. A rolling programme of redecoration is always ongoing. The environment was clean and free from unpleasant odours. The home employs domestic staff on a daily basis. The home is smoke free environment. Residents surveys confirmed that the home was always fresh and clean and one relative stated, The general cleanliness of the home is very good. Care Homes for Older People Page 19 of 29 Evidence: There are several lounges, dining and quiet areas throughout the home as it is split into three specific areas. The main building with communal areas on the ground floor, a unit on the mid floor and the extensions have lounge areas. All areas are comfortably furnished and homely in appearance. Bedrooms are well decorated and furnished some with specialist equipment and many have been personalised with residents own belongings. Mobile and fixed hoists and stand aids are provided along with pressure relieving equipment. Some rooms have contact switches and pressure pads for people who are at risk from wandering at night. There are communal toilets close to the lounge and dining areas. Many of the bedrooms have en-suite toilet facilities. The home has adequate bathing areas in relation to the number of residents. A new wet room shower has been installed on the top floor. Baths have thermostatic mixer valves and the monitoring of hot water temperatures takes place. However three hot water outlets tested indicated temperatures of 50 degrees C. The manager instructed the maintenance man to check and adjust the mixer valve on all baths to reduce the risk of scalding. Radiators were guarded and individually thermostatically controlled. A maintenance man works full time at the home and can be available for emergency repairs as required. The kitchen was recently completely refitted. The Environmental Health Officer has carried out an inspection and awarded the home 5 stars. Proper arrangements are in place for the disposal of clinical waste. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures and records are in good order to protect residents. The home is well staffed with appropriately trained and experienced staff for the number of residents. Good progress is being made training care staff for the benefit of residents. Evidence: The staffing levels are in accord with or exceed the staffing notice. The administration and general management support is provided by two full time administrators who are the daughters of the proprietors. Agency use is minimal but if necessary then continuity of staff can generally be maintained. The domestic, catering and laundry staffing levels are satisfactory. The recruitment process was examined and staff records showed that the home follows correct recruitment procedure and policies. Records contained application forms, references, and a Criminal Records Bureau (CRB) disclosure. Proper arrangements are in place to employ workers from outside of the European Union. Enhanced CRB checks were viewed and the inspector signed the disclosures. These checks are repeated every three years. Registered Nurse qualifications are validated with the Nursing and Midwifery Council (NMC). A monthly electronic check of the NMC list of struck off or suspended staff is carried out. Care Homes for Older People Page 21 of 29 Evidence: Each file has a checklist attached to ensure all documentation is up to date prior to commencement. Residents and a visitor spoken to and in their surveys stated that staff were always or usually available when they needed them and that staff listen and act on what they say. Several surveys expressed positive views about staff and the care residents receive, comments included, The staff do a good job and are very cheerful and There is a happy atmosphere and Staff are patient and considerate. The Registered Nurse training records were not checked on this occasion but the manager listed various clinical learning and update sessions taking place or booked for nurses. There are detailed induction programmes for new registered nurses. The care staff follow common induction programmes facilitated through Training Masters. All new staff are linked with a mentor during their first two weeks of supernumerary shifts. Three care staff have National Vocational Qualifications at level 2 and two are on programmes. One care staff has a level 3 NVQ and further ten care staff are working toward their NVQ 3 this year. Mandatory training for all staff includes fire safety, food hygiene, first aid, load handling, health and safety and adult protection, such training is up to date. The manager is considering taking a training for trainers course to teach core subjects in the future. Dementia care training courses were undertaken in 2008. Twenty-four staff have completed the ASET course with the Norton Radstock College. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 managed and run taking into account the views and wishes of the relatives and residents as they are able. There are good arrangements in place to maintain and service the equipment and facilities in the home. The Home protects the health and safety of residents and staff. The staff supervision and appraisal arrangements are good. Evidence: A new manager has been appointed and is in the process of completing a Commission fitness assessment. The manager is experienced in the running of a nursing home and demonstrated a sound knowledge and understanding of the needs of the individual residents and has clear plans for future development of the service. There is a part time deputy manager in post to support the manager and in addition two administrators are working full time. Mr and Mrs Thompson visit the home on a regular basis and actively support the manager and staff. Care Homes for Older People Page 23 of 29 Evidence: There is a dedicated staff team who work together to try and ensure that high standards of care are achieved and maintained and that the residents receive care, empathy, respect and receive the attention they need. All residents have a named Registered Nurse (RN) and key worker who works with them at least every week. Four senior care staff supervise the work of other care staff in different areas of the home. The surveys indicate and staff say that the home is well managed for the benefit of its residents. Comments included, Its very well run, I think Cholwell is wonderful and They are very helpful. The manager gives all Rns and house keeping staff regular supervision which is then cascaded by the Rns to the care staff. An annual appraisal process is in place from which personal development plans will be drawn up. Accident reports are properly written and monitored. The home submits Regulation 37, significant event reports to the Commission as required. It was agreed that Regulation 26 management reports would be written monthly but need not be submitted to the commission unless specifically requested to do so. As recorded in the last report residents families are encouraged wherever possible to manage their relatives finances as none currently are able to do so. There is an inventory of residents cash and valuables held for safekeeping. Two signatures to evidence all transactions endorse the ledgers for the receipt or use of residents cash. Preferably one of the signatures being the resident, although it is recognised that this is not always possible due to their disabilities. Monies are kept in a locked safe, with a limited number of key holders to enhance security. If there are items of lost property they are recorded in a ledger. The manager has written a policy for the management of unclaimed and lost property The Home has appropriate policies in place to protect the health and safety of residents and staff. An external provider conducts health and safety training in the home. There are good arrangements in place to maintain and service the equipment and facilities in the home. The lifts, hoist and chair lift have been serviced and tested. The periodic electrical safety inspection has been carried out and certificate issued. The gas appliances have been serviced but a Landlord gas safety certificate has not been issued. There is a formal fire risk assessment and fire plan. The fire logbook was up to date and in order. Training, drill and maintenance have taken place. A record of hot water outlet temperatures is maintained although as referred to above Care Homes for Older People Page 24 of 29 Evidence: the bath valves are currently being inspected to ensure their proper function. Care Homes for Older People Page 25 of 29 Leadership and management These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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. . Evidence: This section of the report has been reproduced in error and is a duplicate of the section above. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 2 7 10 The manager should make night care plans more person centred. The manager should ensure that the Principles of the Mental Capacity Act and Deprivation of Liberty Act are implemented in the home following training. The registered person must ensure that bathroom hot water outlets are properly monitored to reduce the risk of residents being scalded. The registered provider should submit a copy of an in date Landlords Gas Safety certificate to the Commission. 3 21 4 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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