Care Home: Church Terrace Nursing & Residential Home

Similar services:

• Coton Hill House
• Doddington Lodge
• Far Croft
• The Lodge Nursing Home
• Bracken House
• Sunnycroft
• Churchill House Nursing and Residential Home
• Field Farm House

What the care home does well Staff try and make the home as comfortable and as safe as possible. People told us they like living at Church Terrace. People using the service told us that the staff were `good,alright and hardworking`. Staff told us the manager and the senior staff are supportive and helpful. The manager ensures that the required checks are completed before a person starts working at the home. The manager also ensures that the staff are well trained and competent to do their job. The expert by experience told us that in their view `It is evident staff make a big effort to get to know individual residents personally, and to try as far as possible and as far as the system allows to accommodate their preferences and choices, which is commendable. I was also impressed with the commitment and ethos of the manager`. What has improved since the last inspection? The variety and frequency of community activities has increased. The service has introduced a new computer care management system to all nursing units. Staff told us this is a more effective way of recording and monitoring a persons care needs. The AQAA tells us of the many improvements that have been made as a result of obtaining the views of people. What the care home could do better: The service user guide should include details of the weekly fees, this will ensure that people have the information to help them make the decision of whether to move into the home or not. Mealtimes could be made more of a social and pleasing experience. 50% of the care staff should be trained to National Vocational Qualification in care, levels 2 or above. This will ensure that staff are consistent and effective at supporting people with their care needs. Key inspection report Care homes for older people Name: Address: Church Terrace Nursing & Residential Home The Terrace Cheadle Stoke-on-Trent Staffordshire ST10 1PA     The quality rating for this care home is:   three star excellent 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: Joy Hoelzel     Date: 2 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Church Terrace Nursing & Residential Home The Terrace Cheadle Stoke-on-Trent Staffordshire ST10 1PA 01538750736 01538754034 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Minehome Limited care home 71 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 71 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 71, Mental disorder, excluding learning disability or dementia (MD) 71 Date of last inspection Brief description of the care home Church Terrace is a purpose built Care Home with Nursing. The home is situated on a main road within Cheadle town and has direct access to the town shops and facilities. The home comprises of two floors, served by a passenger lift, and stands in enclosed gardens. There is a car park within the grounds of the home. The home is registered to accommodate up to 71 service users over the age of 65 years with varying degrees of dementia and mental disorder requiring either residential and or nursing care. There are three units within the main building offering care with nursing (mental health), and Care Homes for Older People Page 4 of 28 71 71 Over 65 0 0 Brief description of the care home a smaller unit for people with residential care needs (mental health). The nursing units are as follows:- Maple Dene (20 people), Autumn Leaves (21 people), and Oaklands (15 people). All of these units care for people who have varying degrees of mental health nursing needs. Blossom Court is a unit dedicated to caring for up to 11 people with mental health (residential) needs. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. The service user guide does not contain details of the weekly fees, the reader may wish to contact the home directly for further information. Care Quality Commission reports for this service are available from the provider or can be obtained from www.cqc.org.uk 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: three star excellent 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 for this service was completed 15th February 2007, with an annual service review 23rd June 2008. The home did not know that we would be visiting on this occasion to conduct a full inspection of the service. We were accompanied on this inspection by an expert by experience. An expert by experience is a person who, because of their shared experience of using services, and or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Their comments are included in this report. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of six people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and Care Homes for Older People Page 6 of 28 staffing records. Discussions were held with people living and working at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to the commission within a given timescale. The registered manager completed this document and returned it to us in November 2009. Comments from the AQAA are included within this inspection report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. 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 8 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 9 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. Admissions are not made to the home until a full needs assessment has been undertaken. This tells the home all about the person and the support they need. Evidence: The AQAA informs that the home Provide a brochure, statement of purpose, service user guide to assist prospective clients make an informed choice. We saw that the service information documents had been reviewed and updated by the manager for 2009. The manager explained that due to the complex care needs of people, the fees are discussed and agreed on an individual basis with the funding authorities. They went on to tell us of the wide variation in the fees and the way that the care package is agreed. To comply with the regulations and to give people full information and details of the service, the service user guide should include the levels of weekly fees payable. Care Homes for Older People Page 10 of 28 Evidence: The AQAA gives information on the admission procedures A full pre admission assessment is carried out prior to admission and views of multi disciplinary team professionals are sought where appropriate. Care plans are obtained from Care managers or others involved. Care Program Approach meetings are attended by a home representative prior to discharge from statutory services. We looked at the case files and care records of two people that had recently moved in. We saw that relevant information had been obtained regarding the care needs of the people prior to offering a placement at the home. One person told us that the home was very new to them but that they were getting used to the environment, the other people living at the home and the staff. They said that they thought they were settling in well. Staff told us that for the first month of a person arriving at the home, comprehensive assessments are made the care needs and any possible hazards or risks are monitored and recorded. This gathering of information ensures that the service can be confident of meeting a persons care needs. The home does not provide an intermediate care service Care Homes for Older People Page 11 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. People who use the service can be confident that they will receive support and care in the way they prefer and need. Evidence: The AQAA informs us that a New computerised care management system is in place in all nursing units. Documents are clear and in a consistent format to ensure unfamiliar staff can access information promptly. The AQAA tells us that within the next twelve months there are plans - To make new care planning system fully operational for the residential unit. Staff told us that they feel the new system of recording information on the computer is an improvement and easy to use. Paper documents can be available if required or requested. We looked at the care documentation in each of the units and saw that each person has very different care needs. These are recorded in depth and offer staff clear instructions and guidance. Each intervention and involvement with the person and staff is documented thus providing continuity of care. Care Homes for Older People Page 12 of 28 Evidence: For example, one person requires regular interventions from the nursing staff for a specific condition. Records were seen for the monitoring of this and included the frequency of the interventions and any changes that are noted. The plan documented the visits and guidance made from other health care professionals when the home requested assistance and support. Another person regularly experiences periods of anxiety and distress due to a specific condition. The care plan offered guidance to the triggers of this upset. Staff explained the regular monitoring of these episodes in an attempt to establish a pattern of behaviour to try and reduce the distress to both the person and to other people. We looked at the care plan and documentation of a person with very complex physical and mental health care needs. The plan gave clear instructions for the care required on a daily basis and the interventions needed from both the nurses and the care staff. The visits from other health care professionals, e.g. general practitioner, tissue viability nurse, mental health specialists, were recorded, with the person being visited by them recently. This person was able to tell us the care and support they receive from the staff, although they were clearly unhappy with their situation. Staff told us that this person relies on them for help and support with everyday living activities and that they give as much support as they can each day. Some people living at the home were able to tell us that they thought the staff looked after them very well. People who were unable to comment appeared well cared for, well groomed and well nourished. The staff described the diverse care needs of the people living at the home and the way they helped and assisted each person with daily life. We looked at the systems for administering medication to people and found that the areas for storing medication were safe and secure. Staff explained the procedures and we looked at the medication administration records (MAR) for a selection of people. These appeared to be completed correctly; there were no gaps in the recording in the selection of charts seen. On one unit we saw that phials of in use insulin were being stored in the medication fridge, this being contrary to the manufacturers instructions. We advised staff to make themselves aware of the correct storage of medications and act accordingly. We spoke with the manager about this; they offered an assurance that immediate action would be taken. Throughout the course of the day we saw staff being very patient, understanding, caring and assisting people with care needs in a discreet and respectful way. Care Homes for Older People Page 13 of 28 Evidence: The care records recorded the name that people preferred to be called and throughout the day we heard staff addressing people accordingly. Screening has been provided in the shared rooms to offer people some seclusion and privacy when they are in the bedrooms. Care Homes for Older People Page 14 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 using the service can be assured that the home will support them with their preferred activities Evidence: The AQAA tells us - Activities are pre planned and special events, in house and community are well advertised. Seasonal events and diverse themed meal nights arranged as required. In house activities take place regularly within each unit on a less formal arrangement by care staff. There are resident led activity sessions and resident led themed days i.e. Scary party for Halloween. Resident meetings provide ideas for activity events. The home has a minibus facility to provide transport to wider activities. No one is obliged to engage in any activity if they prefer not to. The AQAA explains the improvements to the activity programme during the past twelve months - We are now allocated a fixed budget each month in order to facilitate the service users engaging in typical family activities i.e. theatre, restaurants, shows, concerts, cinema, sports events, day trips. The in house events are overseen by a designated member of staff to ensure those who do not go out into the community are still benefiting from co- ordinated personal activity opportunity. Staff have responded by making themselves available for more outdoor activities. Take away nights have Care Homes for Older People Page 15 of 28 Evidence: proved to be immensely popular, they have selection from chip shop, Chinese, Indian, pizza and kebabs from Cheadle local suppliers. Those residents enjoying Chinese food enjoy the trips to the buffet lunches but there are some that are unable to go to these for mental or physical health reasons. This is why we introduced the take out nights. We have purchased a DVD which promotes healthy exercise in the disabled. We are having mixed results. We have a variety of DVD activity facilities and they are available daily. The expert by experience looked at social activities arranged and available . They observed- I did not actually witness any activities taking place in any of the units during the time of my visit, but understand that outings are offered to residents who wish to go out, in the homes minibus. There have been trips to a nearby lake and to restaurants and shopping. I understand that organised activities are provided from time to time in the home, e.g. nail care, rocking Johnny (musical turn), organ playing and poetic therapy (which sounds excellent). Residents are also taken out if they wish to go by individual carers. The expert by experience spoke with two people who were sitting in one of the lounges and asked them how they liked to spend their day. They said just sitting and watching TV. Another person said I dont do anything - just sit here. Another person told the expert by experience that they would like a bit more chatting - no one speaks. We saw that some people were able to go out of the home independently and visit and use the local shops and amenities. We acknowledge that some people who are unable to go out independently may not wish to participate in the activities within the home. The expert by experience was told that it is difficult to motivate residents to join in anything. They commented that some effort could be made to encourage residents to take up some activity to simulate them mentally and possibly some group physical activity to help them retain mobility. Perhaps some board games, crosswords, cards, craft materials etc. could be put out in the lounge and residents encouraged to use them. The manager acknowledged the findings of the expert by experience during the morning of the inspection. They went on to explain that numerous and varied activity does take place but generally arranged for the afternoon and evenings. The manager told us of the quantity and quality of recreational resources that are made available to people and commented that activity is not just about taking part in something but engaging and interacting being equally important. Care Homes for Older People Page 16 of 28 Evidence: We did not see many people visiting the home whilst we were there. The manager told us of the positive action taken to ensure that people maintain contact with their family and friends. The main front door is kept locked for security purposed. There is a key number pad sited on the door for ease of entry for the people living at the home. Number key pads are also sited on the internal doors to the units within the home. People told us that they are able to access the areas as they have the code for the key pad. People are supported to make choices and decisions of how they wish to spend their day. Where a potential risk is identified and assessment is made with an agreement of the action needed to reduce the risk of harm to the person. The people in the residential care unit are encouraged to make their own breakfast and drinks though out the day. In the other units the food and drinks are prepared by staff and offered at regular intervals. People told us that they thought the food was satisfactory and sufficient for their needs. One person told the expert by experience that they did not eat meat but was not offered a vegetarian option. The expert by experience offered some suggestions for improving the mealtimes for example providing menus on the tables so that people are aware what they are going to have. They also made an observation, - Meals were served already plated up this rather excluded residents from being really involved in choosing options and sizes of portions. It did not feel to me much like an enjoyable experience or opportunity for interaction, but rather like a conveyor belt process. Information provided in the AQAA identifies some improvementsTo develop meal time further to become a special 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. If people have concerns with their care, they or people close to them know how to complain. Evidence: The complaints procedure is displayed at the entrance of the home and is included in the service information documents. People told us they would speak with the manager if they had any worries or concerns about the service. They said they did not have anything to worry about at the moment. The AQAA tells us that the home has received five complaints within the last twelve months and all but one has been concluded. A log is maintained of the concerns and complaints that are raised directly with the home. The manager discussed the complaints and the action that had been taken. Three referrals have been made to the safeguarding adults team where there was a suspicion of abuse. All three referrals were considered by the safeguarding team, with recommendations being made to reduce the risk of a re-occurrence. Staff confirmed that they have received training in the protection of vulnerable adults and the safeguarding of people and described the action they would take if they had any suspicions of wrong doings. There is a facility for the service to safe keep small amounts of a persons money. Care Homes for Older People Page 18 of 28 Evidence: Separate records are maintained for each person and the money is stored in a locked safe. We saw people collecting and signing for their weekly allowances. 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. The home provides a physical environment that is satisfactory to the specific needs of the people who live there. Evidence: Church Terrace is a purpose built social care home providing accommodation, nursing and personal care for up to 71 people. The AQAA tells us that - There is a programme of routine maintenance; in addition a system is in place to identify repairs required promptly. Refurbishments have taken place in communal areas and bedroom plans are ongoing at this present time. During the tour of the premises we saw that some areas around the home are in need of attention. The manager explained the work in progress to enable the redecoration and the refurbishment of these areas. We looked at some of the bedrooms and saw that they were as individual as the inhabitant. People told us that they were satisfied with their own bedrooms and were comfortable. One person told us that they would like to have a key for their room so that they could lock their door when they went out. We discussed this with the manager who actioned the request. Care Homes for Older People Page 20 of 28 Evidence: During the tour of the premises we saw that generally the home was clean and hygienic. At times during the day there was a detectable odour in the corridor of one of the units. The manager explained the difficulties met with the effective cleaning of some areas. There are plans for additional domestic staff to be employed and to work out of normal hours. Additional attention can then be given to the communal areas. 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 who use the service can be assured that the staff have the skills and knowledge to meet their needs. Evidence: People told us the staff were very good, alright and hardworking. One person told us They [the staff] dont have a lot of time to talk to you. People who were unable or did not wish to talk with us appeared to be comfortable and cared for. A duty rota is maintained to establish the staff on duty at any given time of the twenty four hour period. Each unit is staffed separately with either nurses or senior carers and a team of care staff. We saw that staff were very busy attending to the care needs of the people in the different units. There appeared to be very good professional relationships between the staff and the people using the service. All seemed to be well at ease with each other with the staff very aware of the different needs of people. The manager told us that there is a stable workforce and that the existing staff cover for any shortfalls in the duty rota. There has been no use of agency staff for the past three years. Care Homes for Older People Page 22 of 28 Evidence: We looked at a selection of staff files to look at the recruitment procedures. The files were very well presented and confirmed that the required checks had been carried out before a person started to work at the home. The AQAA informs that of the 48 permanent care workers, 22 have gained accreditation at National Vocational Qualification in care levels 2 or above. A training matrix is maintained to show the training completed and that which is needed for all levels of staff. The manager discussed the many training opportunities for staff. At the time of the inspection many staff were attending training at the home in moving and handling and health and safety issues. All new staff work through a full induction package to ensure they have the foundation skills to enable them to do their job effectively. Staff told us of the many training sessions that they have recently attended, including protection of vulnerable adults, fire safety, moving and handling and challenging behaviour training. They said that they thought the training was good and in sufficient quantity and frequency for them to do their job. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service can have confidence in the care home because it is led and managed appropriately Evidence: Mrs Lesley Hughes continues in her role as care home manager. Mrs Hughes has the experience and knowledge to run the home on a day-to-day basis. People offered positive comments on the direction and leadership of the manager, very supportive. One person using the service came to us and said that manager was genuinely put together. The AQAA which was completed by the manager in November 2009 contains some excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to the people using the service. The home recognises the areas that it still needs to improve, and has clearly detailed the ways in which they are planning to do this. Care Homes for Older People Page 24 of 28 Evidence: The manager explained the systems in place for assessing the quality of the service. Regular audits and checks are made at regular intervals to ensure the home is operating safely and in the way it says it does. There are plans for a satisfaction survey to be developed and distributed to people using the service and those involved with the service. We looked at systems for safekeeping of peoples money and found they were in good order. The home has good records of all transactions and obtains receipts and the persons signature whenever possible. This will reduce the risk of errors occurring with peoples money and give the added peace of mind to the people living in the home. The manager confirmed that health and safety checks for the building and the equipment are carried out regularly with the findings documented. These checks ensure that the health, safety and welfare of people living in, working in and visiting the home are promoted and protected. 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 1 1 Details of the weekly fees should be included in the service user guide. This will ensure people have the information to enable them to make decisions of whether to move into the home. Improvements should be made to the social aspects of food, to ensure that dining is seen as a pleasurable experience. Systems should be in place to ensure the home is in a clean hygienic state and free from odours. The home should achieve a ratio of 50 of trained care staff at NVQ in care levels 2 or above. This will ensure staff have the skills to provide a consistent and effective service. 2 15 3 4 26 28 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!