Care Home: Claydon Lodge

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What the care home does well People living at the home told us `Life is good here, it`s like being at home`, `The staff are very good here and they always do the best for us`, `We feel safe here and well looked after`. There were suitable systems in place to ensure peoples` healthcare needs were met and a good relationship has been established with local District Nurses and GP`s. The home was clean, tidy and well presented. One person told us `My room is lovely with my own furniture and TV`. Laundry was promptly done and returned to people. People in the home appeared to be dressed appropriately in well cared for clothing. Staff are suitably recruited with all required checks being in place to ensure staff are suited to work with vulnerable adults. The provision of staff trainig has improved with a schedule of training planned to ensure staff are suitably skilled. What has improved since the last inspection? The home has benefited from the appointment of a manager who has taken steps to introduce new systems in the home and ensure that requirements from the previous visit have been met. The works listed in the fire officers report has been actioned to ensure fire safety is being suitably managed. Steps have been taken to improve monitoring of the quality of the service. The Provider is doing monthly reports and feedback from questionnaires from staff, people who live in the home and relatives has been positive. The systems for ensuring variable dosages of medicines are recorded is in place alongside regular audits of medicines and people were receiving their prescribed treatments. A whistle blowing policy has been introduced and issued to staff. There are now staff in the home who have completed first aid and dementia training since our last visit, this will improve the level of skill that staff have. A skill based induction pack has been obtained. What the care home could do better: Significant progress has been made since our last visit and the majority of the previously listed requirements have been met. The exception to this is the requirement for the manager to formally register with the Care Quality Commission, this has not yet been instigated. A solid foundation appears to have been established with systems being introduced there is now scope to improve these further by improving the level of personalisation in peoples assessments and care plans to include establishing life histories and individual information which will enhance the delivery of care to people. Whilst staff in the home have now received training in dementia care the home has yet to develop a dementia care strategy on how it will meet the needs of people with dementia. Key inspection report Care homes for older people Name: Address: Claydon Lodge Crich Place North Wingfield Chesterfield Derbyshire S42 5LY     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: Bridgette Hill     Date: 1 0 0 3 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Claydon Lodge Crich Place North Wingfield Chesterfield Derbyshire S42 5LY (01246)852435 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): tracymillband@btinternet.com Mr Diwan Chand,Dr. Anjuman Diwan Chand Name of registered manager (if applicable) Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 45. The registered provider may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Claydon Lodge Care Home is located in the village of North Wingfield, which is to the south east of Chesterfield. The home is purpose built and it is registered to provide personal care for up to 45 service users with older persons needs or dementia. The Care Homes for Older People Page 4 of 28 Over 65 0 45 45 0 0 6 1 0 2 0 0 9 Brief description of the care home home is arranged over two floors with lounge and dining areas available on each floor. A passenger lift enables those with mobility problems to access all areas of thehome. The range of fees charged at the home are £345.52 - £364.31 per week with extra charges made for Chiropody, toiletries and newspapers. Some top up fees were also aplicable depending on the type of room to be occupied. The manager gave this information at the inspection. The most recent key inspection report was available in the entrance hall. A Statement of Purpose was available as well as a Residents Welcome Pack. 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 focus of inspections, undertaken by the Care Quality Commission (CQC), is upon outcomes for people and their views of the service provided. This process considers the Homes capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that needs further development. This inspection visit was unannounced undertaken by Bridgette Hill and Brian Marks Regulatory Inspectors. In order to prepare for this visit we looked at all of the information that we have received, or asked for, since the last key inspection of the Agency, which took place on 6th October 2009. This included: The Annual Quality Assurance Assessment (AQAA). This is a document completed by the Registered Providers of the Agency that focuses on how well outcomes are being met for people using the service. The previous Key Inspection Report from our last visit on 6th October 2009 where we considered if the requirements listed had been met. We also received an improvement plan from the Care Homes for Older People Page 6 of 28 Provider on 4th February 2010 which told us how the Provider was going to address the listed requirements. Relevant information from Other Organisations, and what Other People have told us about the service. Surveys returned to us by people using the service, and from the staff working in the service. What the service has told us about things that have happened in the service, these are called Notifications and are a legal requirement. For this inspection of the service the questionnaires (a survey mentioned above) was sent to people using the service, to staff and to relatives to gather their opinions of the service. During this visit to the service case tracking was used as a system to look at the quality of the care provided. This involved looking a sample of peoples care plans in detail. During our visit we also spoke with people who use the service, staff and relatives. We discussed the running of the home with the manager and established what progress had been made since our last visit. 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: Significant progress has been made since our last visit and the majority of the previously listed requirements have been met. The exception to this is the requirement for the manager to formally register with the Care Quality Commission, this has not yet been instigated. A solid foundation appears to have been established with systems being introduced there is now scope to improve these further by improving the level of personalisation in peoples assessments and care plans to include establishing life histories and individual information which will enhance the delivery of care to people. Care Homes for Older People Page 8 of 28 Whilst staff in the home have now received training in dementia care the home has yet to develop a dementia care strategy on how it will meet the needs of people with dementia. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had access to information about the home and were given opportunities to visit. Peoples needs were assessed prior to admission to ensure the home was a suitable place for them to live. Evidence: We looked at the homes Statement of Purpose and Residents Welcome Pack, which had been rewritten since the last inspection and these both met the requirements of the Law and the National Standards. They were written in an informative and straightforward style although the information in the homes Statement of Purpose about how it plans to meet the needs of people with dementia was very brief and did not provide enough detail to help people make an informed choice about living at the home or how dementia care was to be delivered. The Acting manager has introduced a new format since our last visit for recording pre admission assessments. This was a form which the assessor completed by the circling Care Homes for Older People Page 11 of 28 Evidence: words which described the person. This format was limited in providing an interactive and personal prospective of the person as an individual, their understanding, abilities and wishes. The quality assurance assessment completed by the home told us that pre admission visits and trials at the home would be routinely offered to people. The home does not provide intermediate care as the National Minimum Standards defines this. 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. Care plans were in place which were detailed enough to ensure peoples needs would be met. Medicines are competently handled to ensure people received prescribed treatment Evidence: Each person in the home had a plan of care in place which had been written on recently introduced documentation. This was tidily presented in an easy to read format. The care plans in place were sufficient in describing the persons needs and how these were to be met however there was scope to expand and improve on these by increasing the level of personalisation in how care was to be delivered. A range of risk assessment tools were in place in each file to highlight any changes. Examples were seen where changes had taken place which had prompted staff to request advice or medical input. A system of recording monthly reviews of care plans and risk assessments were in Care Homes for Older People Page 13 of 28 Evidence: place. Changes were documented though not always consistently in all of the relevant records. Staff monitored progress though log records which they wrote after each shift. This gave an overview of how the person was and the care delivered. We examined the storage and administration of medicines during our visit. Apart from one spelling mistake the recording on medication administration records appear clear and where medicines were due to be given these were signed for and people were receiving their prescribed treatments. The home had improved recording where variable dosages were prescribed and clear dosage recording was being seen. There had been an introduction of auditing of medication administration records undertaken by all staff. Policies and procedures relating to medicines had been reviewed and fully described procedures in place apart from the assessment of staff competency regarding medications which was advocated but the Acting Manager said this had not been completed. There were clear audit trails of medicines possible with medicines received being documented balances updated and returns receipts were in place. Suitable storage was available for medicines including a dedicated medicines refrigerator. Part of peoples care files was dedicated to recording healthcare input from professionals. Where people had seen healthcare professionals, the chiropodist and GP this was documented with the outcome of the visit. The records also informed us that District nurses were involved in the care of some people and advice had been sought by the home where the risk assessments indicated there was a risk of tissue breakdown for some people. Where this was the case equipment was put in place to protect people. Additionally, from the direct comments we received from people living at the home and the visitors we spoke to, it was clear that the staff at the home work hard to care for people in sensitive and dignified ways, and to keep them as independent as possible. People told us that: The staff are very good here and they always do the best for us, We feel safe here and well looked after, Privacy and dignity are well respected; you only have to ask for something and the staff sort things out for you, I enjoy my life here and everything I need in the way of care is provided, Life is good here, its like being at home. Although most of the people we spoke to were generally in good health they did say that if they needed to see their doctor or nurse there were never any problems: The doctor visits my mum regularly and if there is the least thing happening the manager is on the telephone to us, Care Homes for Older People Page 14 of 28 Evidence: I havent seen the doctor recently but the chiropodist comes regularly and provides a good service. The district nurse arrived to attend to one person as we were speaking to her, and provided treatment to her in private. 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. The home offers people a choice of meals and organises some activities to enhance peoples everyday lives. Evidence: The home currently employs an activities coordinator on a part time basis, but she was on leave during our inspection and we noted that there was nothing structured taking place during the day. We saw a written programme of activities that included gentle exercise, crafts, indoor games, music and personal grooming sessions. The manager also told us about a regular visit by members of the local church who organised a service for a small group of interested people, although one resident we spoke to was unclear about this happening. Staff we spoke to also spoke about opportunities to take individuals out for short walks locally and plans to extend this further during the summer months. They also told us that their current workload is such that they have time to sit and talk throughout the day and we saw this happening during the inspection. The people we spoke to confirmed that they are happy with their lives at the home and that they are able to do very much what they like. They develop their own routines, including spending their time in the communal areas or in their rooms; the Care Homes for Older People Page 16 of 28 Evidence: former is where most people spend their time, although we saw a small number who were in their rooms out of choice. The people we spoke to told us: We set our own routines for getting up and going to bed; we dont get up too early, I read my newspaper every day and there are organised activities sometimes, the singers and bingo are what I like, I like to join in with things, Ive always been like that and have friends here, I like the gentle exercise sessions, they keep me active and I used to be a regular church person but Im not sure what is happening lately, She organises the activities for us but I would like more chance to go on outings. We were told that families are always welcome and the visitors we spoke to described a friendly welcome with a cup of tea always and we could stay for a meal as well if we wanted to. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and she works to a four week menu. They now offer more flexibility since the manager has recently taken on responsibility for managing the food budget and the cook told us how they use local suppliers who guarantee better quality. We noted from a sample of menus that there was a variety of traditional style meals on offer and that a choice at the main meals of the day is available, with a hot option available for breakfast and at teatime. People were positive in their feedback about the standard of food at the home, with several mentioning good quality and quantity: They come and ask about what we want for lunch during the morning, and there is always plenty; youve only got to ask if you want more or if you want something else, The food is just how I like it and very nice, The food is very varied and although I dont like everything I eat most things well, The food is good here and you can get a cooked breakfast when you want; Ive just had poached eggs. One person was less favourable about the food and commented about lack of variety and choice, although he did say that things had improved recently. Arrangements for storage and stock control of food supplies were satisfactory, and we saw evidence that food safety is well managed. The cook deals with people who have special dietary needs, and at the time of the inspection these included diabetic and vegetarian, with softened diets a feature in the past. Her arrangements for these indicated a careful approach to individual needs. 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. Arrangements are in place to safeguard peoples welfare and ensure that their concerns are listened to and acted upon. Evidence: The complaints procedure was on display and accessible to people in a variety of locations around the home. The quality assurance document completed by the home told us there had been no complaints received since our last visit on 6th October 2009. No complaints had also been received by the Care Quality Commission. Some of the people we spoke to seemed unsure about who to speak to if they had any problems or wished to complain. Others told us that they knew the manager and would see her but that weve never had anything to complain about. Since our last visit the Acting has developed a whistle blowing policy. The Providers visit reports informed us that this has been given out to all staff to ensure they have information on how to deal with any concerns they may have. Staff told us about the training they had had in relation to safeguarding the people in their care and had a clear understanding of their responsibilities for reporting any concerns they may have. Training records examined confirmed that most staff have attended training sessions Care Homes for Older People Page 18 of 28 Evidence: in safeguarding adults. The exception to this being where staff were off ill at the time of the training. Since our last inspection there have been 3 safeguarding adult referrals and investigations held. These have now been concluded and some actions implemented as a result which has included staff training and supervisions. Disciplinary processes have not always been robust and some actions taken did not proceed due to processed not being followed however the Provider has given written assurances that suitable procedures are now in place. 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 is well presented and maintained and offers a clean and comfortable environment for the people who live there. Evidence: From a brief tour of the building with the manager and visits to some of the bedrooms we saw how good standards of decoration and furnishing have been maintained, although little had changed since the last inspection. All residents were accommodated on the ground floor and the corridors and doorways were wide to aid mobility and orientation. All bedroom doors had the persons name and photograph and the communal areas were decorated with old advertisements and pictures of the local community. Communal areas were light, warm and comfortable and we also noted that bedrooms had good levels of personalisation to suit individual residents and which create a sense of personal space. All of the rooms on the ground floor were single with ensuite facilities, some with additional personal showers. There was a good range of equipment for staff to help people with mobility difficulties and we noted the mobile hoist in use for one person. Comments from people living at the home were positive about the standards of comfort and cleanliness offered: My room is lovely with my own furniture and TV, The laundry is done every day and Ive had no problems, I think its a lovely place, always very clean and my clothes come back from the laundry the same day, My bedroom is very nice and it is always being cleaned as is everywhere else. The heating has been up high throughout the winter, My mums Care Homes for Older People Page 20 of 28 Evidence: room is very spacious and she brought in some of her own things. The home is always clean and spotless without any offensive smells. Problems identified by the Fire Officer which had not been addressed at the last inspection have now been carried out: the fire doors in the two areas identified have been properly attended to, The Fire Risk Assessment has been rewritten using Fire Service guidelines and full records of fire safety activity have been organised and maintained. On the day of the inspection the home was clean, tidy and free from odours and the laundry room was in good order and well equipped. A system is in place for managing laundry and the manager confirmed that clothing is returned on the same day, and that staffing arrangements for this activity will shortly be improved with the commencement of a new domestic worker. All residents observed in the home were seen wearing clean and well presented clothing. 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. Recruitment practices are robustly followed and regular training has been offered to ensure staff have the skills to meet peoples needs. Evidence: Examination of the duty roster and discussion with staff indicated levels of staff on duty that were satisfactory, with the target of two care staff throughout the day with a third in the mornings (for currently thirteen residents) always being achieved. The acting manager is supernumerary to these numbers and any gaps in the rosters are covered by part time staff working extra hours. Staff told us that the impact of this was for a workload that is not too great physically at present. The people we spoke to confirmed that there was always enough staff on hand to meet peoples needs, and that the call alarm is always quickly responded to for people requiring assistance in their rooms. The commitment and loyalty of staff to the people they cared for was summed up by one who said that as long as the residents are happy then Im happy; were here for them. During the inspection we spoke to all the staff on duty during the early day shift, and they reported that morale was currently good with everybody looking forward to the challenge of bringing the home round to being a place we can be proud of. They told us that there had been few changes in staff at the home since the last inspection, and that the staff group offered stability and consistent care to the people living at the Care Homes for Older People Page 22 of 28 Evidence: home. They told us that: Were all good friends and get on reasonably well in work, Training has picked up again in the past six months and I think most of us have got NVQ, The staff team works well together and I feel very positive about things at the moment, Theres a loyalty towards this home and this place holds me here. The personnel records of the last two carers to be appointed were looked at and they supported that their recruitment had been carried out properly with the right checks being made; these included two written references from previous employment and a check by the Criminal Records Bureau (CRB) being obtained before hands on work actually starts. The only evidence of an induction programme being carried out was for one person who had a days basic orientation of the home and the people living there. We discussed this with the acting manager who told us a skill based pack was available but no new staff had been employed since its introduction. A planned approach was being taken to training and a schedule of training for the next year was available. Staff had completed some first aid and dementia training since our last visit to improve their skills as this was a deficit we identified at our last visit. The training for staff was largely up to date with a few gaps mainly where staff had been sick at the time of the training. The manager told us a skill based induction pack was available but no new staff had yet been employed to utilize this. The home had a staff group of 13 care staff of whom 12 had achieved a relevant care qualification. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed with systems in place to monitor the quality of the service that people receive. Evidence: The home is currently being run by a manager who is suitably qualified. The acting manager has been in post since September 2009 but has yet to apply to be formally registered with the Care Quality Commission. The manager told us this was going to be done but they had not yet commenced the registration process. The feedback from all of the people we spoke to was generally positive about how the home is being run, particularly over the past six months since the appointment of the current acting manager. A number of people commented about the homely style and approachability of managers and staff. The staff we spoke to were also positive about the way the home is being run and how the manager supports them if they have any problems. They told us: The manager is one of the better ones we have had and if youve got any problems she sorts things out right away, The managers door is Care Homes for Older People Page 24 of 28 Evidence: always open and she is good at promoting individual interests, The new manager is doing very well, with paperwork now being done properly and the care plans are more easy to use, Shes there for the residents first and gives us a firm but fair leadership approach. Since our last visit the manager has sent out surveys to people who use the service, staff and relatives. The feedback had not yet been collated but general findings from surveys were that people were happy with the service they received. The Provider was visiting the home on a regular basis and was assessing the quality of the service through monthly written reports wihich included an examination of some records and discussions with people and staff. Suitable arrangements were in place to store small amounts of money for people. The records indicated that balances and receipts were kept. A check of monies indicated that all were accurate apart from one which was 5p different to the amount recorded. The quality assurance document supplied to us by the home indicated to us that all service checks were in date apart from the gas systems in the home. We were provided with evidence after our visit that this has since been completed. We looked at accident records which were recorded individually. An audit of accidents was completed on a monthly basis to establish if there were any trends. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 31 8 The provider must ensure 31/05/2010 that a manager is appointed who is suitably qualified and an application made to register the manager with the Care Quality Commission This is to ensure the home is managed in the best interests of residents The timescale of this has been extended 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 The Statement of Purpose and Service User should be reviewed to improve information to people on how care is delivered to people with dementia The pre admission assessment should be reviewed to allow a person centred approach to assessment to be taken and recorded. This should include the abilities and wishes of the person People would benefit from care plans which contained more detail on their individual preferences, abilities and wishes. 2 3 3 7 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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