Care Home: Crossways

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What the care home does well The information about how the home works and who it is for (the statement of purpose and service users guide) called a guide to living at Crossways was clear and well documented. People`s needs are checked before they move into the home to make sure that the staff have the information necessary to make a decision about whether the person`s needs can be met at the home. The home has an established staff team who are keen for high standards to be maintained. Residents` plans of care and individual case notes were well written and reflected each person`s needs so that staff would know how to meet those needs. Meals were varied and reflected people`s individual preferences. They offered choice and variety. The meals are home cooked and fresh vegetables are used. The people who live at Crossways commented, "The food is good", "I like the meals here" and "I asked for a meal that wasn`t one of today`s choices and it was provided for me". There is a wide range of activities that people can join in with, and some people who live at Crossways are supported by staff or relatives and friends to take part in activities in the wider community. People who live at the home confirmed that there were activities available and they could join in with them if they wish. This helps to make sure they are able to take part in social interaction and stay active. A good standard of hygiene was seen throughout the communal (shared) areas and the standard of decor was good. There is a programme of maintenance and redecoration for the home to make sure that it is always well maintained and comfortable for the people living there. People`s bedrooms were individualised and thought had been given to making sure there is enough light and fresh air to ensure their comfort. People who live at the home said, "I always receive the support and care I need. I always like the meals", "The home is usually fresh and clean and there are usually enough staff on to meet my needs" and "The home is always fresh and clean and the meals are good". Staff said, "Very caring home. Staff try to understand everyone`s needs" and "My induction mostly covered everything I needed to know about the job. There are usually enough staff on to meet people`s needs". What has improved since the last inspection? The medication policy is now followed by the staff to ensure there are no errors in the records of the medication sheets. Each staff member now receives regular supervision from their line manager. The programme of maintenance and redecoration has continued and improvements in the environment have been made and are continuing. What the care home could do better: We made recommendations about having details of people`s religious preferences and ethnicity on the form that is completed with people before they move in so that a full picture of a person`s needs could be seen. We also suggested that staff appraisals be completed annually and that copies of the gas safety and electrical system should be kept at the home to show that these are safe. Key inspection report Care homes for older people Name: Address: Crossways Station Road Lostock Gralam Northwich Cheshire CW9 7PN     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: Maureen Brown     Date: 2 6 0 8 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 27 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 27 Information about the care home Name of care home: Address: Crossways Station Road Lostock Gralam Northwich Cheshire CW9 7PN 0160645559 0160646059 sue.houghton@clsgroup.org.uk www.clsgroup.org.uk CLS Care Services Limited care home 39 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person 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. The maximum number of service users who can be accommodated is: 39. Date of last inspection Brief description of the care home Crossways is a registered care home, providing accommodation for 39 older people. It is run by CLS Care Services, a not for profit organisation which runs a number of homes in the northwest of England. The home was purpose built in the 1980s and has single bedrooms on the ground and first floors. Two of the bedrooms are large enough to be used as doubles or twins if required. The home is located in a well- established residential area. It has a small courtyard and garden area for the people who live at the home and their visitors to Care Homes for Older People Page 4 of 27 Over 65 39 0 Brief description of the care home use. Local community amenities such as shops, churches and bus stop are within a short walking distance. There are good links with the local community and relatives of people who live at Crossways. The range of fees for the home is 470.00 pounds to 510.00 pounds per week. Additional charges are made for newspapers, hairdressing, toiletries, holidays and a contribution towards outings. People interested in moving into the home are able to read the latest inspection report, which is available in a copy of the service user guide for the home in the entrance hall. A copy of this guide is also in each bedroom. Other information about the home and CLS is available in leaflets on display in the hall. These outline the lifestyle that people can expect when they move into the home. Care Homes for Older People Page 5 of 27 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: We carried out an unannounced visit to the home on 26 August 2009 and the visit lasted nine hours. It was done by one inspector. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. The visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to people who live in the home and staff members to find out their views about Crossways. Other information received about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of four people who live in the home, to see how their needs were being met. We also looked at four staff files to ensure that thorough recruitment processes had Care Homes for Older People Page 6 of 27 taken place and that people who live at Crossways were safeguarded from harm and supported safely. We spoke with some of the people who live at Crossways, the manager and members of staff who were on duty during this visit., They all gave their views about the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: We made recommendations about having details of peoples religious preferences and ethnicity on the form that is completed with people before they move in so that a full picture of a persons needs could be seen. We also suggested that staff appraisals be completed annually and that copies of the gas safety and electrical system should be kept at the home to show that these are safe. Care Homes for Older People Page 8 of 27 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 27 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 27 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 receive good information about the home for them to make an informed decision about moving into the home and their needs are assessed before they move in so they know that these can be met at Crossways. Evidence: We saw a copy of the information that tells people how the home works, Your guide to living at Crossways. It contained the statement of purpose, service users guide and our last report about the home. It had been updated in July 2009 and was available in larger than standard print with many pictures included and was written in plain English. Other languages and formats were available for these documents on request. Other information included details of the provider, manager and staff, aims and objectives, facilities and amenities and complaints procedure. Other information that was available was The Companion, which is a newsletter produced by CLS for residents and friends. It gives general information about the Care Homes for Older People Page 11 of 27 Evidence: company, what has been happening in the homes around the region and a message board for people to use. There was also the newsletter from the Relatives and Residents Association available in the entrance hall. This is an independent charity for care home residents and their relatives. The newsletter had a range of information for people to look at and also contained a checklist about whether or not people are getting the right support in the home. A document was available for staff to use with people before they move into the home to check on what their needs are. This covers personal information, details of the next of kin and GP, all aspects of personal and health care needs, medical history, general activities and it was signed by the assessor and the person requiring support or their representative. This information is used to make sure that people who move in can be well supported by the staff team. It was recommended that a persons religious beliefs and ethnicity is included in this document to show a full picture of a person and their needs. The manager confirmed that intermediate care was not provided at Crossways. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal and social needs of people living in the home are met effectively by the staff team in a way that enables them to maintain their privacy and dignity. Evidence: We looked at the care plans of four people who live at Crossways, to check the care they receive. They were well written and contained details that had been obtained when the person moved in, relevant personal information, care plans and reviews. There were also details about visits from health care professionals to check on peoples health care needs, risk assessments and daily records. Progress record sheets were completed with details of activities undertaken and changes in a persons wellbeing. These records were signed by the carer. Details of any visitors they had received were also recorded so that staff and others could see that people were well and active. All the files had reviews of the care plans to make sure that these were up to date and still effective. Some of the people in the home were not able to confirm that they had been involved in the planning or reviewing of their own care; however, they were able Care Homes for Older People Page 13 of 27 Evidence: to confirm that staff helped them when they needed it such as with personal care tasks. Risk assessments were included in the care plans. These were up to date and had been carried out for activities such as moving and handling, falls, moving around the home unattended, pressure sores and malnutrition. The risk assessments were completed to make sure that people were safe in their daily activities and that any help they might need was identified. The medication for people living in the home is stored in a locked medication trolley. A monitored dosage system is used which is supplied by the local chemist, Medication administration records sheets were completed when medication was given to people by staff to confirm they have received their medicines as prescribed by their doctors. Staff had completed medication awareness training to help make sure that those who give out medication know how to do it safely so that errors do not happen. Some people needed controlled drugs and we saw these were stored and recorded in an appropriate manner. We checked these during this visit and found them to be correct. Visits from health care professionals were recorded and it was seen that GPs, district nurses, optician, dentist and chiropodist visit the home regularly to make sure that people remain well. Care Homes for Older People Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are well managed and people living at Crossways receive a varied diet they enjoy so they have daily variation and interest in their activities. Evidence: An activities co-ordinator is employed at the home for twenty-five hours each week, which helps to ensure that the people who live at Crossways have a varied programme of activities throughout the week. The activities file has a record of the activities that each person has taken part in as well as photographs of activities taking place. The activities programme includes coffee mornings, quizzes, bingo, music for health, spending time in the garden, bean bag or ball games, singalongs, skittles, drawing and karaoke. Other activities include birthday parties, Christmas lunch and party, carol concert and harpist concert. The home also has a shop trolley which has a range of products that the people who live in Crossways can make purchases from. Days throughout the year such as St Georges Day, St Patricks day and Burns night are celebrated in the home, alongside Christmas and Easter. The manager said that they are starting to work on a daily activity plan and weekly activity plans for each person to go alongside the current system. The manager also explained that they had tried to introduce a day care element to the home, but that take up of this service had been poor and she felt that this was due to a large social services day care provision in the Care Homes for Older People Page 15 of 27 Evidence: area. Entertainers come into the home regularly and staff take people who live at Crossways to the local town. The residents have recently been to Knowsley Safari Park and often will go out and about in the local community with family members or friends. Religious services are held on a monthly basis and they will visit on request. People who live at Crossways can see their visitors in one of the lounges, the dining room, any of the quiet areas around the home or their own bedrooms. There are no restrictions on visiting and during our visit to the home we saw that staff welcomed visitors into the home and offered them refreshments. We looked at the menus which run on a four weekly programme. The meals provided are mainly a traditional type that people living in the home would enjoy. The meals were home cooked and freshly prepared by the cook. The cook told us that he knows peoples preferences and that some people had smaller portions as they had smaller appetites. There were a good variety of meals with a choice of main meal and desert. A menu sheet is taken to each person during the previous day and they choose what they want to eat on the following day. This is used as a guide to preparing the following day. However, the cook said that extra meals were made so that if someone changed their mind then this could be accommodated. Also when they introduce new meals they have taster sessions and discuss them with the people who live at the home. The cook confirmed that if a person doesnt want either of the choices on the menu then they will discuss what they would like and he will prepare that. During our visit one of the people didnt want the meal on offer and in discussion with the cook decided to have a sandwich instead. Records were kept of the meals served, the temperatures of hot meals as well as the temperatures of the fridges and freezers to ensure all food is kept at the appropriate temperature. Care Homes for Older People Page 16 of 27 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. The homes procedures for complaints and safeguarding are effective so that the concerns of people who live at Crossways are listened to and they are protected from abuse or harm. Evidence: We looked at staff files during our visit and these showed that staff had completed training about safeguarding adults. The manager confirmed this and showed that she was aware of the policy, procedure and guidance on safeguarding. There were also policies available in the home on physical restraint, physical intervention by staff, POVA guidance, recognising and reporting abuse of a vulnerable adult and violence to staff. The home had one safeguarding issue which was still ongoing; although the person it related to was no longer at the home, the issue was still being investigated by the police, but the home had no further involvement in this case. The training and the policies helped to make sure that staff would know what to do to protect people living at Crossways from abuse. The complaints procedure we saw was satisfactory and contained details of how to contact us. We have not received any complaints about Crossways since our last inspection there. The home had not received any complaints over the last year. People who live at the home said they would contact the staff or manager if they had any concerns or problems. Care Homes for Older People Page 17 of 27 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 maintained so that the people who live at Crossways live in clean, comfortable and safe surroundings. Evidence: During our visit we walked round the building and we saw all the shared (communal) areas as well as a number of bedrooms. There are thirty-nine single bedrooms, two of which are en-suite. The home was clean and odour free in all the communal areas and most of the bedrooms visited. Two bedrooms had an odour of urine and it was suggested that steps be taken to eliminate this odour, either by deep cleaning or change of flooring. A programme of maintenance and redecoration was in place and ongoing to make sure that the home remained safe and comfortable for the people living there. At the time of this visit the courtyard was being renewed and the workmen had to go through part of the dining area to achieve this. This meant that this area of the home was very dusty and the staff were taking steps to ensure it was kept as clean as possible. The workmen were due to complete their work shortly and the manager confirmed that the flooring in the dining area would be replaced with wooden flooring once the workmen had completed their job. Other areas of work that had been completed since the last visit included redecoration Care Homes for Older People Page 18 of 27 Evidence: of all corridors, a bathroom and fifteen bedrooms, replacement of upstairs corridor carpet and five bedroom carpets, new raised beds and patio area and new fencing in the garden to make this a secure area for people to walk in. Also the courtyard is being re-landscaped to include raised beds, a water feature and block paving. All this work helps to keep the home is a good state of repair and improve the environment for the people who live at Crossways. Care Homes for Older People Page 19 of 27 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 living at Crossways are supported by well trained, effective staff who have gone through a thorough recruitment process, so that peoples needs are met and they are safe from possible harm or poor practice. Evidence: The staff rotas showed the numbers of staff on duty over the week. There were four care staff and a care team leader on duty each day. The manager said that the staffing levels were a bit higher at the moment because one person was currently being nursed in bed. Other staff such as the manager, cook and domestic staff support the care staff team at the home. People who live at Crossways confirmed there were enough staff around to help them and during this visit we saw that staff were attentive to peoples needs. We checked four staff files and they all had the necessary pre-employment checks in place including Criminal Records Bureau checks, proof of identity, references and completed application forms. These checks are carried out to make sure that staff are suitable to work with the people who live at Crossways. The training staff had received included an induction course, moving and handling, safeguarding adults, infection control, dementia, first aid, fire safety, medication and customer care. Other courses they had done included palliative care, food safety and Care Homes for Older People Page 20 of 27 Evidence: national vocational qualifications in care. Within the training file we saw copies of certificates from training courses, courses completed and when they are due to be retaken. Staff meetings are held regularly. They are split into meetings for care team leaders days and nights, care staff, domestic staff and full team meetings. These meetings help make sure that the managers and staff know what is happening in the home, about any changes that are needed and that things continue to be run in the best interests of the people who live in the home. Excellent progress has been made with National Vocational Qualification (NVQ) level 2 in care. Eighteen out of twenty-four staff have obtained this award. This means that a high percentage of staff have a nationally recognised qualification in care to help them provide good quality support for the people who live at Crossways. Care Homes for Older People Page 21 of 27 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. Crossways is well managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there are promoted and protected and that the home is run in the best interests of the people who live there. Evidence: The manager has many years experience in providing care for older people. She has worked for CLS for ten years and has been the manager at Crossways for a year. She was registered with the commission in September 2008. Prior to working for CLS she worked in the private sector and the NHS. She has completed the registered managers award, A1 Assessors course and other courses as required to update her knowledge and skills. She has completed a CLS self assessment of Crossways in which she marked herself and the home against the current standards for care homes for older people. This is a useful process to undertake to show that she has audited the service and to help plan the future needs of Crossways. During our visit we saw the document and were able to use some of this information to inform our inspection process. The manager knows the service well and can make sure that it is run well for the people Care Homes for Older People Page 22 of 27 Evidence: who live there. There is a quality assurance process for the home which includes residents meetings, surveys given out to people who live in the home, relatives and visiting professionals and monthly visits to the home by the provider. Residents meetings are held on a regular basis with records kept and we saw these at the time of our visit. The most recent satisfaction surveys about Crossways were completed in August 2008 and were due to be completed again. They are given to people who live in the home, their relatives and visiting professionals. An analysis of each group of information had been produced and was available for people to look at. People who live at the home commented, I am very happy, well cared for and my family feel the same, Happy with everything, Any problems that I might have are sorted out promptly and Staff are wonderful, if you ask for anything the staff will accommodate you. Relatives commented, My family are very grateful for the love, care and support offered by Crossways to Mum, Dignity and Kindness is shown by all the staff, My Mum appears happy and praised the level of care and Mum is very happy and that makes me happy and gives me peace of mind. Other professionals commented, Friendly staff and helpful, Residents seem content, Good quality care and Provide a homely environment. A representative of CLS visits the home monthly to check on how it is running and produces a report of each visit. Copies of these reports are kept at the home and were seen during this visit. No issues or concerns have been raised recently in these reports. The manager confirmed that money was held at the home for a number of people who live there. The administrator showed us the system used. Each person has their own record sheet of expenses and the money is kept securely in the home so it is safe. We looked at the records of several residents finances and found these to be correct. Day to day supervision of staff was good and formal supervision is undertaken regularly with records kept. Annual appraisals had been carried out in the past with records kept. However, these were now out overdue and a recommendation was made regarding this. These ensure that staff have a chance to discuss their work with managers so they can continue to provide good quality care for the people who live at Crossways. Safe working practices were in place in the home. There were up to date safety checks on the homes electrical system and gas installation. However, although appropriate Care Homes for Older People Page 23 of 27 Evidence: checks had been completed on the gas system, a certificate had not been issued at the home and it was recommended that this be obtained from the engineer, so there is a copy in the home to confirm that the system is safe. Also the copy of the electrical system is held centrally and it is recommended that a copy be kept in the home to confirm that the system is also safe. We checked the accident records and procedures, and the fire safety equipment tests log book. Both these were up to date with good records kept. There were policies and procedures with regard to safe working practices within the home and these included health and safety, food safety, infection control, prevention and management of falls, moving and handling and safe use of chemicals. The home also had a policy on smoking which stated that a smoking lounge was available for people who were resident prior to 2007 but that any new residents, relatives or staff must smoke in the appropriate outside area. The home also has a policy on gifts and loans which stated that staff must never accept gifts of money from service users...and that a small gift of up to 20.00 pounds can be accepted from relatives. It also made clear that staff must not witness a residents will. However, we noted that no mention was made about benefiting from a will of a person living at Crossways. This was discussed with the manager and the business support manager who was at the home at the time and had recently reviewed this policy. It was suggested that the company may wish to re-review this policy. The business support manager stated that if a member of staff was thought to have fraudulently received money from a resident then this was be reported to safeguarding under financial abuse. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 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 3 Information about a persons religious beliefs and ethnicity should be included in the information gathered about them before they move into Crossways to show a full picture of a person and their needs. Appraisals should be carried out on an annual basis so that staff have the opportunity to discuss their work and development with their line manager. Copies of the gas safety and electrical safety certificates should be kept at the home so that proof is available that the home is safe for the people who live there. 2 36 3 38 Care Homes for Older People Page 26 of 27 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). 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