Care Home: Dovercourt House

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What the care home does well People enjoy living at Dovercourt House. People made positive comments about all aspects of the service and these can be read in individual sections of this report. The home is well managed in the interests of the people who live there. The manager is competent and experienced and people spoken with were complimentary about the way she manages the service. People are supported by a competent, stable staff team. The relatives of people living in the home spoke favourably about the way staff provide care. People`s healthcare needs are well met and there are good relationships between the home and healthcare professionals. There is a range of activities in place that are designed to meet peoples wishes and needs. The relatives of people using the service said the lifestyle provided at Dovercourt House is good. The home encourages and promotes the involvement of family and friends. Relatives told us they are made welcome and are consulted about their relative`s care. What has improved since the last inspection? There has been redecoration and refurbishment throughout the home as part of the ongoing programme of maintenance and redecoration, including people`s individual bedrooms. The system for the ordering, storage, administration and recording of medication has been updated and improved. People living in Dovercourt House can be confident that they will be supported appropriately with any medication that is prescribed for them. What the care home could do better: They could look at ways of improving signage around the home. Good, clear signage that includes pictures, familiar objects and memorabilia can help people who are becoming forgetful or confused or who have dementia to understand their surroundings better. Key inspection report Care homes for older people Name: Address: Dovercourt House 23 Fronks Road Dovercourt Harwich Essex CO12 3RJ     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: Ray Finney     Date: 0 6 0 7 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: Dovercourt House 23 Fronks Road Dovercourt Harwich Essex CO12 3RJ 01255506010 01255553099 miketibbles@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Amanda Jane Tibbles,Mr Michael Frederick Tibbles care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: One named person, whose name was made known to the Commission in January 2003, under the age of 65 years, who only falls within the category of mental disorder (not to exceed 1 person) Person of either sex, aged 65 years and over, who only fall within the category of mental disorder (not to exceed 4 persons) Persons of either sex, aged 65 years and over, who only fall within the category of dementia (not to exceed 27 persons) The total number of service users accommodated in the home must not exceed 27 persons Date of last inspection 0 0 Over 65 27 4 Care Homes for Older People Page 4 of 27 Brief description of the care home Dovercourt House is a large property refurbished from two substantial buildings situated in a residential area of Dovercourt, near Harwich. The home provides accommodation for older people with varying needs. Car parking is available in the road outside the home. The home is located close to local amenities and the sea front with good bus routes to other areas. Most of the accommodation is provided in single rooms, some of which have en-suite facilities. Access to the upper floors is provided by stairs or a passenger lift. Communal areas include two lounges and a pleasant dining room. The home has well-maintained and attractive gardens to the rear with picturesque sea views. The home charges between £390.54 and £440.00 per week. Toiletries are provided by the home; there are additional charges for hairdressing services and chiropody. This information was provided to us in July 2009. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of the service was completed on 13th July 2007. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as care plans, rotas, menus and personnel files. The manager completed an Annual Quality Assurance Assessment, which is required by law to be completed by the service, with information about the home and sent it to us at the Commission when requested. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 6th July 2009 and included a tour of the premises, discussions with people living in the home, members of staff and visiting relatives. On the day of the inspection we had a telephone conversation with a healthcare professional who gave us their views on the service provided. Observations of how members of staff interact and communicate with people living in the home have also Care Homes for Older People Page 6 of 27 been taken into account. On the day of the inspection we were given every assistance from the proprietors and the staff team 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: 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 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 9 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. Through the comprehensive admission process people choosing to live at Dovercourt House can be confident their needs will be met. Evidence: The manager told us in the AQAA, residents needs are assessed to ensure this is the right choice of home. Families informed at all stages. Through discussions with the manager on the day of the inspection, it is evident that there is a comprehensive assessment programme in place to assess the needs of anyone wishing to move in to the home and ensure they are able to meet those needs. The manager spoke with confidence and knowledge about the importance of a good pre-admission assessment process. A sample of four care plans examined all contained a pre-admission assessment. The assessment process documents on overview or history of the individual and records Care Homes for Older People Page 10 of 27 Evidence: the service users view of their needs. The assessment looks at the persons needs around mobility, nutrition, communication, personal hygiene, medication, mental state, sleep pattern, socialisation and personal preferences. Where people are placed by the local authority, there is also a Com 5 assessment of the persons needs carried out by the care manager. People have a contract of terms and conditions signed by the proprietor and the resident or their representative, so that it is clear what the service will provide. Care Homes for Older People Page 11 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. People using the service can expect their personal and healthcare needs to be identified and to be provided with the support to ensure these needs are met as they would wish. Evidence: The manager told us in the AQAA that there is, comprehensive recording in the care plans of all services received by a resident and some of the things they do well are, care in maintaining personal and oral hygiene of each resident. Identifying the risk of pressure sores. Excellent liaison and support from health professionals. Nutritional screening undertaken and details recorded. Access to GPs and specialist services available and promoted. Residents privacy and dignity respected at all times. On the day of the inspection a sample of four care plans was examined. The care plans identify the care need, the objective for the person and the detailed approach of how that care need is met. There are good details in the care programme for night care that specify what the Care Homes for Older People Page 12 of 27 Evidence: individuals needs and wishes are around rest and sleeping. There are details of what aids or equipment are required, the persons needs around continence at night, whether the person wishes or requires staff to check on them during the night , their preferences around whether the light remains on or is turned off and whether they prefer to have the bedroom door open or closed. Each person has a manual handling assessment in place that sets out details of factors that have an impact on the persons manual handling needs. These include behavioural risk factors, physical risk factors, any identified handling constraints such as pain or skin condition and there is a history of falls. Any equipment normally required for safe moving and handling of the individual is recorded. The manual handling care plan identifies problems and capabilities around walking, standing. transfers and bathing which specify what the person can do independently and what assistance is required from staff. We observed that good practices were being followed when supporting people with their moving and handling needs. Staff spoken with were knowledgeable about peoples individual needs and abilities. Care plans contain a detailed section on the persons routines and habits. This records what time the person likes to get up, their preferences for what to do in the mornings, afternoons, evenings and what time they prefer to go to bed. One persons daily routine to guide staff stated, in the morning X has breakfast, likes to do crosswords and knitting, listens to music in the lounge. In the afternoon X sometimes has visitors, joins in with aerobics or any other entertainment, likes to help the carers wash up the tea things. In the evening X likes to have a bath or shower, sometimes helps the girls washing up supper things and likes to sit and watch soap operas. Relatives spoken with on the day of the inspection were complimentary and enthusiastic about the care provided by the home. One relative told us they had reservations about placing their relative in a home but it is the best thing we have done and their relatives every need is looked after. Specific individual care plans examined included details of peoples sensory and communication needs, mobility, food and drink, hygiene and grooming, clothes preferences. This range of care plans was developed from peoples assessed needs. Peoples individual files contain ample evidence that peoples healthcare needs are well met. There are records of appointments with and visits from a range of healthcare professionals including doctors, district nursing services, chiropodist, optician, dentist. There are charts completed to monitor peoples weight and, where relevant, to monitor urine testing. Care Homes for Older People Page 13 of 27 Evidence: A healthcare professional spoken with told us, the home meets peoples needs well and takes the relatives needs into account as well. The manager told us in the AQAA that improvements made in the last year included, Reviewed medication handling and recording. Changed to a new supplier of medication with blister packs distribution method. Care plans contain a medication profile that sets out details of the medication that has been prescribed for the person, the dosage, what it is used for and any possible side effects. On the day of the inspection the system for the storage, administration and recording of medication was examined and found to be robust. There is appropriate secure storage for medication including a controlled drugs cupboard. Medicine Administration Record (MAR) sheets examined were completed appropriately and records were well organised. Staff spoken with were aware of their responsibilities around following appropriate procedures when dealing with medication. 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 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 people who live there with variety and choice in their daily lives and peoples expectations and preferences with regard to lifestyle are well met. Evidence: The manager told us in the AQAA improvements around activities in the past year include, more professional companies utilised for activities. Use personal entertainment systems such as Nintendo DS and they continually seek other forms of entertainment for the residents to improve daily living. The AQAA also stated, social contact is maintained as per residents preferences and organised outings to outdoor activities for those residents able to transport [are arranged]. Care plans examined contained details of activities that people take part in, such as sing-alongs, quizzes and games. On the day of the inspection there was a visiting entertainer which people had enjoyed. On the day of the inspection there were visitors coming and going throughout the day. Two relatives spoken with were very positive about the support provided and the lifestyle that their relative enjoys in the home. They said they visited every few days and there was always something going on. Care Homes for Older People Page 15 of 27 Evidence: Peoples religious and spiritual needs are catered for, including a regular visit by someone from a local church. Many of the people living in Dovercourt House were unable to discuss with us how they make choices. However, relatives spoken with told us that staff listen to their wishes and go out of their way to find out what people want and enjoy. Care plans record the things that people like and also what they dislike. One persons plan records that they do not like to wear trousers, only skirts or a dress. Another states that the person likes a certain brand of lipstick and likes to have nails manicured. Care plans also record areas where people are able to maintain their independence and how they are encouraged to do this. It was evident from discussions with the manager and staff that they know people well and go to great lengths to ensure people are treated in ways that they prefer. We also observed good interactions between staff and people living in the home, which were calming, relaxed and caring. Three relatives spoken with were very positive about the support provided for their relatives. One said it, couldnt be better and another told us the lifestyle is, wonderful. Food is home cooked and a range of fresh and frozen ingredients is used including fresh fruit and vegetables. Relatives spoken with told us the food is, very good. Care plans record if people are unable to express choices in the menu and there is information about how they have been made aware of the persons likes and dislikes from family members or others who know the person well. 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. People using the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: The manager told us in the AQAA, all complaints investigated thoroughly and dealt with promptly and efficiently once all the facts have been gathered. Only one complaint received in 5 years of owning the home. As previously reported, Dovercourt House continues to have a robust complaints policy in place and the process for recording complaints and dealing with issues is appropriate. There have been no complaints received by us or recorded in the homes complaints log since the last inspection. There is ample evidence of letters and cards that have been received from relatives and friends of people using the service complimenting the home. It was evident from discussions with the management team that the ethos of the home is to take every concern seriously and deal with minor issues as they arise to ensure people are happy. Relatives spoken with were confident any concerns they may have would be dealt with appropriately but they said they had not had any reason to complain. Any little Care Homes for Older People Page 17 of 27 Evidence: concerns are dealt with straight away. A healthcare professional spoken with told us they receive no complaints from anyone they place there. The manager told us in the AQAA, Policies in place to safeguard residents from any type of potential abuse. Safe storage of money. Physical and verbal aggression is understood by staff and they are trained in dealing with it. Policies include whistle blowing and reporting acts of neglect and CRB and POVA checks carried out. As at the previous inspection, there is a robust recruitment process in place that ensures relevant checks are carried out before someone is employed. Personnel records examined contain evidence that staff have had training around safeguarding (previously referred to as Protection of Vulnerable Adults or POVA). Members of staff spoken with were able to demonstrate a good understanding of their responsibilities around recognising and reporting any suspicions of abuse or poor practice. Records examined also show that people are supported appropriately with their finances and there is a robust process in place for recording individual transactions. Care Homes for Older People Page 18 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. People can enjoy living in an environment that suits their lifestyle and which is homely, well maintained and clean. Evidence: The manager told us in the AQAA they, provide a safe, accessible, well maintained home that meets the residents needs and improvements include, Garden makeover. Furnishings and decoration continually upgraded. More water temperature valves replaced. Window restrictors fitted. More radiator covers utilised. As at the previous inspection, a tour of the premises confirmed that Dovercourt House continues to carry out a programme of maintenance and re-decoration. Communal areas are homely and the furnishings are of good quality and well maintained. Peoples individual rooms are personalised with a wide range of possessions, including photographs, ornaments and memorabilia. We discussed with the proprietors the benefits of good, clear signage to help orientate people who are becoming increasingly forgetful or confused and also and stimulate people whose dementia is more developed. This includes the use of photographs, pictures, memorabilia or familiar objects. This is one area where the service could consider making improvements. Care Homes for Older People Page 19 of 27 Evidence: The manager told us in the AQAA, Comprehensive maintenance programme and substantial financial investment have transformed the home into a comfortable and well maintained building for the benefit of the residents living here. Liquid soap and paper towels are provided in toilet and bathroom areas so that good practices can be followed around hand washing in order to promote infection control. On the day of the inspection staff practices around infection control such as hand washing were observed to be good. The standard of cleanliness throughout the home is high and everywhere is fresh and odour-free. The management team put a high value on cleanliness and told us it is important to keep on top of regular cleaning, particularly flooring, to prevent odours. On the day of the inspection the proprietor was purchasing another carpet cleaning machine. Credit must be given for the high standards achieved, particularly in a property of this age, where maintenance and repairs are continually required. The gardens are also maintained to a high standard and are very pleasant with beautiful views over the sea. The proprietor is in the process of planning a raised decking area or viewing platform so that people can enjoy the view better. Care Homes for Older People Page 20 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 in the home can be confident they are cared for by a competent staff team who can meet their needs. Evidence: The manager told us in the AQAA that what they do well includes, High proportion of staff with NVQ [National Vocational Qualification] level 2 or higher [95 per cent]. New staff carefully selected to maintain high levels of care and reputation within the community. Very low turnover of staff. Records examined confirm that staffing levels are appropriate for the size of the home and the needs of the people living there. On a typical shift there are three carers, a senior care manager and the manager, who also takes a hands on role. At night there are two awake staff to deal with peoples night care needs. On the day of the inspection staffing levels were observed to be good and peoples needs were being attended to promptly. The staffing levels enabled staff to care for people in a relaxed manner, no-one was being hurried or waiting to have their needs attended to and staff were able to spend time talking to people. Staff spoken with on the day of the inspection were able to demonstrate a sound knowledge of good care practices and of the specific needs of individuals living in the home. Care Homes for Older People Page 21 of 27 Evidence: The relatives of someone living in the home told us, the staff are very good, nothing is too much trouble for them. A sample of three personnel records examined were well organised with a checklist of contents on the front. All contained appropriate documentation as required by regulations including proofs of identity, two written references, appropriately completed application forms with no unexplained gaps in employment history and enhanced Criminal Record Bureau checks. The manager told us in the AQAA that improvements in the past year include, New training packs purchased for dementia awareness. Sourcing training providers for a range of other appropriate staff training. More courses arranged. Refresher training implemented. Personnel records examined contained evidence that staff undergo a formal induction when they commence work. Staff training in the past year included Basic Food Hygiene, Basic First Aid and Manual Handling. Staff have also completed training to enable them to support peoples needs around specific conditions including diabetes and dementia. Basic awareness of diabetes training was provided by the Primary Care Trust. A healthcare professional spoken with told us that the manager is, very good at training staff about dementia. Staff spoken with were also able to demonstrate a sound knowledge of their responsibilities. Care Homes for Older People Page 22 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 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 appropriately managed in the best interests of people living there. Evidence: The manager told us in the AQAA that what they do well is, Hands on management of the home in a competent and professional manner to meet the needs of the residents that reside here and maintain a homely environment. To continually monitor the health, safety and welfare of residents and staff and comply with all relevant legislation concerning the running of the home. Dovercourt House is run on a day to day basis by the providers, who both have their particular area of expertise and who work well together as a team. The proprietors provided ample evidence to demonstrate an awareness of their responsibilities and a commitment to providing a good service. People spoken with were complimentary about the way the home is managed, including a healthcare professional that told us that Dovercourt House is very well Care Homes for Older People Page 23 of 27 Evidence: run. The AQAA submitted by the manager prior to the inspection was completed to a good standard and contained appropriate information about all aspects of the home and the service it provides. Other evidence examined as part of the inspection process confirmed that the information in the AQAA was accurate. The manager told us in the AQAA that they, conduct a Quality Assurance Audit of all services linked to the home including residents representatives, professional colleagues and staff. They stated,managers meetings, staff meetings and regular contact with residents and their families contribute towards incorporation of ideas and views of people connected to the home. Improvements made as a result of these consultations include, thicker chair pads, better entertainment and a garden makeover including a gazebo and benches. The manager stated in the AQAA that they had, excellent feed back from quality assurance audits to health professionals, families and representatives and they plan to, review comments and action any suggested improvements. On the day of the inspection we discussed the homes Quality Assurance process with the providers and examined the Quality Assurance records. It was evident from the information examined that the ethos of the service is that it values the views and opinions of the people living in the home and their relatives. Relatives of people living in the home spoken with on the day of the inspection told us their opinions and views are listened to and valued. It is evident from personnel records examined that there is a robust system in place for the supervision of staff. The supervision process included formal one-to-one supervisions and observations of practices. On the day of the inspection staff spoken with felt well supported. A sample of health and safety documents examined were all in order, including maintenance certificates for the lift, hoist, assisted bath, the fire alarm system and fire equipment. It was evident from a tour of the home that the premises and grounds are well maintained. 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 19 The management team could consider how they could improve the environment for people who are forgetful or confused by using a range of signage. 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). 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 27 of 27 - 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. 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