Care Home: Drake Court

What the care home does well People who may be considering living at the home are given the information they need to make a choice about living there. All people are assessed before they move in and will have the opportunity to discuss their care needs with the manager. There are activities for people to take part in. The current activity programme is being further developed so that people have more choice. People can feel confident that their views will be listened to and acted upon, should they need to make use of the complaints procedure. The home environment is clean and offers a relaxing place for people to live. What has improved since the last inspection? The home has a registered manager who is gradually improving the care and attention people receive in the home. There has been alot of staff training and more is planned. This will mean that staff are more equipped to deal with the care needs of the people living in the home. Care plans and risk assessments have been developed to make them more person centred. This means individual choices and preferences are included in the care plans and people are more likely to have the care they want as a result. What the care home could do better: People living at the home have told us, repairs and refurbishment take a long time to put right. One person said "I have been waiting for years to have my mother`s room decorated, it has been promised but doesn`t happen", another person said "they can be very slow to mend things, I would like the curtains back in the lounge, I don`t like those blinds". The home has worked to developed it`s care planning system, they need to improve further by recording all of the care they give. This needs to include all the care they give to people in relation to pressure area care such a position changes and application of creams. The manager needs to develop the quality assurance system so that regular audits of medication take place. This will enable the home to recognise errors and put them right. Key inspection report Care homes for older people Name: Address: Drake Court Drake Close Bloxwich Walsall West Midlands WS3 3LW     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: Mandy Beck     Date: 1 5 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 29 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 29 Information about the care home Name of care home: Address: Drake Court Drake Close Bloxwich Walsall West Midlands WS3 3LW 01922476060 01922407555 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Drake Court Healthcare Limited Name of registered manager (if applicable) Tina Marie Tolley Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 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 (OP) 29 Date of last inspection Brief description of the care home Drake Court is a two-storey, purpose built, home situated close to Bloxwich Town Centre and the local amenities it offers. Accommodation is provided for the 29 people in 27 single and 1 double room, all have en-suite toilet facilities. There is small garden with a patio area to the rear, and car parking to the front and side of the building. The most recent inspection report is not on display at the home but a copy is available Care Homes for Older People Page 4 of 29 Over 65 29 0 Brief description of the care home upon request. The current fees included in the Service User Guide are £368.49 per week. This fee does not include extras such as newspapers, toiletries or hairdressing. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of the home, they were given no prior notice that we were going. The inspection was completed in one day by one inspector and one Local Area Manager. We looked at all the information that we have received, or asked for, since the home was last inspected in April 2009. This included the annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have how the home has managed any complaints and safeguarding investigations. Care Homes for Older People Page 6 of 29 What the home has told us about things that have happened in the home, these are called notifications and are a legal requirement. We have also used the information from the random inspection we have made to the home since the last key inspection and also the results of any enforcement action we have taken with the home. We spent time talking to people living in the home and to the staff who support them. People have also provided us with information from surveys we sent to them. We have also included information we have been given from other health care professionals, their comments have been added into the report. We also looked at the care of three people who use this service in depth. This is part of our case tracking process and helps us make judgements about the homes ability to meet peoples needs. Care Homes for Older People Page 7 of 29 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. Care Homes for Older People Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People choosing to live at this home will have all of the information they need in order to help them make a choice. Each person can be confident the home will complete a needs assessment before they move into the home. Evidence: We looked at the information the home provides for people. There is a service user guide and a statement of purpose. Each of these documents tell people what they can expect should they choose to move into the home. In our last inspection report we recommended the home includes the range of fees it charges. This has now been done. The manager told us that the service user guide is not available in alternate formats, such as large print or audio versions. The manager also told us that some people currently using the service would benefit from a large print guide. We have recommended the home considers providing this for peoples use. We looked at the care records of three people in depth during this inspection. In each Care Homes for Older People Page 11 of 29 Evidence: case we saw the home manager had visited people prior to admission to discuss their needs and to make sure that any questions people had about the home could be answered. The manager takes with her a welcome pack, that includes the service user guide and statement of purpose. People are included in the assessment process and the home also requests an assessment from the care manager to make sure that no information is missing. This means the home can be sure that peoples needs are known and the home is able to plan their care for them. We also noted that assessments are regularly updated as peoples needs change. This home does not provide intermediate care facilities. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home get the support and help they want to meet their healthcare needs. Evidence: We looked at the care three people in depth. The home is required to provide each person with care plan that details their needs and how they will be met. In order to do this risk assessments are also used to support the process. We found there has been improvement in this area. Each persons file we looked at had care plans that detailed the care they needed and each plan had been personalised to reflect the persons wishes. Each person is risk assessed for malnutrition, falls, moving and handling and pressure sore development. We looked at one persons care plan and risk assessments in relation to nutrition. The care plan stated that the person should be weighed monthly. We found that this had not been done. There were gaps in the recording of the weight. The last time the weight was recorded for this person was 14/12/09. Another persons file was checked and we saw that the last time they were weighed was 20/12/09. We checked a further Care Homes for Older People Page 13 of 29 Evidence: six files and saw that peoples weights had been recorded in February 2010. We spoke to the manager about these inconsistencies. She told us its because people refuse to be weighed, staff are clearly not recording this. The recording of peoples weights is an ongoing issue in this home. We have made requirements about this in the past. The home has addressed them but does not appear to be able to sustain these improvements. We have made a requirement that peoples weights are recorded at least monthly. The home must record when they have asked people and document the response into the care plan if people choose not to be weighed. We looked at the way the home manages pressure area care. We know they are supported by the district nursing service to do this. We looked at the care plan for one person who has developed pressure sore. We saw that the person had the appropriate equipment in place such as a pressure reducing mattress and cushion but we could not see from the care plan any other interventions the home is doing as part of this persons management. For instance, we could not see any record of positional changes taking place or barrier cream being applied. We know when we spoke to staff that these things were happening but they should also be recorded into the care plan. The home has spent time improving the quality of peoples care plans. They needed to do this so that people were included in the care planning process and also to make sure the care they were planning was actually a reflection of peoples needs and wishes. We spoke to one person who told us I am asked all the time about what I want and if Im happy, If ever I need the doctor they are very quick to call him and get him out. Another person said I feel better since I have been here, they really do look after me. I came out of hospital and felt low but the staff cheer me up. People who answered our surveys said we always get the medical attention we need. We looked at the systems in place for the ordering, safe storage and administration of medication. We found the home has adequate systems in place and medication is mostly administered as the doctor has prescribed it. There are systems in place for the storage and administration of controlled drugs. We looked at the Medication Administration Record (MAR) sheets for people, we found on one persons MAR there was a duplication, this was bought to the managers attention during the inspection and steps were taken to address this. The manager has told us that regular audits of the medication do not take place, we have recommended that this happens to avoid errors occurring in the future. When we visited we found the medication storage rooms were too warm and the home was not storing medication as manufacturers recommended. Care Homes for Older People Page 14 of 29 Evidence: This was an outstanding requirement from our previous inspection, we asked the home to address this urgently. We visited the home a week later and found the problem has been addressed satisfactorily. This means that peoples medication is now being kept at temperatures that are within the recommended guidelines. We spoke to some of the people living in the home during this inspection. They told us staff here are very lovely. We asked if staff paid particular attention to their dignity and need for privacy. They said, Yes, they help because its not easy coming into a home, it can be embarrassing. We saw staff talking to people in a polite manner and when they were giving assistance to people they did so sensitively and did not rush people. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home are supported by staff to lead an active life and to maintain their relationships with family and friends. Evidence: The home has told us in their AQAA they have regular activities for people to take part in. We spoke to some people during this inspection who told us I think that there could be more at times but generally the staff make a good effort to keep us entertained. Another person said they staff try really really hard to sort things out for us to do. There is always something going on but most of the time I like to sit in my bedroom. There are regular activities planned and these are displayed on the notice board by the main reception. Recent activities have included dominoes, pampering sessions, church services and outside entertainers. The home has an open visiting policy and people are encouraged to have visitors when they choose. People have the opportunity to see their visitors in the comfort of their own rooms or in one of the lounges in the home. We saw a steady stream of visitors during this inspection. People who answered our surveys told us they were happy with Care Homes for Older People Page 16 of 29 Evidence: the activities on offer. They raised some suggestions for the home to consider such as more outdoor trips and more pub lunches. Meal times appeared to be a relaxing occasion. Staff were busy trying to give out meals to everyone so that people did not have to wait too long for them. The dining room was pleasantly decorated and seemed to be nice place for people to eat their meals. We observed people being assisted to eat their meals by staff and noted that this was done discreetly and in a sensitive manner. People do have a choice about where they want to eat their meal. We have made one recommendation for the home to consider. The practice of pre dispensing cereals into dishes for people before they have sat at the table does reduce their right to choose what they want for breakfast. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can feel confident their views will be listened to and acted upon by the home. Staff have had training and demonstrate a good understanding about safeguarding vulnerable adults. Evidence: The home has a complaints policy that is available to all people. A copy of the complaints policy is in the service user guide and in each persons bedroom. Since the last inspection in April 2009 there have been one complaints recorded. The manager told us that she is always there to talk through any concerns that people have and will always act upon them. We looked at the way in which the home manages and investigates complaints. We have been made aware of three complaints since the last key inspection. As result of those complaints we conducted a random inspection. The random inspection report is available in the home for people to read and upon request from the Care Quality Commission. People we spoke to during this inspection told us yes I know who to talk to if I am unhappy, I go to the front desk, Ive never really had to raise any concerns but I would talk to the staff. Each person who answered our surveys told us they knew who to make a complaint to and they felt happy their concerns would be listened to by the home. The home has policies in place for dealing with allegations of abuse and keeping Care Homes for Older People Page 18 of 29 Evidence: people safe from harm. We call this safeguarding vulnerable adults. We spoke to staff about this. All of the staff we spoke to were able to tell us what different types of abuse there were and how they would recognise the signs of abuse. Generally most of the staff knew who to refer to if an allegation was made to them or they had witnessed an act of abuse. The manager of the home understands what is expected of her in relation to reporting of incidents and allegations to the safeguarding team. We also talked to staff about their knowledge of the Mental Capacity Act 2005 and the deprivation of liberty safeguards. We did this because we wanted to know if staff were aware of what the implications for practice this legislation has. Staff need to be able to understand what a deprivation of liberty is so that they can take action to prevent it from happening or to take steps to protect the people in their care. Staff told us they had not had any training in this and were not aware of what it meant. The manager told us that she had received training and understood her role was in making sure that people did not have their liberty deprived. The home will need to arrange for this training to take place. We looked at recruitment practises and found the home is taking steps to prevent unsuitable people from working with vulnerable adults. This includes required checks against the Independent Safeguarding Authority (ISA) and a Criminal Records Bureau disclosure (CRB). Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and is a pleasant place for people to live. The home could improve upon the repair of equipment by attending to it promptly. Evidence: We looked at most areas of the home during this inspection. There has been some improvement in the redecoration and refurbishment of the home. There is a new carpet in the entrance replacing the old stained carpet. The dining room has been decorated and offers a pleasant place for people to eat their meals. The main lounge was clean and tidy and there were alot of fresh flowers on display, snacks were freely available for people to take, crisps, fruit and sweets. There are two televisions in the main lounge, we found that each television was broadcasting a different channel, it made it very difficult to watch and concentrate on either. This is something the home should consider addressing. People who answered our surveys told us the home is good in most every way but it takes so long to get any repairs done, my mothers rooms has not been decorated in the seven years she has been there, despite promises this would happen. We spoke to people living in the home. They told us Im not a fan of these blinds they have put up everywhere, I prefer the curtains they make the place feel warmer and cosier, another person said my room is very nice especially when the sun comes through and lights it up. We spoke to the manager about these comments and we were told, the Care Homes for Older People Page 20 of 29 Evidence: home has ordered new curtains for the lounge area, but at present there are no plans to redecorate the bedrooms although they realise this is in need of doing. We looked at one persons bedroom and heard the sound of running water. We found that the toilet in the en suite facility was not in working order. The person told us it keeps me awake at night constant running water make it hard to sleep, We spoke to the manager about this, she told us the staff have to flush it in a certain way and it stops the running. Whilst this may be suitable as a very temporary measure it is not acceptable as a long term solution. We asked the home to repair the toilet promptly. We checked that people had the correct pressure relieving equipment in place. We found the home is supported by the district nursing service who supply this equipment for people. There are adaptations in bathrooms to assist people whilst bathing, including bathing chairs, hand grab rails and hoists. Since our last inspection the home has now purchased a hoist. This is not yet in use as staff wait for training so they can use it safely. This will help with the moving and handling of people in the home. We saw most of the bathing facilities, we found them to be clean and tidy. The home supplies liquid soap and paper towels in communal toilets and bathrooms. They do this as part of their infection control procedures. We looked at the laundry facilities, we found them to be clean and of a good size. The home has dedicated laundry staff throughout the week. We also looked at the homes training matrix that showed us staff are having training in infection control and current best practice. Prior to this inspection we visited the home in October 2009. We found that there was an outbreak of scabies. We said the home must contact the Health Protection Agency for further advice about scabies management. This was done and we have not been notified of any more outbreaks of infectious conditions in the home since then. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At the time of the inspection people living in the home were supported by staff who had been trained and were supplied in sufficient numbers to meet their needs. Evidence: We have been made aware of concerns about staffing levels in the home. We were told that staff were not freely available to meet peoples needs and they were bored. We looked at the staff rotas and found the home to be sufficiently staffed at this time given the dependency and needs of the people living in the home. The home will need to keep staffing levels under review as the needs of the people living in the home may change. The rotas were also an accurate reflection of the staff on duty during this inspection. We spent time talking to staff who work in the home. They told us at times it is a bit rushed but mostly we cope, well one more carer would help so we can spend more time to sit with people and talk to them, we are busy but this doesnt mean that we arent meeting needs. We spoke to people who live in the home. They told us I find the staff very polite and very helpful, there used to be a bad atmosphere here with the staff but this is much better now, you had to be careful who you spoke to but I dont feel like that anymore. People who answered our surveys said, my relative is looked after here I Care Homes for Older People Page 22 of 29 Evidence: dont have to worry about that. The home supports all care staff through training in National Vocational Qualifications. Staff we spoke to confirmed that they had completed both their level 2 and 3 NVQ training in Health and Social Care. This means that staff have the knowledge and understanding to be able to meet the peoples needs who live in the home. The home has also provided training for staff in dementia care and person centred care since our last visit. We looked at the recruitment processes in the home. We saw the staff files of four people. All of them contained the required information and security checks such as previously mentioned ISA and CRBs. This means the home has systems in place to prevent unsuitable people from working with vulnerable adults. We looked at the training records for some staff. The home has supplied us with information of training that has been arranged. It is clear that staff will be trained as required. We spoke to several staff on duty during the inspection who confirmed they regularly take part in training and keep their knowledge and skills up to date. New workers are supported through an induction that meets the Skills for Care common induction standards. This induction will provide staff with the basic skills needed for completed their NVQ training Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and there are systems in place to make sure it is run in the best interests of the people who live there. Evidence: Since our last inspection we have registered a new manager for the home. Tina Tolley is the manager and she holds the qualifications necessary to be in charge. She is beginning to bring about improvements in the home and staff we spoke to said, shes very good, I feel that I can approach her for anything, people living in the home said since she has been here it has changed for the good, the bad atmosphere between the staff has gone, I think she ruffled a few feathers but thats good if it gets things done isnt it. We have seen since our last inspection there have been improvements in the home. We have seen better record keeping, better management of medicines in the home and staffing levels have been kept under review. The home also has their own quality assurance system. The manager has begun to audit areas of service provision as a Care Homes for Older People Page 24 of 29 Evidence: result and has also provided surveys for people to complete. There are regular meetings during which time people are encouraged to share their thoughts, views about the home and offer suggestions for improvement. Recent meetings have included a discussion about the decoration of the lounge and replacing the curtains. In addition to surveying the people living in the home the manager also completes monthly audits of accidents and incidents, care plans and the environment. This allows the home to identify problems earlier and to take action to prevent further problems occurring. The Home Manager completed the homes AQAA which was returned to us when we asked for it. The AQAA gave us adequate information about the service and developments that have been made although more information could have been included on current developments. We also spent time talking to the manager about her role and responsibility in understanding the principles and practice of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The manager has received training in this area and understand her role in making applications to the appropriate authority should they feel that peoples liberty is being deprived. The manager also told us there are further plans to arrange training for all staff. The home takes charge of some personal monies on behalf of people who live there. The monies are kept securely and written records are kept of all transactions. An audit takes place each day. A random sample of the monies and accompanying records were seen during our inspection and there were no discrepancies. We have made one recommendation for there to be two signatures for each transaction. This will reduce the risk of errors occurring. Staff training in ongoing, recent training has included moving and handling and fire safety. Training for staff has been a priority for this home. It was pleasing to see the progress the home has made. Staff told us we have had that much training, the training is very good. Most of the staff have also taken part in first aid training, food hygiene and infection control training. The manager has a training matrix that enables her to see what staff are due training and when this should be arranged. There is a Fire Risk Assessment in place and a fire drill takes place at least every six months. The Emergency Lights are tested on a monthly basis and records were seen to verify this. Records were seen to verify the regular servicing and maintenance of various systems, including: the emergency lighting system, the gas system and boiler and the lift, the electricity system and all electrical equipment. We have said the home must also make sure that the slings used with the hoist should be included in the Care Homes for Older People Page 25 of 29 Evidence: regular safety checks and servicing of the hoists. This will make sure that all equipment is safe for use. The water temperatures are tested regularly and recorded. There are policies and risk assessments in place with regard to safe working practises. Staff receive training in safe working practice topics during their induction. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The manager should incorporate regular medication audits into the homes quality assurance system, this will reduce the risk of errors occuring or enable the home to take swift action if an error happens. The home should not predispense cereals into dishes but wait for people to be seated and then offer them a choice. 2 15 Care Homes for Older People Page 28 of 29 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. © 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. Care Homes for Older People Page 29 of 29 - 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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