Care Home: Dunkirk Memorial House

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What the care home does well Dunkirk Memorial House consists of a listed house and a purpose built building and the environment is excellent. The home has a warm and welcoming atmosphere. All areas are well maintained, decorated to a high standard and spotlessly clean. The gardens are pleasant and provide seating areas for people who live at the home. Bedrooms were nicely personalised to reflect people`s individual interests and tastes. Residents told us that they are very happy living in the home. Comments included `staff mix care with a bit of sunshine..a joke and a chat` and `staff all good, some even better`. Care plans contain a good level of detail and are person centred. The home ensures that people have the opportunity to take part in the development of their care plan. The home provides a wide range of activities and outings for residents. Two activities co-ordinators and volunteers provide a weekly activities programme. A weekly newsletter is distributed to residents so they know what`s on. Residents told us that they are happy with the meals and choices available to them. Comments included `there was kippers for breakfast today, I don`t like kippers so I have haddock instead`, `there`s more than enough food` and `endless choice of breakfast cereals`. Residents benefit from a friendly, well trained and experienced staff team. Staff had a good knowledge of the people they support and encourage residents to be independent where possible. The home involves residents in the running of the home and keeps them informed through regular meetings and newsletters. The residents` representative shows people around the home, assists with surveys & meetings and liaises with management. What has improved since the last inspection? The home has purchased a second minibus. This provides easier access with hand rails. Staff files viewed now contain all of the required information to protect people from risk of harm or abuse. What the care home could do better: We found that care plans generally contain good information for staff to follow. The home should review the organisation of the care plans so that it is easy for staff to find the information they need. We found that one resident had recently been having falls. The care plan and risk assessments had not been updated to reflect this. When a resident`s needs change the home must ensure that the care plan is reviewed and updated. This is so that staff know how to minimise the risk of the resident falling and to protect the resident from the risk of injury. Staff told us that they meet with their manager to discuss their work. The registered person should formalise staff supervision sessions to ensure there is documented evidence that staff receive formal supervision at least 6 times a year. The home should ensure that they keep records to evidence that electrical equipment is periodically examined to establish standards of electrical safety. Key inspection report Care homes for older people Name: Address: Dunkirk Memorial House Minehead Road Bishops Lydeard Taunton Somerset TA4 3BT     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: Alison Philpott     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Dunkirk Memorial House Minehead Road Bishops Lydeard Taunton Somerset TA4 3BT 01823432407 01823433083 pshields@britishlegion.org.uk www.britishlegion.org.uk The Royal British Legion Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 60 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 60. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Dunkirk Memorial House is a home owned by The Royal British Legion. As such the admission criteria limits admissions to those who have served in the armed forces and/or their spouses. The main building has been purpose built and the home sits in its own well-tended Care Homes for Older People Page 4 of 28 Over 65 60 0 Brief description of the care home grounds with ample parking. The home is close to and in walking distance of the village of Bishops Lydeard and approximately eight miles from Taunton. The home is registered with the Care Quality Commission to provide nursing (max 30) and personal care for up to a maximum of 60 older persons. The registered manager is Mrs Pauline Shields. The building is on three floors with the basement being used as the service area. All floors are linked by passenger lifts and there is disabled access throughout. Bedroom accommodation is provided in single rooms with en suite facilities, although couples can be accommodated in some of the larger rooms. In addition there are assisted bathing facilities. Immediately outside the home there are a number of seating and walking areas that include a large pond with carp, a sensory garden and greenhouse facilities. Residents also have the use of a mini bus. The homes current fee range is between £535 & £770 per week. Additional charges are met by service users for hairdressing, chiropody, newspapers and toiletries and taxis. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over 8 hours. On the day of the inspection, 55 people were living at the home. 27 residents were receiving nursing care and 28 residents were receiving personal care only. We were given unrestricted access to all parts of the home and all records requested for this inspection, were made available to us. We were able to meet with people using the service and staff. The term we, used throughout this report, refers to we the Commission. The preferred term for the people who live at the home is residents. This is used throughout the report. Care Homes for Older People Page 6 of 28 We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: We found that care plans generally contain good information for staff to follow. The home should review the organisation of the care plans so that it is easy for staff to find the information they need. We found that one resident had recently been having falls. The care plan and risk assessments had not been updated to reflect this. When a residents needs change the home must ensure that the care plan is reviewed and updated. This is so that staff know how to minimise the risk of the resident falling and to protect the resident from the risk of injury. Staff told us that they meet with their manager to discuss their work. The registered Care Homes for Older People Page 8 of 28 person should formalise staff supervision sessions to ensure there is documented evidence that staff receive formal supervision at least 6 times a year. The home should ensure that they keep records to evidence that electrical equipment is periodically examined to establish standards of electrical safety. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of information including its Statement of Purpose and Service Users Guide to people before they move into the home so that they can make an informed decision that it is the right place for them. The home carries out comprehensive pre admission assessments to ensure that it can meet the needs of the prospective resident. Evidence: The home has a detailed Statement of Purpose and Service User Guide which provides information about the homes facilities and services. These can be provided in alternative formats on request. A new resident told us that they were very happy with the information they received about the home. We looked at the initial assessment for a person who has moved to the home since the last key inspection. This contained a good level of detail. We spoke with the Care Homes for Older People Page 11 of 28 Evidence: resident and they told us that they had visited the home to have a look around. One of the residents had shown them around and told them what it is like to live at the home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are person centred and contain good detail. People are involved in the development of their care plans. When one residents needs changed the care plan had not been updated. The homes medication procedures are well managed. Staff respect residents privacy and dignity. Evidence: Residents told us that they are very happy with the care and support they receive at the home. One resident commented staff mix care with a bit of sunshine..a joke and a chat. Since the last inspection, the Royal British Legion has introduced a new person centred care planning system which was developed with the University of Bradford. The previous care plans are currently being transferred into the new care plans. Care Homes for Older People Page 13 of 28 Evidence: We looked at four of the new style care plans and we spoke with these residents. The care plans contained detailed information for staff to follow so that they know how to best support people. They tell staff what residents can do independently and any assistance required. Residents preferences are written in the plan. Residents told us that they had discussed their care plan with the staff. The care plans contain a detailed life history for each resident so that staff can learn more about the resident and their life before they came to live in the home. Residents have signed their care plan and hold a copy in their bedroom. The care plans do not contain an index and we found it difficult to find some information. Staff told us that they dont find it easy to retrieve information from the new care plans. We discussed the possible use of indexing and order of the care plan with the manager. We looked at a wound care plan which contained good information and evidenced regular review. We found that one resident had fallen four times in the two weeks prior to the inspection. The falls were documented in the daily records. The home had kept a log of the doctors visit. We spoke with staff who were aware of the falls. We spoke with the resident who had sustained some bruising as a result of one of the falls. The resident told us that they had been given a pendant call bell to use but they did not have this on at the time of the inspection. There was no care plan or risk assessment in place relating to falls. We discussed this with the manager who confirmed that this would be put in place immediately. The home must ensure that when a persons needs change or risks are identified the care plan and risk assessments are updated. This is to ensure that staff know how to minimise the risk of the resident falling and to protect the resident from the risk of harm. Residents have access to a wide range of health care professionals including GP, Tissue Viability Nurse, Physiotherapist, optician, and dentist. We looked at the homes medication and records. The home uses a monitored dosage system. We looked at the Medication Administration Record Sheets. These were fully completed. We checked the balance of one controlled drug. This was found to be correct. A number of residents control their own medicines and have a lockable space in their bedrooms to store them. The home carries out a risk assessment prior to people controlling their medicines to ensure that they will be safe. Trained nurses and care Care Homes for Older People Page 14 of 28 Evidence: staff administer medication to other residents. The manager confirmed that the staff have undertaken training in the administration of medication and completed competency assessments. The home told us that they carry out monthly medication audits. We observed good interactions between staff and residents. Residents told us that staff respect their privacy and dignity. We observed staff knocking on residents bedroom doors and waiting before entering. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to enjoy a wide range of activities, outings and entertainment. Staff support residents to be independent where possible. Meals are well balanced, highly nutritious and cater for individual residents needs and preferences. Evidence: A full and varied programme of activities is available. A noticeboard in the home tells residents about planned activities and outings. The home also distributes a weekly newsletter called DMH weekly Bugle to each resident to inform them whats on and whats happening in the home. The home employs two activities co-ordinators. A number of volunteers visit the home. Residents told us that they are pleased with the activities in the home. One resident who spends time in their bedroom told us that the activities co-ordinator will come in for a chat. Activities during the week of the inspection included Scrabble, quizzes, whist, Care Homes for Older People Page 16 of 28 Evidence: computer lessons and musical entertainment. The home has its own art group. We observed residents artwork in their bedrooms. Residents told us that they were trying to paint more pictures in time for the homes art exhibition. Special events at the home have included the Remembrance service, an open day and coffee mornings. The home holds themed dining in nights several times a year. During the summer a barbecue was organised in a marquee on the lawn. 140 people attended, relatives and friends were invited. The home has two minibuses to take people on outings. Both minibuses have a wheelchair lift, the new minibus has easier access with hand rails. Some residents have their own cars and told us that they enjoy having the freedom to go out, and visit friends and family. The home has arranged various outings for residents. There is a regular outing to Taunton. Residents told us about the monthly Luncheon Club where they go out to a local pub and rate the experience. Some residents attended the Lloyds of London ex service dinner and the Garden Party at Buckingham Palace. Residents stayed overnight in a hotel, went sightseeing and to the theatre. The home has links with the local school. The children visit the home at Christmas to sing carols. Two of the residents told us that they went out to the local school to talk about what they did whilst serving in the forces. Residents told us that the homes library contains a good range of novels. A shop trolley is available in the home twice a week for small purchases. Residents told us that they can buy old fashioned sweets on a Wednesday. The home has its own hairdressing salon and hairdresser. The home has its own chapel and holds a regular church service for people. Individuals religious beliefs are acknowledged and people are supported to attend the service of their chosen religion. Residents told us that their visitors are made to feel welcome. A number of residents have telephones in their bedrooms so that they can keep in contact with family and friends. A computer with e-mail is also available. The home has wireless broadband for residents use. When we spoke with residents, they told us they can choose how they wish to spend their time. Staff support residents to be as independent as possible. The residents representative told us about their role in showing people around the home, sitting in on meetings, and liaising with management and the chef. Care Homes for Older People Page 17 of 28 Evidence: Two people currently visit the home one day a week for day care. They take part in activities and have a meal at the home. Staff and management told us that this had been very beneficial to the people, their families and the other residents. Residents told us that they are happy with the food at the home and staff know their personal food preferences. Each resident is asked each day what they would like to eat and if this differed from the set menu then the home would do their best to provide it. Residents told us there was kippers for breakfast today, I dont like kippers so I have haddock instead, theres more than enough food and endless choice of breakfast cereals. We observed that menus were displayed at the entrance to the dining room and on each individual table. The lunch menu on the day of the inspection was tomato soup or juice followed by a choice of roast loin of pork with stuffing and apple sauce or cottage cheese salad. Dessert was creme brulee. We observed that lunch was a very social event with people chatting and enjoying the experience. Staff offered a choice of drinks,and water jugs were placed on each table so that people could help themselves. The tables were laid nicely and the atmosphere was relaxed and unhurried. The home has various points in lounges and kitchens where residents can help themselves to a hot or cold drink at anytime. The home also benefits from a licensed bar. Care Homes for Older People Page 18 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture that allows residents to express their views and concerns. Policies and procedures for safeguarding adults are in place to protect people from the risk of harm or abuse. Evidence: The home has a complaints policy and procedure in place. People who live at the home know who to talk to if they have any concerns. A log of complaints is maintained. We looked at one complaint that the home had received. The home had responded to the complainant in appropriate timescales. We found that staff recruitment files contained all of the required checks to protect people from risk of abuse. The home has a whistleblowing policy and staff spoken with knew what to do if they suspected or witnessed abuse. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a comfortable, attractive and homely environment. The home is well maintained and decorated to a very high standard. The home has up to date specialist equipment and adaptations to meet the individual needs of residents. The home is clean and smells fresh throughout. Evidence: Dunkirk Memorial House consists of a large listed house and a purpose built building. It has pleasant gardens and grounds with a summerhouse. The footpaths lead to a subway which connects the home with the village of Bishops Lydeard. There is ample car parking and a residents car park near to the entrance to the home. The accommodation is arranged over two floors. The first floor can be accessed by passenger lift or stairs. During the inspection, we observed most areas of the home including a number of bedrooms, bathrooms, and communal areas. All areas of the home are maintained to a very high standard. Furniture and furnishings are good quality and comfortable. The home has ongoing plans for maintenance and improvement. On the day of the Care Homes for Older People Page 20 of 28 Evidence: inspection, the dining room flooring was being replaced. The home had sent a letter to each resident to inform them of the work. The management had relocated the dining room to two of the lounges and devised alternative seating plans to ensure that the disruption to residents was limited. Residents bedrooms are nicely personalised with photographs, pictures, and furniture that people had brought with them when they moved into the home. Bedrooms face onto the courtyard, railway, garden or Quantocks. All of the bedrooms have en-suite toilet and showers. In addition to this, the home has two assisted communal bathrooms. Each bedroom has individual controls for heating and air conditioning so that residents can adjust the temperature according to their preference. Equipment provided is individualised to meet each persons needs appropriately. This included chairs, slings, electrically adjustable beds and mattresses. The home employs maintenance staff to deal with day to day repairs. The laundry is spacious and well organised. Residents benefit from a daily laundry service. The home was spotlessly clean throughout and all areas of the home smelt fresh. We observed that hand washing facilities are available in all areas of the home. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have a good knowlege of the people they support. Recruitment procedures are robust to ensure that residents benefit from good staff support. The home provides a comprehensive training and development programme for staff to ensure they are able to meet residents needs. Evidence: Residents told us that they are very happy with the staff at the home. One commented staff all good, some even better. The home provides a weekly sheet in the Bugle so residents know whos on duty. We looked at the rotas. Residents and staff told us that there are enough staff on duty to meet individuals needs. On the day of the inspection, there were two nurses on duty; one student nurse; and eight care staff . In addition to this there was an activities co-ordinator, domestic staff, maintenance, laundry staff, a receptionist and administration staff. We looked at four staff recruitment files. These contained all of the required checks and information. Care Homes for Older People Page 22 of 28 Evidence: We spoke with a new member of staff. They confirmed that they were happy with the induction programme at the home and had benefited from shadowing more experienced members of staff. The homes induction programme is available at level 2 and level 3. This covers the Skills for Care Common Induction Standards and links to NVQ 2 and NVQ 3. Staff commented Im happy here, I get all the training I need and feel well supported and if you want training and development the Royal British Legion is the place to come. The home gave us a copy of the staff training matrix. Training is provided in the following areas; first aid; food hygiene; manual handling; fire; health & safety; infection control; adult protection; care planning, communication and equal opportunities & diversity. There were some gaps in the training matrix, the home confirmed that the training had been completed. Twenty five of the thirty two care staff have an NVQ at Level 2 or above and three staff are working towards an NVQ. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has quality assurance systems in place to seek the views of residents and other stakeholders. Systems are in place for staff supervision though these could be further improved on. The homes policies and procedures relating to health and safety generally protect people from risk of harm. Evidence: The registered manager is Pauline Shields. During the inspection, we were informed that Mrs Shields will be leaving at the end of January 2010. We were told that the provider has made alternative management arrangements, we request that these are confirmed with the Commission. Mrs Shields is supported by a deputy matron, registered nurses and team leaders. Staff told us that the management of the home is very approachable. The home told Care Homes for Older People Page 24 of 28 Evidence: us that they have an open door and are always happy to listen to residents. The manager has also trialled a drop in session for residents to come and talk about anything they wish to. Residents are invited to attend regular meetings and discussions so that they know what is happening at the home and can have their views listened to. The Operations Manager carries out regular visits to the home to monitor quality. A record is kept of these visits. The home sends out surveys every year to residents, staff, relatives and health professionals. This information is collated and a report is produced. A suggestion box is available in the reception area. The home has monthly team leader meetings. The team leaders then pass this information onto the care staff. Staff told us that they receive an appraisal every year. Staff told us that they meet with their manager for supervision, to discuss their work. The home does not currently document each supervision. We discussed possible ways of doing this with the manager. The home stores small amounts of money for some of the residents. A weekly audit is carried out to ensure that peoples monies are protected. We looked at servicing records for legionella; lifting equipment; and gas safety. These were all found to be up to date. The home has recently appointed a new maintenance person. They have completed the course in portable appliance testing. We looked at the new file relating to this which is well organised and indexed. It was not clear from the old file when some of the testing had been carried out. The home should ensure that they keep records to evidence that electrical equipment is periodically examined to establish standards of electrical safety. The home maintains accident records. The manager told us that these are monitored and audited with the use of a spreadsheet. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 When a residents needs change the home must ensure that the care plan is reviewed and updated. This is so that staff know how to minimise the risk of one identified resident falling and to protect the resident from the risk of injury. 18/02/2010 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 2 7 36 The home should review the organisation of the care plans so that it is easy for staff to find the information they need. The registered person should formalise staff supervision sessions to ensure there is documented evidence that staff receive formal supervision at least 6 times a year. This recommendation was made at the previous inspection. The home should ensure that they keep records to evidence that electrical equipment is periodically examined to establish standards of electrical safety. 3 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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