Care Home: East Clune Care Home

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What the care home does well People living at the home are cared for in a safe homely environment, and they are encouraged to personalise their rooms with their own possessions and furniture. The home has a relaxed atmosphere and people were positive about the care they receive and the warm and relaxed relationships they enjoy with the staff. A lot of the staff have worked at the home for a long time and they have developed close relationships and patterns of care that are individual to the people concerned. Leisure and recreational needs are identified, and people living at the home are encouraged to join in by the activities coordinator now in post. The importance of maintaining links with family, friends and the community is also recognised and supported. People were positive about the meals provided at the home, and they stated that they were provided with choice and variety. Similarly they were positive about the standards of cleanliness and hygiene around the home and about the care given by staff. Staff work in planned ways and have clear documentation to help them care for and support people in their day to day needs. People`s needs are properly assessed and their healthcare needs are effectively met. Staff have a good understanding of older people and training about caring for the needs of people suffering from dementia has been planned for later this year. What has improved since the last inspection? The home`s management have continued to maintain a good standard of service and have worked hard on the requirements set at the last inspection. The documentation supporting care has been updated and the processes covering initial assessments have been completed for everybody coming to live at the home. Similarly all care plans have been updated and improved. The range of activities available for people has improved with the appointment of an activities organiser, and systems are in place to support the management of complaints and recording of incidents. The home`s physical environment has continued to be maintained. What the care home could do better: Work still needs to be done on improving the level of training completed by staff and the key areas need to be prioritised. A legal requirement has been made as a result of this inspection which requires the home to make its medicines management systems completely safe and there are good practice recommendations that relate to indirect aspects of care and people`s lives. Key inspection report Care homes for older people Name: Address: East Clune Care Home West Street Clowne Chesterfield Derbyshire S43 4NW     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: Brian Marks     Date: 2 2 0 9 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: East Clune Care Home West Street Clowne Chesterfield Derbyshire S43 4NW 01629537080 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): amanda.cooper@derbyshire.gov.uk www.derbyshire.gov.uk Derbyshire County Council Name of registered manager (if applicable) Mrs Amanda Cooper Type of registration: Number of places registered: care home 30 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: 30 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: Oldage, not falling within any other category - Code OP Date of last inspection Brief description of the care home East Clune provides personal care for up to 30 older people. It is located within the village of Clowne, which lies to the north east of Chesterfield. Accommodation is arranged over two floors and there is a choice of lounge and dining space. There are 22 single and 4 double bedrooms, with one of the single room having an en suite. There are 3 bathrooms and a shower room and toilet facilities, which are suitably Care Homes for Older People Page 4 of 27 Over 65 30 0 2 9 1 0 2 0 0 8 Brief description of the care home equipped. There is a central kitchen and laundry. Access to outside garden areas is level and provides seating. The Manager has the support of a team of deputies, care and hotel services staff and also external management arrangements of Derbyshire County Council. One of the communal rooms is accessed by a small group of older persons for the purpose of day care. Service users who live in the home are able to access activities there if they so choose. The home provides both short term respite and long term care provision. Fees charged are charged on a sliding scale dependant on a persons savings and income. Additional charges are made for hairdressing, private chiropody, newspapers and toiletries. 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: This was a Key unannounced inspection that took place at the home over one day. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, records held by us, the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection, and surveys that had been previously sent out to the homes staff, the people living there, their relatives and some local health and social care professionals. All of the above material assisted with the preparation of a structured plan for the inspection. From the surveys that were returned before the inspection, the information supplied was analysed and the outcomes included in the inspection process and reflected in this written report. At the home, apart from examining documents, files and records, time was spent speaking to homes line manager and one of the deputy managers, who was in charge of the home during the visit. We also spoke to most of the staff working on the early day shift. The care records of three people who live at the home were Care Homes for Older People Page 6 of 27 examined in detail and they were interviewed along with a number of others. The relatives of one more were also spoken to. No other inspection visits have been made to the home since the last Key unannounced inspection on 29 October 2008 and the assessment was made against the key National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. 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. People do not come to live at the home without the care they need being properly identified but more attention paid to their social world and background history would help staff provide person centred care for everybody. Evidence: In the AQAA we were told that when people come to live at the home they are provided with a comprehensive assessment of individual needs completed by an outside care manager and this is supported by an initial care plan. The home then develops a written personal service plan based on the information provided, which ensures that the home can meet the needs identified. We were also told that the majority of residents have visited the home for several periods of respite care, or for a daytime service, in advance of admission. We looked at the care records of three people who had moved to live at the home since the last inspection, and these confirmed that local care managers had been Care Homes for Older People Page 10 of 27 Evidence: involved in the process of making arrangements; two of them had been at the home for periods of respite care before deciding to stay on a permament basis. Within these records, there were assessments of the physical care needs of the person concerned and these assessments were carried out at the time, or before, that the person came to live at the home. They were completed using the same standard documentation provided by the Adult Social Care Department and the information had been obtained from the person concerned, from their family, or from other professionals. However the amount of information about the psychological and social worlds of the people concerned was variable, and in most of the files we looked at was very brief. This does not fully support the intention to provide person centred care for everybody living at the home. Two of the care records looked at contained a number of formal assessment documents indicating the risks in their lives and these were covered in detail; they included personal handling, falls, medicines and skin integrity, as well as any general issues relating to the immediate environment. They were not completed for the third person, although other areas of his care documentation indicated that he was independent in many ways. One of the three people whose needs were examined suffers from unstable diabetes but there was no specific documentation that recorded how she would be helped to manage this condition, which may place her at risk should any breakdowns occur. The home does not provide intermediate care. 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. The people living at the home have care and risk assessment records that promote safety and consistency, and staff work in ways that respect individuality, privacy and dignity. Evidence: In the AQAA we were told how knowledge of peoples needs is comprehensive and well documented and that residents are viewed as individuals and receive person centred care. Maintaining independence, dignity, choice and privacy are given a high priority. We were also told that people are given access to local healthcare services, including their own GP and pharmacy audits are completed quarterly. The three care records that we looked at all contained a detailed care plan prepared by the homes managers, and these were supported by the more general initial care plans from the local care managers. All of this documention gave clear descriptions of the areas where people need help and all included evidence that they were looked at and evaluated regularly through formal meetings involving everybody concerned. These reviews were carried out according to the standards of the Social Care Care Homes for Older People Page 12 of 27 Evidence: Department and did not indicate that they were carried out more than three monthly; when things become settled they are carried out annually. Care records did contain a monthly report from the persons keyworker, one of the care staff, but these were general in nature and not focussed on specifuc care issues. As before, none of the records contained detailed descriptions of the persons social history and interests, which would fulfill the provision of a person centred approach. All the care plans that we looked at indicated detailed actions for staff to carry out, and staff told us that the care documentation helped them carry out their duties properly. There were clear records of the medical and health needs of residents being regularly monitored, and also of visits by outside professionals such as G.P and district nurse, and by the chiropodist, optician and dentist. Additional specialist services such as diabetic nurse and memory clinic had been used by particular individuals. In the written records and from the direct comments and written feedback we received, it was clear that the staff at the home work hard to care in sensitive and dignified ways, and to keep people as independent as possible. In response to our written survey people told us that they always or usually receive the care and support they need, that staff are available when they need them and that the home makes sure that they receive the medical care they need. People we spoke to told us: I have a pleasant life here and they help me when I need it. My diabetes is under control at present and they arranged for me to see a specialist which was good. I have everything I need and go to staff if I have a problem. The staff are very kind and coming here was good move for me. I get on well with all the staff, you just press the call button and somebody will come. Ive no complaints with life here. We also received written replies from local professionals about the service provided at the home and these were generally positive. One local doctor told us that the staff seem to care for the residents well and we have few concerns, and a care manager said that the people whom Ive placed there have on the whole been very satisfied with the service and I have confidence in arranging care for people there. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these were generally satisfactory and that entries in the written records had been made properly. Medication is stored securely and the home uses a Monitored Dosage System for organising administration. However there was one instance when the contents of the storage cassettes did not tally with the written sheet and one sheet where handwritten entries were not signed by the person writing them. The arrangements for managing controlled drugs was generally satisfactory with secure record keeping and storage. Care Homes for Older People Page 13 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. People at the home enjoy lifestyles and routines that suit them and have good opportunities to take part in organised leisure and social activities. Evidence: In the AQAA we were told that the residents choose how they wish to spend their time and how the home has allocated staff hours for activities. People have had individual consultations to ensure that they are involved in the development of the homes programme of activities. Visitors and people from the local community are encouraged to visit and participate with things going on there. We were also told that main meals are served at regular times and that snacks and drinks are available throughout the day and night. We spoke to the staff member currently responsible for organising activities, for which she is available five days a week. She told us about the activities that had been organised,which at the present time have only been within the home and included craft activities, music sessions and gentle exercise, dominoes and other games and the ever popular bingo. There is also a newly arrived handheld computer games console which is also proving popular. She told us that although some people are difficult to get involved and prefer to keep their own company, there is a core of keen Care Homes for Older People Page 14 of 27 Evidence: participants who look forward to involving themselves. We spoke to people who fall into both these descriptions. The service manager also described plans to revive involvement with the day service based in the home, and during the afternoon of the inspection staff from that unit were seen to be inviting residents to join in with a session of bingo. Additionally we were told that there have been irregular visits by professional entertainers and the hairdresser is a regular visitor. We noted that a selection of newspapers was available in the seating area in the entrance hall. The people we spoke to confirmed that they are happy with their lives at the home and that they are able to do very much what they like. They develop their own routines, including spending their time in the communal areas or in their rooms; the former is the choice of most people although we saw a number who were in their rooms out of choice or because of illness. One of the people we spoke to showed us her room and told us that I am comfortable in my room and please myself what I do during the day. We also received written feedback from our surveys and were told that there are always or usually activities for people to take part in. We also spoke individually to people around the home: East Clune is a good care home and looks after her very well. Ive settled in well and was able to choose my room on the ground floor. It was very lonely at home but now Ive got plenty of things to do , I like the social life here. The companys good here and I really enjoy my regular game of dominoes. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 4 week menu is being followed. The cook described how a choice at the main meals of the day is available and that a hot option is available on some days for breakfast and at teatime. People were generally positive in their feedback about the standard of food at the home with several mentioning good quality and quantity. Arrangements for purchase, storage and stock control were satisfactory. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and softened, the arrangements for which indicated a careful approach to individual needs. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. Evidence: In the AQAA we were told that the home staff follow the complaints procedure for Derbyshire County Council, which is published to residents, carers, visitors and staff. We were also told that all comments and informal complaints are investiagted promptly and resolved as soon as possible. The AQAA indicated that there had been two formal complaints since the last inspection and our examination of the homes records indicated that investigations had been properly carried out and recorded. In the feedback that we received everybody said that they knew about making a complaint and were confident that they would be listened to: Id go to the staff if I had any problem. We saw examples of problem resolution recorded on individual files. As noted above the home is operated by Derbyshire County Council, which is the key agency with lead responsibilities in law for the protection of vulnerable adults; the home is automatically governed by those policies and procedures. The AQAA told us that staff have received training about this subject when they start work and also through regular updates but the records we looked at did not support that any updates had occurred recently, particularly for long established staff and those who had not completed a National Vocational Qualification (NVQ). The records we looked at indicated that there have been no situations at the home that have required Care Homes for Older People Page 16 of 27 Evidence: investigation under those procedures since the last inspection, and that there had been no incidents of concern in terms of difficult to manage behaviours. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has been maintained to a good standard and people continue to enjoy a comfortable environment suited to their physical needs. Evidence: In the AQAA the manager told us that the home provides a homely, clean, safe and comfortable environment, which is well equipped and maintained. Regular reviews of the environment are included in the visits by the homes line manager. We were also told that the home has access to the local handyman scheme which means that small repairs can receive prompt attention and redecoration planned in advance. There are twenty two single rooms and four double rooms. The home is on two floors, with a passenger lift and there are three bathrooms and a shower room, with equipment to assist people with mobility difficulties. There are three lounge areas and a large dining room. There is also a hairdressing room and a good sized garden area. From a brief tour of the building and visits to some of the bedrooms we saw how good standards of decoration and furnishing have been maintained: All bedrooms were brightly decorated and a good number were personalised with photographs and personal furniture. Whilst some bedrooms had been refitted with modern furniture the majority contained older pieces that had not been updated. The communal areas had been decorated in recent years and provided with furnishings that were colour matched. All the people we spoke to were happy about the standards of their rooms, Care Homes for Older People Page 18 of 27 Evidence: although they all commented that the rooms were always warm and the radiators difficult to control: I was able to choose my room on the ground floor, the home is spacious and I can move around OK. My room is very comfortable and I like spending time in it. All the recommendations made at the last visits by the Fire and Environmental Health Officers have been carried out. On the day of the inspection the home was clean, tidy and free from odours and all the feedback we received, written and verbal, was complimentary about the service provided by the laundry. All residents observed in the home were seen wearing clean and well-presented clothing at the time of the inspection. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has adequate numbers of staff to carry out the physical care needs of the people living there and they have been recruited properly. However, they have not received a good standard of training and are not fully equippped to do their work safely and in a professional way. Evidence: In the AQAA we were told how the home has a stable care team with staff who know the residents and their needs well. We were told that staff turnover is low and several staff have worked at the home for a number of years. We were told about the qualifications that staff have achieved and about the training programme and recruitment process that ensures that only appropriate staff work at the home. During the inspection we interviewed most of the staff on duty during the early part of the day, including a student who was on a long term placement at the home. Staff told us how new workers are instructed in basic care techniques, working under the supervision of the experienced staff and that they get regular training through updates with good access to the training service provided by the parent organisation. However we were not able to confirm this through sampling of individual staff files or from the overall training record, which indicate that very little training activity had been achieved since the last inspection. We identified that there were shortfalls in all the key subjects, particularly in safe manual handling and safeguarding vulnerable adults. Care Homes for Older People Page 20 of 27 Evidence: Whilst staff will have covered these subjects in completing the National Vocational Qualification (NVQ), for a number of staff this will have not been recently. The AQAA and the training record indicated numbers of staff with at least a level 2 NVQ was in excess of the national target. We did see in the training record how a programme of staff training about caring for people who suffer from dementia is planned for later this year. At the beginning of the inspection we requested that the recruitment files of two recently appointed staff be sent by fax from Councils central staffing department, but they were unable to send complete records. The home does not retain these records on site and this has been a regular problem during inspections of services provided by the Council away from headquarters. The information we did receive indicated that the staff concerned had not commenced work until two written references from previous employment and a check by the Criminial Records Bureau (CRB) had been received. Examination of the duty roster and discussion with staff indicated levels of staff on duty that were generally satisfactory. We were told about occasions when the numbers of staff on duty are reduced because cover is not available; staff told us that the impact of this was for a workload that was a bit presurred from time to time. In the written feedback we received from people living at the home and their families, we were told that there is always or usually enough staff on hand to meet peoples needs and that: The staff are there caring for us all. Others said that the home should have better cover for holidays and sickness of staff and that staff are at times under pressure. The people we talked to told us: Staff are responsive and and I never have to wait. They give me help when I need it. Staff are usually around and theyre very good. I get plenty of staff to help me, just press the button. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 a well-managed and safe environment in which to live and work. Evidence: In the AQAA we were told that the manager of the home is fully qualified and is well experienced, and that the home seeks to run effectively for the benefit of all residents. There is a clear action plan each year and residents have full access to all their personal records. We were also told that risk assessments are made of the home environment and that the home has access to a handyman scheme and managers can use this service to ensure repairs are done in a timely way. The manager was appointed in 2008, has been registered with the Commission since the last inspection, and she has achieved the required managers qualification. There have been regular formal meetings for the staff group in the past year, and planned meetings between managers and individual staff, supervision, have been occurring, but not regularly enough to meet the National Standard. However, the staff we spoke to were positive about the way the home is run and how the management team Care Homes for Older People Page 22 of 27 Evidence: supports them if they have any problems: Were getting used to the new manager, who is approachable and respects confidentiality. Things have changed since the new manager arrived; there have been a lot of good things which weve now got used to. We can influence things and are now involved in the running of the home. The feedback, both verbally and in writing from people living at the home and their relatives, was positive about the general aspects of how the home is run. This mirrored the results of the homes surveys which are carried out by the parent organisation as well as more locally. The results of this years survey are published throughout the home and this indicated that all of the residents taking part rated the overall service of the home as either excellent or good. The homes manager and line manager are required to carry out regular audits of specific aspects of the homes operation and these in turn are monitored by senior management. The team of deputy managers has now been completed and they offer consistency of support to staff and people living at the home. The parent organsiation is planning to gain approval for all the care homes it operates within the international quality standard ISO2001 during early 2010. The systems in place for looking after residents money were found to be satisfactory at the last inspection and remain unchanged. The AQAA told us about good standards of health and safety activity at the home and about the regular servicing of equipment, and we examined records of the latter as part of this inspection, which supported this. Additionally observations made around the building and of fire safety and equipment records indicate that the home was hazard free at the time of the inspection. Care Homes for Older People Page 23 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 24 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 1 3 13 All areas of risk affecting the 31/12/2009 health, welfare and safety of people living at the home must be identified, assessed and minimised So that they remain free from harm. 2 9 13 The recording of medicines administration must be carried out at all times according to the relevant legal procedures. So that the system is safe for all people living at the home. 31/12/2009 3 30 18 The homes managers must prepare a detailed staff training programme that addresses the current shortfalls in training achievements, and then must implement the plan , with particular attention to safe manual handling and 31/12/2009 Care Homes for Older People Page 25 of 27 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 safeguarding vulnerable adults. So that all staff are properly prepared for the work they carry out and the welfare and safety of people living at the home is protected. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 Assessments of the needs of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. The care plans of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. All staff at the home must have individual supervision sessions with members of the management team six times per year, so that they receive professional support and the quality of their work can be monitored. 2 7 3 36 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. 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