Care Home: Eden House

What the care home does well The home provides a comfortable, clean and homely environment. As most of the staff are family members and live in the vicinity, the people who live here enjoy continuity of care and are treated as one of the family. The care and support of people is person-centred with an emphasis on treating each person with dignity, respect and valuing their individual abilities and preferences about how they spend their days. Two of the many very positive comments the home received in the satisfaction surveys it sent out included `Excellent service, well beyond that that to be expected of a residential home` `It`s a warm, friendly, clean and wellrun home. My mother is very well cared for`. All areas of the home are cleaned to a high standard. There is excellent joint working with the GP surgery and community nurses to the benefit of the residents. Record keeping is of a high standard so that peoples individual care and support needs are clearly set out in their care plans with information about the actions that staff need to take to provide the appropriate care and support. What has improved since the last inspection? Two new senior care staff have been appointed since our last inspection. This has meant that the managers and other family members who work at the home have been able to have more time to spend on the necessary administrative, training and supervisory aspects of their roles. The registered manager has reviewed and updated most of the policies and procedures for the home so that these promote and protect residents` and employees` health, safety and wellbeing. The required AQAA information was completed and returned to us when requested and contains clear, relevant information that is supported by a good range of evidence. The home has accessed more external training courses for staff to go on so that all staff have the opportunities to develop their knowledge and skills in their roles, which in turn will benefit the people living here. The manager has introduced a key worker system that will mean each resident and their family and representative has a named staff member who has extra responsibility for, and knowledge about the individual resident and their care. The home holds a weekly staff meeting at which all staff are able to share information and good practice ideas about the care and support of the people living here. This means that managers and staff continue to develop the service in a way that increases the quality of life for residents and that is based on promoting their dignity, individuality and independence. The home has shown that it has used the suggestions and stated preferences ofresidents from their Satisfaction Surveys to make changes and improvements to the menus and range of activities available. What the care home could do better: The homes managers and staff work continuously to improve their service. In their AQAA they have identified things they plan to improve, such as providing further opportunities for residents to be involved in community arts projects and to revisit their local communities and workplaces if they wish. We have made no requirements or recommendations following this inspection visit and commend the home for the standard of care it provides and its commitment to ongoing development to the benefit of the people who live here. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eden House 50 Horspath Road Cowley Oxfordshire OX4 2QT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Delia Styles     Date: 1 3 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Eden House 50 Horspath Road Cowley Oxfordshire OX4 2QT 01865776012 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : eden.house@ntlworld.com Mrs Marjorie Chungtuyco care home 8 Number of places (if applicable): Under 65 Over 65 0 8 dementia old age, not falling within any other category Additional conditions: 8 0 The maximum number of service users to be accommodated is 8. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Eden House is the larger of two residential homes and is registered to take eight older residents. The home is privately owned and managed. It is a family run home with all family members having a role to play. The home is situated in a residential area on the outskirts of Oxford. Local amenities are available as is transport to Oxford and beyond. Accommodation is provided in four single rooms and two shared rooms. Assistance with bathing can be provided using a lifting bath chair. The home also has a shower room. There is a large conservatory/sitting room in addition to a shared dining and lounge area on the ground floor. The family also have accommodation within this building. Care Homes for Older People Page 4 of 28 Brief description of the care home The fees for this service range from 424 pounds to 600 pounds per week. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was completed on 19.05.2008. The inspection process included an unannounced visit to the home that took place from late morning to early afternoon. The key standards for older peoples care homes were assessed. Information received about the home since the last inspection was taken into account in the planning of the visit. Before the visit, the manager completed an annual quality assurance self-assessment (AQAA). The AQAA tells us how well the home feels they are meeting the standards of care for people living at the home. We sent some of our questionnaires to the home to give out to residents, visiting health and social care professionals and staff, but the Care Homes for Older People Page 6 of 28 manager told us these had not arrived. We looked at the homes own quality assurance Satisfaction Surveys and have reflected some of the comments seen in this report. The inspection visit also included a tour of the home, looking at a sample of residents care plans and records, medication records and staff recruitment and training files. Feedback from residents and their relatives that had been gathered from the homes own most recent Satisfaction Surveys was read. The inspector spoke to some of the residents and a visitor during the visit. Discussions took place with the manager and staff on duty. We would like to thank all the residents, the registered manager, Mrs Rosario and the registered person (proprietor) Mrs Chungtuyco, and other family members and staff for their time and help during the inspection process. What the care home does well: What has improved since the last inspection? Two new senior care staff have been appointed since our last inspection. This has meant that the managers and other family members who work at the home have been able to have more time to spend on the necessary administrative, training and supervisory aspects of their roles. The registered manager has reviewed and updated most of the policies and procedures for the home so that these promote and protect residents and employees health, safety and wellbeing. The required AQAA information was completed and returned to us when requested and contains clear, relevant information that is supported by a good range of evidence. The home has accessed more external training courses for staff to go on so that all staff have the opportunities to develop their knowledge and skills in their roles, which in turn will benefit the people living here. The manager has introduced a key worker system that will mean each resident and their family and representative has a named staff member who has extra responsibility for, and knowledge about the individual resident and their care. The home holds a weekly staff meeting at which all staff are able to share information and good practice ideas about the care and support of the people living here. This means that managers and staff continue to develop the service in a way that increases the quality of life for residents and that is based on promoting their dignity, individuality and independence. The home has shown that it has used the suggestions and stated preferences of Care Homes for Older People Page 8 of 28 residents from their Satisfaction Surveys to make changes and improvements to the menus and range of activities available. 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 set out 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 undertakes personalised needs assessment for prospective residents so that peoples diverse needs are identified and planned for before they move to the home. Evidence: A sample of 2 residents care records was examined and found to have clear and detailed pre-admission assessments of the individuals care and support needs. The registered manager described a careful process of assessment and admission to the home that includes information from the prospective resident, their family or representative, care managers, and other health care professionals. The assessments and care plans seen were signed by the individual or their representative showing that the assessment of peoples care needs had been carefully discussed with them. Pre- admission information helps the manager to draw up accurate initial care plans. Care Homes for Older People Page 11 of 28 Evidence: The manager said that they hold a weekly in-depth handover meetings at which residents care and support needs are discussed and reviewed to make sure they continue to meet their assessed needs. The managers and staff show a commendable commitment in making sure that each of the people who come to live here are able to express their individual wishes and preferences about their care. The homes AQAA tells us that they plan to develop a welcome pack for prospective residents that will include a letter from the manager, sample menus, advocacy information, the most recent inspection report from the Care Quality Commission and the homes own newsletter. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The support, health and personal care needs of the people who live here are well met. The planning and delivery of care is person-centred, ensuring each individuals care needs are consistently well provided for. Evidence: The care records and care plans for 3 residents with very different care needs were examined. The care plans are computer generated and drawn up by the home manager. These are of a very good standard and set out in detail the individuals care and support needs. The staff meet together weekly for an in-depth handover to review peoples care plans to make sure that they are up to date and reflect any changes in care and support that is needed. A section is included for residents and their relatives comments at formal review meetings that are held with residents, care managers and family members. Care Homes for Older People Page 13 of 28 Evidence: There are excellent working relationships with the local GP surgery and the community nursing service. The residents care records show that people living here have regular checks with their GP and dental, hearing, opticians and podiatry appointments are arranged as needed. Specialist equipment, such as variable height beds, a hoist and pressure relieving mattresses and chair cushions, have been provided for those residents who are more physically frail. The medication system - the storage arrangements and a sample of residents Medication Administration Records (MAR) - within the home was examined and found to be in good order. The pharmacist dispenses each residents tablets in a monitored dosage system (MDS) - a convenient form of packaging that lasts a week. The dispensing pharmacist makes regular visits to the home to ensure the systems are working well. The manager said that all staff who have responsibility for giving residents their medicines have had training from the pharmacist in the safe administration and that this meets the required standard. Staff are due to take an exam in July to formally assess their knowledge about medications. From the inspectors own observations, conversation with residents and a visitor, and the comments written by relatives and health care professionals who visit the home regularly, it is evident that the home provides a high standard of personalised care and support to the people living here. Discussion with the manager and residents showed that the care and support of the people who live here is very much person-centred and residents feel that they are genuinely valued as part of the family. Comments included were - Excellent service, well beyond that to be expected of a residential home and my mother is very well cared for. The inspector observed staff assisting the residents in a kindly and respectful manner. Those rooms that are shared have screening appropriately placed to maintain the residents dignity when care is carried out. Care Homes for Older People Page 14 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. The range of activities within the home and community meet the needs of the people living here. There is a good understanding of the various needs and abilities of residents and people are able to participate in stimulating and motivating activities. Meals and mealtimes are an enjoyable social occasion for residents. Residents choose from a nourishing and well-balanced menu. Evidence: The majority of staff are family members living in the vicinity of the home and as a consequence of this, the residents form part of an extended family with the advantage of being involved in the activities of daily living with younger people around them. The residents spoken to really appreciated the children being around and loved seeing them and engaging in conversation with them. Since our last inspection, two senior care staff have been appointed to work at the home. Having additional staff has allowed Mrs Chungtuyko (the registered person and co-owner of the home) more time with residents to support them in following their individual hobbies and interests, and increased opportunities for outings to local shops and places of interest. Two residents regularly go to local day centres and enjoy the Care Homes for Older People Page 15 of 28 Evidence: activities and social contact there. The home has asked residents about the kind of activities and outings they enjoy and would like to have the opportunity to do regularly. From the survey answers they received the home has been able to draw up a monthly activities calendar that includes all of the residents chosen interests. The AQAA information from the home tells us that the home works hard to maintain contact with the community by taking people who live here out to places and restaurants that interest them and familiar places that they once used to go to. The home has developed a Book of Memories for each resident. These are collections of photos and recollections about families and times past, as well as photos of places and home entertainments that people have enjoyed since living at Eden House. The Book of Memories are a good way of helping people to remember and celebrate past and present achievements and life events and help new staff to understand and value the life experiences of people living here. Discussion with the manager showed that the home takes a great deal of care to involve residents and their family and friends in building up relationships. This helps staff to understand peoples individual needs and choices about the way they spend their days and how they can maintain and develop new interests and hobbies. Visitors are welcome at any time and the home encourages residents and their families and friends to keep in contact. One person has no known relatives but does have a professional independent advocate to protect their interests and welfare. With the homeowner living in the house and other family members who staff the home, relatives are kept up to date with any relevant information - such as outpatient and medical appointments. Meals and mealtimes are an important part of the residents day. The main course for lunch on the day of inspection was salmon. The meal provided looked appealing and appetising and the residents said that it was very tasty. The main course was not as shown on the printed menu for the day and one resident commented that you could not always rely on having what was planned as it was often changed, However, the same person said that they always enjoy the meals and would happily eat fish every day. The menus for the week were displayed in the kitchen and in one persons room. This showed that a wholesome nutritious diet is always offered to the residents. Residents had taken part in a survey by the home about food and their preferences earlier in the year. The responses seen showed that people like the food and variety on Care Homes for Older People Page 16 of 28 Evidence: offer and that the home does try to meet individuals needs and provide their favourite foods regularly. The home marks and celebrates seasonal and religious events with music and food appropriate to the occasion. An annual garden party, with a pig roast, is held when residents invite their family and friends and enjoy the live music, entertainment and being part of the celebrations. Care Homes for Older People Page 17 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 and residents feel safe and listened to. The procedures and practices followed by the staff protect the people living here from abuse and exploitation. Evidence: The complaints system was seen posted in the entrance hall, and is contained within the Service Users Guide. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. Staff records showed that they are aware of the issues of the safeguarding of vulnerable adults through training and discussion. The manager and all the family and staff members are always available to residents and their relatives and friends to listen to any concerns or grumbles that may arise and deal with them promptly. The homes AQAA states that the home is good at updating the residents relatives and their representatives about any changes, progress or deterioration in a residents condition, and sharing ideas about how to improve peoples quality of life. The manager states in other words, working together and openess has helped to avoid complaints. The homes own Satisfaction Feedback Form responses (December 2008 to January Care Homes for Older People Page 18 of 28 Evidence: 2009) confirmed a very high level of satisfaction with the service and that managers and staff are always available to answer any queries or concerns. Regular review meetings with care managers, residents and their family or representatives, and visits from health care professionals all provide additional opportunities to raise any concerns. The AQAA tells us that all staff have received training about Safeguarding Adults inhouse and further update training is booked from an external trainer for the managers. The home has access to the local Oxfordshire Safeguarding information website. The homes policies and procedures in relation to management of service users money, valuables and financial affairs, and safeguardng adults and the prevention of abuse have been reviewed and updated since our last inspection. 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 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 comfortable, clean and well maintained so that people have a very pleasant family environment to live in. Evidence: All areas of the home are cleaned to a high standard, and the condition of the decor and furnishings is good. The communal rooms are comfortable and homely, and the residents individual rooms are personalised by the residents own possessions, and photographs. The home is kept scrupulously clean throughout. There is a continuous programme of redecoration. The AQAA states that since our last inspection, the first floor corridor and a bedroom have been redecorated and new windows fitted to a first floor bedroom. Adaptations have been made to help those people who are less mobile, for example, a seat and a frame to assist people using the lift to and from the first floor of the house. The laundry room is small but adequate for the personal laundry work done. New commercial standard washable floor covering has been laid in the laundry and kitchen, so that these can be more easily cleaned and are slip-resistant. Outside the garden is attractive with large mature tree and shrubs, lawn area and Care Homes for Older People Page 20 of 28 Evidence: summer bedding plants in containers. Runner beans and tomato plants have been planted for use in the kitchen later in the year. The family has also started to keep chickens with a view to having fresh eggs. Residents are involved in choosing the plants for the garden and many take an interest in the garden. 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. The care and support needs of the people living here are met by skilled and experienced staff. Since our last inspection, staffing numbers have increased and this has benefited the home because there are more opportunities for developing the social life of residents and allowing time for the training and development of staff in their work. Evidence: The manager confirmed that the numbers of staff on duty, daily are 3 care staff and a manager in the morning, 3 staff in the afternoon and evening, up until approximately 8 pm and then 1 waking and one sleeping-in member of staff to meet the needs of the 8 residents. The role of the care staff includes cleaning and laundry work in the home as well as personal care of residents. The home does not use agency staff. The majority of the staff are family members who live in the vicinity of the home. This ensures good continuity of care for the residents and adds to the overall feeling of family and home. At our last inspection we were concerned that the family worked long hours to meet the residents care needs and their own domestic and childcare commitments. Since our last inspection the home has recruited two senior care staff. This has meant that the staffing and management responsibilities can be more evenly spread and the home has been able to access more training and development Care Homes for Older People Page 22 of 28 Evidence: opportunities for staff outside the home. The training sessions booked for 2009 show that the home meets the need for regular training and updating of staff in mandatory health and safety topics such as safe moving and handling, fire safety, first aid, food hygiene and infection control. With the appointment of the new staff who have a nationally accredited equivalent of National Vocational Qualification (NVQ) in Care at Level 2, there has been some improvement in the proportion of permanent care staff working at the home who are qualified. Of the total of 6 permanent staff, 2 have NVQ 2 and are working towards Level 3. The registered manager and deputy manager are continuing to study for the Registered Manager Award and NVQ Level 4. All four staff hope to have completed their courses by early 2010. The staff files for the most recently employed staff were checked and showed that the recruitment process was thorough and that all the necessary references and police checks were completed and satisfactory before the individual started work at the home. There was evidence that staff also have regular formal supervision meetings with the manager as required, so that they can discuss their progress and any training needs they may have. The home has introduced a key worker system so that each resident has a named member of staff who has additional responsibilities to make sure the residents care needs are met and their care records are kept up to date. The homes AQAA states that they intend to let each resident and their family or representative know who their key worker is. In practice, because this is a small home, all the managers and staff have a good knowledge of each residents care and support needs and preferences. 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 is managed in a way that promotes and supports person centred care for the people living here, so that they have an increased quality of life. Since our last inspection, improvements have been made to the record keeping and administrative aspects required to show that the health, safety and well-being of the residents and staff are promoted. Evidence: The registered manager and deputy manager are continuing the Registered Managers Award and NVQ 4 courses and hope to complete these in early 2010. Residents comments, discussion with the manager and observations made during the inspection show that the home is well run and that the family members and staff work well together to provide a very good standard of support and care for residents and their families. This was also reflected in the homes own satisfaction survey comments seen (completed in the period from December 2008 to January 2009). Care Homes for Older People Page 24 of 28 Evidence: When we last inspected the home, we found that some of the administrative work was not up to date or had not been completed - for example, some of the homes policies and procedures had not been reviewed and updated, and the home did not complete the AQAA that all homes are required to submit to us every year. This year the home submitted the completed AQAA and it contains clear, relevant information about the changes they have made and where they still intend to make improvements. The manager has completed the review of most of the homes policies and procedures and said she will continue this process to make sure they are in line with current thinking and practice. By introducing a key worker system and regular in-depth review meetings with staff to discuss the care and share feedback about their work, the home has developed good systems to check that the staff team are putting theory into practice. The ethos of the home is consistently followed and each of the people living here are treated as valued and respected individuals, whose preferences and choices are understood and acted upon as far as possible by the staff team. The home has demonstrated that it actively seeks the opinions of residents about all aspects of life here - for example, changes have been made to the menus and activities on offer to reflect peoples individual suggestions and preferences. The residents personal allowances and financial affairs are safeguarded in that the staff do not deal with residents personal finances - these are dealt with by their family or Social Services Money Management if they are unable, or do not want to manage their own finances. The home works to a clear health and safety policy. All staff receive mandatory training in moving and handling, fire safety and food hygiene. The homes training plan shows that there are sessions booked for the year ahead. The fire safety log book was examined and showed that training sessions and checks of the fire fighting equipment, alarms and emergency lighting are regularly undertaken. The annual fire safety risk assessments are overdue and should be repeated for 2009 to incorporate any changes or new potential risks that might affect residents and staff safety. The manager said this work will be done. 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 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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