Care Home: Elizabeth House

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What the care home does well The home has worked hard to improve standards. People can be assured when moving into Elizabeth House, that a thorough assessment has been carried out and the home can meet their needs. People`s relatives we talked to spoke highly of the home, and the care provided by the staff to support individuals. Relatives and people using the service said that health care needs are promptly met, and every one kept informed. We have received no complaints about the service provided at Elizabeth House, no complaints have been made to the home. What has improved since the last inspection? The central enclosed garden area has been developed and provides flower beds, pathways and seating, for people using the service. The home continues to provide activities, on a daily basis in the afternoon with an activities co-ordinator. One to one activities are provided for people with dementia, and those people with short consentration span. Staff records have been reviewed, expanded, and enhanced. A new staff room has been created from the old smoking room, and staff refreshment facilities provided. Nutritional assessments are now in place for people using the service. Each new person using the service has one to one with a designated member of staff, for the whole of their first day at Elizabeth House. What the care home could do better: . Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elizabeth House Sandy Hill Werrington Stoke on Trent Staffordshire ST9 0ET     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: Kathryn Marks     Date: 2 4 0 4 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: Elizabeth House Sandy Hill Werrington Stoke on Trent Staffordshire ST9 0ET 01782304088 F/P01782304088 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) : Mrs Susan Elizabeth Fradley,Mr Philip Harold Fradley care home 28 Number of places (if applicable): Under 65 Over 65 0 28 dementia old age, not falling within any other category Additional conditions: 14 0 The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 28 Dementia (DE) 14 Date of last inspection Brief description of the care home Elizabeth House is a Registered Care Home for 28 older people, 14 of whom may have dementia care needs and 10 of which may have a physical disability. The Home is owned by Mr and Mrs Philip Fradley, both of whom are actively involved in the running of the business. Mr Fradley is also the registered manager. The Home stands in private grounds, which provides ample car parking for visitors. The Home is situated in Werrington, in a residential area on the outskirts of Stoke-onCare Homes for Older People Page 4 of 28 Brief description of the care home Trent, bordering the Staffordshire Moorlands. Internally the accommodation is of a high standard with a good standard of housekeeping throughout. It is warm, well furnished and comfortable. There is a choice of three lounges/sitting rooms of varying sizes and a separate dining room. There are twenty-eight single bedrooms, twenty-six of which have en-suite facilities. There is a safe courtyard area in the centre of the Home. Information contained in the service users guide tells us that the fees charged are from £408 up to £431 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: This unannounced key inspection was carried out on Friday 24th April 2009 by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. The last key Inspection on this service was completed on the 17th April 2007. On arrival for this inspection the care manager, two deputy managers and five care staff were on duty. There were two cooks and housekeeping staff also on duty. The care manager provided written information regarding staffing, staff training, menu and dietary provision, that was observed to be in place at the home. Care Homes for Older People Page 6 of 28 We discussed with the care manager arrangements for the day, to avoid disruption to people using the service, staff, and routines in the home. We spoke to people using the service, and their relatives who were visiting them. We checked the financial records of three people using the service. Three peoples care records were checked, and the records of three staff, including recruitment and training records. We discussed the food with people living in the home, observed lunch being served, and talked to the cook. We also looked at the Annual Quality Assurance Assessment (AQAA) this is a self assessment tool, and had been very well completed with a lot of detail, and sent to us prior to the key inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. 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 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service have the information they need to make an informed choice about living at the home. Evidence: The AQAA we received prior to the Key Inspection told us that Every potential person using the service has an individualised pre-admission assessment to determine if the service would be able to meet their needs. The assessment is passed to the manager who ensures that the assessment has included the opinion of other professionals. Where social services are involved the social services care plan and care management assessment is requested for reference. Prospective people are encouraged to visit the home. The pre-admission assessment form is used as a two way question and answer with the person if possible. We saw the homes Statement of Purpose and Service Users Guide that have been Care Homes for Older People Page 10 of 28 Evidence: updated and provide detailed information for people who may wish to use the service. We saw records that told us peoples relatives had visited the home prior to admission. We talked to peoples relatives who were visiting the home, they confirmed this to us. We saw three peoples care records and examined them in detail. Peoples records contained information collected by the assistant manager, who carried out the assessment. Generic risk assessments were in place and included manual handling, fire risk, nutritional assessment. Risk assessments were signed and dated. This means peoples needs had been assessed, risks identified, and the home was satisfied it could meet those needs. A new persons checklist had been introduced, and on admission people are given a welcome pack by the staff member, who is spending their first day with them to settle the person in. The pack includes information about meal times, housekeeping, who is looking after them, telephone arrangements and where the telephone is. This provides reassurance to the person and assists them to find their way around the home. Two relatives we verbally surveyed told us they were very happy with the information they and their relative received prior to admission to the home. The Home does not provide intermediate care. Care Homes for Older People Page 11 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. The health and personal care needs of people using the service are met, personal care is delivered in the way the individual wishes. Evidence: The AQAA we received prior to the inspection told us that The care plan is generated initially from the pre-admission assessment. The person using the service, their relatives and friends and care staff are encouraged to contribute to the contents of the care plan. When complete, it must be agreed and signed by the person using the service or representative. The majority of changes to the care plan are performed on an ongoing basis, with a care plan review scheduled at the end of the homes 4 week cycle. Other changes to the care plans follow the annual persons review and annual quality assurance survey. Every person has to be registered with the Werrington doctors surgery because of the distance to other practices. The surgery also provides specialist healthcare from Matron, district nurses and chiropodist. Every person using the service is encouraged to be independent where possible and make decisions about their own care. The care plan contains the persons health care, mental and dietary Care Homes for Older People Page 12 of 28 Evidence: requirements and how they are to be delivered. The storage, handling and administration of medication is given high priority at the home. The policies, procedures and methods are inspected by the local pharmacist who also advises on an individual person basis. Spot checks are carried out on a daily basis to ensure procedures are followed. Only senior staff administer medication following the completion of accredited training. Full records of medication arriving at the home and administered are kept. We checked the care records of three people during this inspection. We saw that records contained information regarding health care, personal care, and risk assessments that are reviewed on a monthly basis. A care plan summary is kept in peoples bedrooms and provided information for staff, to ensure that they know the level of support required. The care summary is updated on a daily basis, and the care plan is updated monthly. We saw health care records that identifed people are registered with the local health care practice. Appropriate referals are made to professionals as necessary. One relative we spoke to told us that she was more than happy with the health care arrangements for her relative in the home. As at the previous inspection, all people using the service have general pratitioner and community matron support from the local practice. The Assistant Manager told us The Matron from the health care practice said the team work between the home and the practice is good and working well. We saw a detailed system in place for recording accidents, that quickly identifies people who are prone to accidents. We observed that medication is administered from a blister pack monitored dosage system, with the exception of medication not compatable with the system. The care manager told us that the system was working well. We saw records that identified medications are administered by senior staff who have been trained in the management of medication. We saw risk assessments on peoples files that identified areas where support is required, and how it would be given. Detailed nutritional risk assessments are in place. We saw throughout this inspection courtesy being shown to idividuals, with privacy and dignity being promoted. New induction for staff includes the promotion of privacy Care Homes for Older People Page 13 of 28 Evidence: and dignity. Peoples visitors were all offered refreshments as they would be if in the persons own home. We observed that one to one time was being given to people with dementia to ensure that interaction was taking place socially. 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. People using this service make choices about their daily lifestyle, with their visitors and friends made very welcome. The food provided is of a high standard, with a varied and nutritional diet being offered. Evidence: The AQAA we received prior to the inspection told us that Elizabeth House is the only residential home in the village and, have strong links with the community, shops, hairdresser, newsagents, church and choir, doctors surgery, library and neighbours. The community is normally involved with the homes celebrations. All people using the service are made aware of advocacy services available and the contact numbers if required. The Home pays an annual fee for the Care Aware helpline, making it available to all of the people and their families. Where appropriate people are encouraged to vote in parish, district and national elections. Monthly forums are held where people are encouraged to suggest improvements that are documented and passed to management. Staff cars that are insured for the purpose, and the community bus are used for transport for people living at the home. The people are offered and kept informed of daily activities, entertainers and birthday parties. All people are treated as individuals, one to one activities, records are maintained. Care Homes for Older People Page 15 of 28 Evidence: Peoples privacy is respected, normally visitors in the privacy of persons bedrooms. Refreshments are offered, there are no restrictions on the number of visitors. A private telephone in persons bedroom can be arranged if the person wishes. Activities coordinator attempts to include families in annual activities to maintain family relationships. The home provides three meals a day plus a light snack supper. All meals have alternatives offered. Additional snacks and refreshments are available during the day and night. Special diets are catered for. All home cooking and baking. Personal allowance is managed by the person themselves or the homes manager. The privacy, dignity, confidentiality, and respect are always considered by staff . We saw that a daily activities programme is in place in the afternoons, that involves and provides for the social needs of all people living at the home. Activities were recorded in peoples care plans that we looked at. We sat in on a quiz that people enjoyed and involved themselves in, and observed that a game of dominoes was taking place with people who needed one to one staffing. We saw that the staff on duty stimulated the people involved in activities, and they really enjoyed their afternoon. We chatted to people in a small group where jovial banter was being exchanged, and we talked to two people with their relatives. Relatives told us that they were very happy with the care they had observed at the home. One person who has no relatives, staff take them out for a walk or shopping and spend time with them on a one to one basis. People told us in general conversation that the staff at the home are wonderful We are well looked after you could not ask for more soon send for doctor if you are not well. The three people whose care records we looked at, we observed the personal allowance and the records relating to this. Cash balanced with the records maintained. We saw the menu displayed in the dining room with alternative choices available. The cook told us that food is all cooked fresh and home made. We saw the food being served to people, this was nicely presented and portions were generous. We saw that people who needed assistance to have a meal this was done in a discreet and sensitive manner. Care Homes for Older People Page 16 of 28 Evidence: We talked to people after lunch and they told us that they had enjoyed their meal, that the food was always nice, and that they had enough to eat. Staff training records told us that the majority of staff have completed food hygiene training. 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. People who use the service are able to make complaints and are safeguarded by the homes procedures. Evidence: The AQAA we received prior to this inspection told us that One of the homes priorities is to ensure that each person feels happy and safe. The home has the complaints procedure in clear and large print, displayed on each en/suite door of every bedroom. The procedure is explained to each person. All people where there is no supporting family or friend is offered the use of an advocate, who together with the manager ensures the persons rights are upheld. The protection of people from abuse is wide ranging. The training and the policy and procedures ensures the staff are aware of the many aspects of abuse. All staff undergo a Criminal Records Bureau and Protection Of Vulnerable Adults check, two references are taken up by phone and by letter. The manager ensures the homes policy and procedures are complete regarding peoples money, and are audited. We saw the home has in place a complaints book, no entries have been made since 2005. A grumbles book has also been introduced for people and their relatives to use. There have been no complaints made to the home or to the Commission. We talked to people in the home and three of their relatives. People using the service Care Homes for Older People Page 18 of 28 Evidence: said they would talk to staff if unhappy about something and staff would sort it out. Relatives said issues were dealt with quickly by management, and that they had not had cause to complain. We talked to a small group of people about one of the monthly activities, this is a peoples forum where individuals can raise any issues they want to discuss. They told us people do talk about different things, activities being one of them. We looked at the finances of three people using the service, the cash balanced with the records kept. We saw staff training records that identified the staff have received training in the Protection of Vulnerable Adults. All senior staff have received Equality and Diversity training, all people using the service are treated equally, and offered the same choices. We saw on staff files that Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out, and two written references are taken up prior to employment. 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 physical design and layout of the home enables people to live in a safe, clean, well-maintained and comfortable environment. Evidence: The AQAA we received prior to the inspection told us that Management ensure that the home is well maintained both internally and externally including grounds and garden. This provides a homely and safe place to live. The service has a schedule of maintenance which is continually updated. Health and Safety and Fire risk assessment have been completed. The service ensures that the infection control procedures are up to date and employed on an ongoing daily basis, by all staff and people using the service. Each room has an infection protection box with lid that houses the disposable gloves, aprons, red bags. The staff training in Infection Control is included in induction and is then ongoing. The laundry equipment is commercial and rented with built in ozone facility for infection control. Hand washing and hand gels are applied to peoples hands by staff as part of infection control procedures as a precaution in case a person who self toilets forgets to wash their hands. All visitors are requested to use the gel provided. We saw that the physical design and layout of the home meets the needs of the people using the service. The three communal areas are comfortable and homely, people Care Homes for Older People Page 20 of 28 Evidence: were relaxed in their surroundings, and moving freely around the home. We saw that Health and Safety checks are carried out and individual fire risk assessments are in place. One person has had a Dorgard fitted to ensure their safety. We saw good infection control practices in place, infection protection boxes were in the bedrooms we visited, hand gel was freely available around the home. We saw staff training matrix that identifies the staff have received infection control training. Policies and procedures were in place for the control of infection. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and consistent staff team support the people using the service. Evidence: The AQAA we received prior to the inspection told us that the staff operate in a manner which promotes independence, security, confidence and confidentiality. The qualifications of the staff are closely monitored and training scheduled to ensure staff have the knowledge they require. The staff training matrix identifies experience and qualifications. Extra hours have been inserted into the schedule for daily group and individual activities, these have not been included as part of the care hours requirement. The recruitment procedure is proactive, involves equality, forward planning, advertising, Criminal Records Bureau and Protection Of Vulnerable Adults checks, references, employment history, application forms, written documentation of the interview. All new recruits receive a starter pack consisting of the homes aims and objectives, list of staff, floor plan, job description, staff handbook, codes of practice, policies and procedures index. Homes Brochure, fire alarm instructions,. Contingency plans are in place for sickness, vacancies, on occasion agency staff are used we always try to ensure the agency member has been before. All staff complete a twelve week induction unless already qualified to NVQ 2. Senior staff must be NVQ 3 or taking it. The care manager is NVQ 4 as is the assistant manager. All staff have annual assessments and a minimum of 6 supervisions a year. Care Homes for Older People Page 22 of 28 Evidence: We saw staff records of the last three people employed by the home. Records told us staff have received appropriate pre-employment checks prior to commencing work at the home. We saw staff training records in staff files, and on the training matrix, that identified 70 of staff are trained to National Vocational Qualification level 2. All new staff receive a general induction to the home, followed by a first shift always being a training shift where they are additional to the rota. All staff complete a twelve week induction period, this is recorded in staff files. We saw records that told us senior staff are completing National Vocational Qualification in Customer Care, recognising when people need assistance and looking after their families. One Assistant Manager deals with all pre-admission assessments, this provides consistency for the person using the service. We talked to the assistant manager who told us that she felt well supported by the management of the home. We talked to members of staff who told us they received regular training opportunities, and that training is scheduled into the rota. Mandatory training is recorded in staff files and identified in matrix. We talked to the cook who told us that provisions are ample, all fresh produce is used, one cook has completed Elderly Nutrition course, one has a Professional Cooking qualification. Cook is on duty 7 days a week, we saw the rota that confirmed this. We talked to the Care Manager who told us that recruitment is via local newspaper, or Care Match which is an organisation where people put there Curriculum Vitae and employers can access. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are safeguarded by competent management systems. Evidence: The AQAA we received prior to this inspection told us that The manager has twelve years of management experience in a care setting and holds NVQ level 4. The assistant managers have 26 years between them in a supervisory role in a care setting. The home has a clear management structure that people are aware of. The policies and procedures are extensive and up to date. The management monitor that staff have read, understood, and follow all of the policies and procedures in place. The service analyse the quality of the service, review the risk assessments and modify care plans to accomodate changing needs. All personal records are made available to the person if requested. The home has a safe, which houses peoples personal allowance and valuables. A record is kept of the safes contents and audits performed on a regular basis. The health safety and welfare of people, the public and staff are protected as far as is possible by the manager via compliance with Health and Safety Care Homes for Older People Page 24 of 28 Evidence: legislation and advice, COSHH and RIDDOR regulations. All of these topics are subjected to risk assessments and the resulting action plans. The manager is experienced and qualified to National Vocational Qualification Level 4, and has the Registered Managers Award. We saw that good leadership was in place, and staff knew what was expected of them. Relationship between management, staff, people using the service and their families generates a happy and homely atmosphere. We saw good quality monitoring systems in place, the assistant manager monitors the well being of the people using the service and the practices in the home. We saw a sample of questionnaires that had been sent out to people and an analisis of the results. We saw robust systems in place for the management of peoples personal allowance, records are kept and audited on a regular basis. We looked at the finances of three people using the service, cash balanced with the records maintained. We observed safe working practices to be in place, all staff records show that health and safety training has been completed, along with other mandatory training. We saw that a generic fire risk assessment had been completed and all people had an individual evacuation plan. 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!