Care Home: Ferendune Court

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What the care home does well The home provides a clean, homely atmosphere, and welcomes visitors to the home. People living at the home appreciate the kind caring attitude of the staff members. Some of the comments we received included `The place is clean and cheerful` `Provides a very caring and cheerful support to residents` `Good meals and good care service`. Communication with relatives is good and the home has the benefit of support from the organisations management team. The managers and staff work well as a team and there are lots of opportunities for staff training and development so that the people living here have the care and support they need provided by a skilled and enthusiastic group of staff. What has improved since the last inspection? People living here have individual care plans that have been developed and updated since our last inspection to reflect their choice of care, support and lifestyle. Residents are now able to order the meals of their choice on the day of service, instead of the day before. This means people have improved choice because they can visually see and choose the food. The activities available for residents have been much improved with more choice and social diversity. New activities that are linked to everyday living, such as helping prepare vegetables, cakes, flower arranging, gardening and collecting eggs from the homes free-range hens. The home now has a monthly newsletter for residents and relatives to keep them informed about activities and new developments in the home. A programme of development and refurbishment is ongoing and work to update resident`s flats is underway to improve the en suite and kitchenette facilities. The training and development of staff has continued to develop, with individual staff taking on extra responsibility for looking at a range of health and safety topics in the home. This means that the whole staff team is involved in making sure that the home is safe and comfortable for the people living and working here. Several staff have also been trained and nominated as Dignity Champions so that they can advise other staff about how to recognise and meet the needs of people living with dementia. What the care home could do better: We found that the home is providing a very good service and we have not made any requirements for changes that must be made after this inspection. Any good practice recommendations were made during the inspection and at feedback with the homes managers. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ferendune Court Ash Close Faringdon Oxfordshire SN7 8ER     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 0 0 6 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 29 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 29 Information about the care home Name of care home: Address: Ferendune Court Ash Close Faringdon Oxfordshire SN7 8ER 01367243834 01367244421 virginia.santos@ancho.org.uk 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) : Anchor Trust care home 48 Number of places (if applicable): Under 65 Over 65 0 48 0 dementia old age, not falling within any other category physical disability Additional conditions: 48 0 48 The maximum number of service users to be accommodated is 48 The registered person may provide the following category of service only: Care home with Nursing (N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Physical disability (PD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ferendune Court is a purpose built home that opened in 1992 in Faringdon. It is divided into three units, one looking after elderly residents in their own flatlets, one unit looking after residents for a short stay and one looking after the more dependent resident with long term nursing needs. Each resident in the residential unit has their own flatlet that has a bedroom, lounge, a hallway and an ensuite shower room with toilet and wash handbasin. Each flat has its own lockable front door, letterbox, doorbell and peephole to enable residents to identify visitors prior to opening the front door. Care Homes for Older People Page 4 of 29 Brief description of the care home There is one flat identified for residents coming in for short stay. The home has a nine bedded nursing wing on the ground floor. Each room has its own ensuite facilities comprising wash handbasin and assisted toilet. One bedroom has ensuite shower facilities. The home has a short stay nursing unit and there are strict admission procedures for these beds. There is an agreement between Anchor Trust and the primary care trust on referrals for admission. There is a good range of assisted baths and toilets in addition to the ensuite facilities. There are two ground floor sitting rooms, and access to a large pleasant dining area. A lift serves all floors. There is a patio area outside the lounge cum dining room with an attractive bank of shrubs and flowers beyond, and a short walkway leading to a seating area. The registered manager and a team of nurses, carers, administrators, kitchen and household staff manage the service. The fees range from 465.00 to 695.00 pounds per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection of the service was an unannounced Key Inspection. The inspector arrived at the service at 10.20 am and was in the service for 6 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service - their Annual Quality Assurance Assessment AQQA - and any information that the Commission has received about the home since the last inspection. The inspector saw most areas of the home, observed staff interactions with the individuals living at the home, spoke to staff members and looked at records and documents relating to the care of the individuals. Staff recruitment records were also seen. We asked the views of the people who use the service and their supporters who Care Homes for Older People Page 6 of 29 responded to surveys that the Commission had sent out. We received 4 surveys from residents, 5 from staff, 1 from a relative and 1 from a health care professional. The inspector also spoke to several residents at the home during the day, and to two visitors. The views of those who responded to our surveys or who spoke with the inspector are reflected in this report. There are no individuals from ethnic minorities living at the home at present, but the home would be able to meet the cultural and religious needs of individuals, because of the focus by staff members on peoples individual needs through person-centred care. 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. Care Homes for Older People Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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: We looked at the pre-admission assessment information for 3 people, one of whom was someone due to come to the home for a short respite care stay for the first time. At our last inspection we found the home did not have enough up to date information about a person who regularly used the short-stay service. We made a requirement for the home to improve the pre-admission assessments or review of care needs before their planned short stay at the home begins. At this inspection, we found that the home has improved the way it assesses and updates information. The deputy manager explained the process followed to make sure they have enough details about the needs of people coming to stay at the home. There Care Homes for Older People Page 11 of 29 Evidence: appears to be a good level of information available from the prospective residents, their families and any health or social care workers who have been involved with them. This means that nursing and care staff can start to write care plans that accurately show how the individual coming in would like to be cared for and supported. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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: Since our last inspection the home has improved the service user care plans and there have been in-house training sessions for staff. This has helped staff know how to use the new health assessment forms and focus on peoples individual care needs and preferences, so that the care plans are person-centred. A small sample of the care records seen showed that people are assessed using a new health assessment system and recorded in their care folder. The care plans are drawn up with residents or their representative so that they accurately describe how they want to be cared for and supported. People spoken with during the inspection said that the staff were very good and that Care Homes for Older People Page 13 of 29 Evidence: they were helped to attend any appointments at hospital or for dental and opticians checks. The response to our surveys also showed that people were satisfied with the care and support they receive - two answered this is always the case and 2 that is usually so. A sample of the Medication Administration Records (MAR) was examined. These were correctly completed and showed that there is a safe system of recording and giving out peoples prescribed medicines. One of the MAR sheets seen had the list of medicines hand written by a senior staff member. Good practice recommendations are that if staff receive any verbal instructions from the doctor to make changes to someones MAR chart, the homes staff should have their handwritten instructions checked by the doctor in person and countersigned by them as soon as possible, to minimise the risk of mistakes that may harm the resident. If the doctor is not able to check and countersign the new instructions, then a second member of the homes staff should do so as an additional safeguard. Handwritten instructions on MAR charts should be clearly written, preferably in capital letters and without using abbreviations, to minimise the risk of misunderstandings and errors made by the staff giving out the medicines. These observations were made to a Team Leader who said she would take action to make the suggested changes. Observation of staff practices, conversation with residents and visitors, and peoples responses to our surveys showed that people living here feel they are treated with respect and dignity. Some of the comments were - Provides very caring and cheerful support to residents This home caters for lots of different needs. All 5 staff who completed one of our surveys mentioned that they thought the home does well in providing person-centred care to the residents. Four of the staff - the deputy manager, chef manager, activities co-coordinator and nurse team leader - are Dignity Champions within the home. They support and advise staff about recognising and meeting the needs of people in the home living with dementia. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a good range of activities and opportunities for people to take part in meaningful and enjoyable pastimes that suit their personal preferences and abilities. Mealtimes are relaxed and social occasions. The food is varied, nutritious and meets peoples needs and expectations. Evidence: At our last inspection, we found that some people said that they were sometimes bored and did not have enough to do. It is good to see that the organisation has worked hard to improve the way in which it provides activities and events. People living here have been consulted about the kinds of things they would like to do and where possible the home has acted on peoples suggestions. For example, a visit from Farm Animals was so popular with residents that the home had an egg-hatching to raise 3 free range chickens that are now part of the attraction of the gardens. Each month has a theme, for example May was Gardeners and Walkers and June was Blue Skies, Fresh Air and Hawaii. Events and activities involve everyone in opportunities to enjoy the gardens and outside events. Staff and residents had been busy preparing the garden for an external local gardening competition. Care Homes for Older People Page 15 of 29 Evidence: Within the home, facilities such as the introduction of a Wii games console and a large screen cinema television screen have given more people the opportunity to enjoy games and entertainment. The home has introduced a new questionnaire to assess peoples personal preferences about the activities and hobbies they enjoy and would like to continue or try out. The manager said that they are planning to convert a first floor sitting room to have computers for residents to use. The home is working to encourage participation with local schools and community groups. they have links with local sheltered housing schemes, schools and colleges. A Lottery funded project, Bridging the Gap, involved residents in meetings and then residents visited schools to share their stories. Local churches have a befriending service and residents have visitors on a regular basis. Some residents were looking forward to taking part in a local pub Quiz night. The home manager said that they have recently started quarterly relatives meetings. These are well attended and relatives and friends have been very supportive of the changes and improvements made at the home in the last 12 months. There are plans to improve the sitting room and facilities for visitors in the short stay unit on the ground floor. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel safe and listened to. The homes policies and procedures are available, understood and consistently applied so that the people living here are protected from abuse and exploitation. Evidence: The homes complaints procedure is included in the Service User Guidance, Statement of Purpose, leaflets and is on display in the reception area to the home. The homes AQAA tells us that Anchor organisation has good processes that ensure any complaints are responded to, and followed up quickly and lessons learned from them. Staff records and training information seen during the inspection confirmed that new staff have training in safeguarding adults from abuse and neglect. All staff have mandatory updates about safeguarding and there is a confidential whistle blowing policy through which staff can raise any concerns with the organisation. The homes AQAA states that Anchor has improved the way it deals with complaints and concerns through the appointment of a Care Specialist. This person makes sure that any issues to do with safeguarding, complaints and protection are followed up rigorously. They make sure that everyone is informed about any changes that may be necessary to avoid similar incidents or complaints happening again. Care Homes for Older People Page 17 of 29 Evidence: Neither the manager, nor CSCI, has received information about any formal complaint about the home since the last inspection. Residents conversation and responses to staff, together with written comments we received in the surveys we sent out, show that people living here are encouraged to share their opinions and suggestions about the home and standard of care and facilities. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides people living here with a clean, comfortable, safe and attractive environment to live in. Adaptations and improvements are made to rooms to best meet the range of different needs and abilities of residents. Evidence: The home is welcoming, with seating, information for visitors and fresh flowers in the entrance area, and the gardens and grounds are well maintained. A tour of the home and spot check of 3 rooms showed that the house keeping staff achieve a high standard of cleanliness. Two of the 4 residents who completed our survey said that the home is always fresh and clean, and 2 that this was usually the case. The home has a planned maintenance and refurbishment programme supported by a Surveyor Team from Anchor. Several of the flats have been redecorated and updated to improve the ensuite facilities and kitchenettes. Care has been taken to choose colour schemes and signs that are specifically designed to be helpful to those residents who have dementia. The home regularly reviews how well the building and facilities meets the needs of Care Homes for Older People Page 19 of 29 Evidence: people living here. There are plans to upgrade and improve the under-used sitting room in the short stay unit, to make it more welcoming and homely for service users and their visitors. Similarly, an internal room on the first floor landing area is to be refurbished with a view to making it into a computer room for residents to use. Staff training and practices in control of infection are given high priority. The home has appointed a named nurse to monitor infection control in the home. The AQAA tells us that in 2008 the homes staff were involved in the making of a film by the Department of Health. The resulting DVD about infection control is to be used by the Health Protection Agency for training staff in all health care organisations to demonstrate best practice in infection control. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care and support needs of the people living here are met by skilled and experienced staff. The homes procedures for recruiting, screening and training new workers are robust and protect the people living here from harm. Evidence: Examination of the staffing duty rota for the period May 31 2009 to 13 June 2009 showed that the home maintains consistent staffing levels. There is a registered nurse (RN), a senior care assistant (Team Leader) and 6 care assistants on duty during the day and a nurse, a team leader and 3 carers on duty overnight. The number and skill mix of staff appears to meet the varied level of needs of the residents. However, a GP who completed one of our surveys, wrote that there are not enough nurses for the amount of patients, but added that the nurses are caring and helpful. The four residents surveys indicated that staff are usually available when they need them. All the feedback we received was positive about the staff. Peoples comments included Staff are friendly and helpful and Provide very caring and cheerful support to residents. The manager confirmed that the home has not needed to use any agency care staff since 2007 and this maintains continuity of care for residents and their confidence in a staff team that knows their needs. Care Homes for Older People Page 21 of 29 Evidence: Staff surveys were very positive about working at the home and in particular the training and leadership they have. One person wrote - we have a fantastic team here. I enjoy my work and go home feeling that I have done everything I could to make everyone happy and content before I leave the building. The 4 staff who completed surveys said that there are always or usually enough staff to meet the individual needs of residents. An undergraduate student nurse, on placement at the home, was positive about the standard of care she had observed and the way in which staff worked together with community nurses, physiotherapists and occupational therapist to the benefit of residents. A small sample of staff files was examined. The files seen showed that the staff recruitment process is robust - they contained all the necessary information, references and police checks that are required before new staff are started in employment at the home. The programme of induction for new staff was described by the home manager. She confirmed that induction training meets the required Skills for Care standards (the national training organisation). The induction training uses Anchor Care services and on-line computer training. Since our last inspection, the home has increased the number of staff who have achieved the nationally recognised qualification in care - National Vocational Qualification (NVQ) at Level 2 or above. Several staff in the home are NVQ assessors and this helps staff who are on NVQ courses to complete their assessments and course work. The homes AQAA completed in March 2009, states that 21 of the 56 permanent care workers have NVQ Level 2 or above. The home manager and her deputy have encouraged the team leaders in their roles by giving them the opportunity to have individual specific responsibilities and roles within the home - for example, Back Care, Health and Safety, and Fire Safety Coordinators. Team leaders are also expected to attain NVQ Level 3 Anchor organisation shows a commitment to staff training and development and this has a positive effect on staff morale and confidence and in turn, the quality of care and support for the people living here. Anchor recognises good practice and the achievements of staff through a company awards system - 2 members of staff were awarded with Care Awards in recognition of their contribution and service to the residents. Seven staff reached the semi-finals for the national Anchor Trust awards. Within the home, there is a monthly award for a member of staff who has done an outstanding job. Several newspaper and journal articles were on display in the home reception area, highlighting the achievements of the home and the staff team. Care Homes for Older People Page 22 of 29 Evidence: Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 has been at Ferendune Court for several years and is well qualified for her role. She is also a Area Support Home Manager for Anchor Trust. The home deputy manager has been at the home for over a year and has developed in her post, with completion of courses relevant to her work. She intends to start a management course in the coming year. Both the manager and her deputy were nominated by the staff for the Anchor Trust Care Award and were semi-finalists. It is evident that the manager and staff team Care Homes for Older People Page 24 of 29 Evidence: work well together. This was reflected in the comments we received (everyone has a good relationship with our manager and deputy manager; I enjoy working at Ferendune Court and feel I am supported by the care staff and managers here; The home as a whole is very good at making sure that the residents and staff alike are treated equally and have freedom of choice; all the staff at Ferendune Court are helping each other thus there is a good understanding of team work that boosts staff morale. The home has good systems for looking at how well it is meeting the needs of service users - The Customer Journey. Residents and their families are invited to take part in customer consultation surveys every year. These surveys are undertaken by an independent care industry organisation. Residents meet together monthly, and relatives and friends quarterly, to discuss how they would like the home to develop and share suggestions activities, social events and menus. The minutes from meetings are posted or e-mailed to everyone, together with the monthly copy of the Ferendune Court Activities newsletter. The home also completes a self audit, based on the National Minimum Standards for care homes for older people. Different staff members complete different sections of the audit and the manager said that this has proved very useful in that the staff team know about the minimum standards and how the home is assessed by the commission. There are regular meetings of staff at all levels and staff satisfaction surveys are used to get feedback from staff. As part of a larger organisation, Ferendune Court benefits from having the support of training, personnel and maintenance departments and access to information and support from the wider group. The managers and staff have up to date information about changes in legislation and how this affects the residents and staff living here. For example, the Mental Capacity Act and Deprivation of Liberty guidance that staff must be aware of in order to safeguard the rights of people living here to make individual choices and decisions about the way they live. The home keeps no petty cash for people living at the home. Personal accounts are held in a residents account in a local bank, and invoices are sent to request payments for services such as hairdressing and podiatry. Good records are available to show individuals accounts. Anchor Trust has a comprehensive range of policies and procedures, copies of which are available in staff offices. The AQAA document shows that most of the policies and procedures were reviewed in 2008. Care Homes for Older People Page 25 of 29 Evidence: Staff training records were found to be lacking in detail at our last inspection, but are now better organised, with electronic records to show when staff have completed the required annual health and safety training and updates. Residents records included risk assessments for example, use of bed rails, and when people go out of the home on outings. The home has regular audits of residents care plans, medication records and infection control measures. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 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). 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