Care Home: Fernbank Nursing Home

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What the care home does well The home is well furnished and feels cosy. Residents interviewed were satisfied with their accommodation and the premises had been kept clean. Residents and relatives who were interviewed spoke highly of staff and were of the opinion that residents were well cared for. They described staff as respectful, friendly and caring. The home has a comprehensive training programme for staff. Staff were found to be knowledgeable regarding their roles and responsibilities and able to provide care that is responsive and sensitive to the needs of residents. Staff were also aware of Equality and Diversity issues and the need to treat all residents with respect and dignity. There is a good team spirit and staff indicated that they worked well together. The home has a computer with internet access for the use of residents. This is located in the lounge. What has improved since the last inspection? Improvements had been made in the administration of medication. Deficiencies identified in our pharmacist inspector`s report had been complied with. The required fire drills had been carried out and this included one held during the night. This ensures the safety of residents and staff in the event of a fire. A report following the last consumer survey carried out in the home had been prepared. This ensures that residents and staff are fully informed. What the care home could do better: The Statement of Purpose and Service User Guide must be amended to reflect the recent change in management and change in address of The CQC. This is to ensure that prospective residents and their representatives are fully informed. The care and plans of care of the resident identified to the manager in the section on Health and Personal Care must be reviewed with professionals involved and with the resident`s family. This is to ensure that this resident is well cared for. A review of the amount of social and therapeutic activities provided by the home should be carried out. This is to ensure that residents can be given more activities and stimulation. A review of staffing levels during the morning shift must be carried out to ensure that there are sufficient nurses on duty and the nurse responsible for the administration of medication is supported and able to have a break in the morning. Key inspection report Care homes for older people Name: Address: Fernbank Nursing Home Finchley Way Finchley London N3 1AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Daniel Lim     Date: 2 4 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fernbank Nursing Home Finchley Way Finchley London N3 1AB 02083493426 02083494748 fernbank@ECGhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Karim Nizarali Bhanji,Rozita Heshmati-Bhanji Name of registered manager (if applicable) Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The Registered Person may provide the following categrory of service only: - Care home with Nursing - Code N 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 - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Fernbank Nursing Home is a care home which has been registered to provide nursing care for a maximum of thirty four older people. The home changed ownership in December 2007. The current owners inform us that they also run other registered care homes in this country. Care Homes for Older People Page 4 of 28 Over 65 0 34 34 0 2 4 0 2 2 0 0 9 Brief description of the care home The stated aim of the home is: To provide service users with a secure, relaxed and homely environment in which their care, well being and comfort are of prime importance. The home provides care for a culturally diverse group of residents including a significant number from the Greek Cypriot community. The premises comprise of a large detached three storey period house. The ground floor contains ten single bedrooms and four double bedrooms. Four of the single bedrooms have ensuite facilities. The first floor contains eight single bedrooms and four double bedrooms. Four of the single bedrooms and one of the double bedrooms have ensuite facilities. The home has a large communal lounge on the ground floor and an additional smaller lounge on the first floor. There is a small front garden and a medium sized garden at the side of the house. There is also a small parking area at the side of the house. The home is situated in a residential area near to West Finchley tube station and close to shops, restaurants, bus routes and other community facilities located along the High Road and Ballards Lane. The scale of fees charged by the home can be obtained from the manager. The provider must make information about the service available, including reports to service users and other stakeholders. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on the 23rd of December 2009 and took a total of 7 hours to complete. We were assisted by the new manager, Nelisiwe Sylvia Mthabela. A relative was also interviewed as part of this inspection on 24th December 2009. A total of four residents and three relatives were interviewed. Seven completed CQC surveys were received from residents. These were on the whole, positive and indicated that residents were well cared for. Statutory records were examined. These included four residents case records, the maintenance records, accident and incident records, complaints records and fire records of the home. The premises including residents bedrooms, communal bathrooms, laundry, kitchen, Care Homes for Older People Page 6 of 28 garden and communal areas were inspected. Four staff were interviewed regarding the care of residents and other areas associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. Staff records, including evidence of CRB disclosures, references, supervision and training records were examined. In addition, the minutes of residents meetings were examined. These indicated that residents had been consulted and informed of changes affecting the running of the home. The completed Annual Quality Assurance Assessment form or AQAA was received by us. Information provided in the assessment was used for this inspection. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 28 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken by the manager or a sufficiently skilled member of staff. This ensures that the home is able to meet the needs of residents. Evidence: The homes AQAA stated that: Residents are assessed prior to admission and clearly given information about the service that they will receive. A social workers comprehensive assessment is faxed to Matron prior to Matrons own assessment. Residents are invited to spend a day in the home so that they can get a feel as to whether they will feel at home there. The pre-admission assessments which were examined were noted to be appropriate and comprehensive. These assessments included details of the personal, mental, Care Homes for Older People Page 11 of 28 Evidence: cultural and spiritual needs of residents. Risk assessments had also been prepared for residents admitted to the home. These were appropriate. We examined the Statement of Purpose and Service User Guide. They had not been updated with details of the new manager and current address of The CQC. The manager agreed that this would be done. This is to ensure that prospective residents and their representatives are fully informed. Residents in the home were noted to be clean and appropriately dressed. Residents and relatives who were interviewed by us indicated that residents were well cared for and their care needs had been attended to. Comments made by residents and their relatives included : We are very satisfied with the care in the home. The staff are very good and responsive. This is the sort of place I would recommend to others. The manager stated that the home did not have any contracts for intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place for meeting the healthcare and personal care needs of residents and these are recorded in residents care plans. The arrangements for the administration of medication are satisfactory. This ensures that residents are well cared for. Evidence: The AQAA states: All our service users are treated with dignity and respect. Care plans which have been agreed by the service user, next of kin and carer are in place which contain information about the individuals wishes, choices and decisions. They are given a choice on daily routines. As their health deteriorates we put in place information to monitor food or fluid intake, monitor pain and any pressure ulcer. During the dying process there are serious illness and death wishes on file. We liaise with other healthcare professionals to ensure dignity and comfort of the resident is maintained, that they are pain free and their wish as to where they die is respected. Family involvement is a key factor and they can visit and stay as they wish. Care Homes for Older People Page 13 of 28 Evidence: Comments made by residents and their relatives in interviews indicated that there is a caring atmosphere in the home and the personal and healthcare needs of residents had been attended to. This was also confirmed in seven completed CQC surveys received from residents. Residents interviewed stated that they were well cared for and they had been treated with respect by staff. A random sample of four care plans which was examined were on the whole well prepared and regular monthly care reviews had been carried out. The care plans were holistic and addressed the cultural and spiritual needs of residents. Nutritional monitoring and weight monitoring charts were evident. There was evidence that residents had access to healthcare professionals such as the chiropodist, dentist, optician and their GP. Appropriate risks assessments had been prepared for residents. These were generally of a good standard. The care plans of a resident with dementia and challenging behaviour was examined. We note that staff continued to have difficulty caring for this resident. In view of this a requirement is made for a review to be arranged with the professionals involved and with the family. This is to ensure that problems experienced can be discussed and an appropriate and effective plan of care can be prepared for this resident. The manager agreed that this would be done. The home has an up to date medication policy which covered areas such as safe administration, ordering and disposal. Residents in the home were able to administer their own medication if they wished to, subject to risk assessments and giving consent. We inspected the Medication Administration Records. There were no omissions in the records. A separate book was used for recording the disposal of unwanted medication. Overall records of administration were accurate. We inspected the recording of controlled drugs. The records examined were satisfactory. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily life, meal arrangements and routines of residents are on the whole well organised. The views of residents and their relatives are being sought when planning the homes activities and routine. People using the service are given the opportunity to take part in activities that are appropriate and varied. They also have opportunity to maintain important family relationships. Residents are offered wholesome and varied meals which meet their needs and preferences. Evidence: The homes AQAA made the following statement : Residents are now being encouraged to make choices about their lifestyle and being supported to develop their skills. The activity person is ensuring that social, educational, cultural and recreational activities meet individual expectations. The residents appear to be enjoying the new karaoke, monthly live entertainment, 1 to 1 sessions and many more. Staff enjoy joining in. We now have computer and service user internet access in the main lounge. We are attempting to encourage some residents to experiment with this facility. We discussed the programme of activities with the activities organiser. She informed Care Homes for Older People Page 15 of 28 Evidence: us that residents are consulted regarding what activities they like and these are documented. The activities provided included arts and crafts, exercise sessions, hand massage, reminiscence sessions and books being read to residents. Residents and relatives interviewed were able to confirm that the home has a range of activities which residents can participate in if they wanted to. In addition, arrangements had been made to ensure that residents from various faiths can celebrate and observe their religious and cultural events. Priests from the orthodox and catholic churches regularly visit the home and hold services for residents. We note that the activities organiser only works part time. The manager explained that staff are also involved in organising activities when she is not around. One person who spoke to us suggested that more activities be organised so that residents can be given more activities and stimulation. This was discussed with the manager who agreed to review the matter. An example of good practice was provided by the manager. She informed us that the home now has a computer in the lounge with internet access for residents. Residents who are able to use the computer were encouraged to do so. The home had a visit the previous year from the local environmental health officer and was awarded 4 stars. The kitchen was clean and well equipped. A record of fridge and freezer temperatures had been kept. These were satisfactory. The chef who was interviewed was knowledgeable regarding her responsibilities and the special dietary needs of residents. The menu examined was varied, balanced and there was a choice of main dish. Traditional English food and various cultural meals were noted on the menu. Residents interviewed stated that they were satisfied with the meals provided. This was reiterated in the seven completed residents surveys received by us. One resident stated that she had more than enough while another stated that she could have her ethnic meals if she wanted to. Care Homes for Older People Page 16 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 arrangements for responding to complaints and for adult protection were satisfactory. The home has an open culture that allows residents to express their views and concerns in a safe environment. This ensures that residents are well treated and protected from abuse. Evidence: The AQAA states: People who use the service are encouraged to express their concerns verbally or in writing. All staff on induction are informed about POVA and whistle blowing. Mandatory training on POVA is delivered by a qualified person. Staff are aware of where to access the policies and procedures. Residents and their relatives who were interviewed by us indicated that they were well treated and satisfied with the care provided to residents. The home has an adult protection procedure. It included examples of abuse and guidance to staff on reporting allegations of abuse to Social Services and The CQC. The local authority safeguarding guidelines were also available. The manager and her staff who were interviewed were aware of the homes policy and procedures for the protection of vulnerable adults. There was evidence that staff had been provided with the required training. One safeguarding allegation was notified to us and brought to the attention of the Care Homes for Older People Page 17 of 28 Evidence: Police and Social Services. The home co-operated fully with the subsequent investigation. The allegation was not substantiated. The home had a record of complaints received. There was documented evidence that they had been promptly responded to within the required timescale of 28 days. Residents stated that they were on the whole, satisfied with the services provided. When asked, they indicated that they know who to complaint to if they wanted to make a complaint. Care Homes for Older People Page 18 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 clean, tidy and well furnished. The manager and providers have ensured that the physical environment of the home provides for the requirements of people who live there. The necessary equipment and adaptations for supporting residents are available. Residents are allowed to personalise their bedrooms. Overall, the home provides a comfortable and homely environment to live in. Evidence: The AQAA states : The home has been refurbished to a very high standard. Evidence is recognised by visiting the home and seeing the changes throughout. Residents see Fernbank Nursing Home as their own home and feel that they are part of a family. They are free to move around the environment as they wish. Residents were involved in choosing the pictures to be hung around the home. They are encouraged to personalise their rooms and, prior to admission, encouraged to visit the home and choose their own room. They can use their own furniture and television if they wish, as long as they comply with the required regulations. Residents interviewed by us indicated that they were happy with the accommodation provided and their bedrooms had been kept clean. The home employs a full time maintenance person on site. Care Homes for Older People Page 19 of 28 Evidence: Beautiful paintings and pictures were displayed along the corridors of the home. The bathrooms, toilets and hand basins were clean. Bedrooms inspected by us had been personalised by residents with their own pictures and ornaments. Various specialist equipment for the care of residents was available. These included portable hoists, walk-in showers and baths, air mattresses, wheelchairs, and a call bell system. New beds with electric controls had been purchased. The home has a laundry. The manager was aware that soiled laundry items must be subject to a special high temperature or healthcare wash. This ensures effective infection control and protects the health of residents. The required safety inspection had been carried out on the gas, electrical installations and portable appliances and documented evidence was kept in the maintenance folder. The home has a small garden at the front and a medium sized garden at the side. Seating was provided. Care Homes for Older People Page 20 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 service has a good recruitment procedure that is followed in practice. The manager recognizes the importance of training and tries to deliver a programme that meets statutory requirements. Residents and their representatives are satisfied with the staffing arrangements. Evidence: The AQAA states: We provide good induction, training and all our healthcare assistants have NVQ level 2 or 3 or are in the process of undertaking these qualifications. Matron has completed her Registered Managers Award NVQ level 4. Patient centred care is the ethos of the home. Staff support each other and share skills and knowledge with colleagues and daily handovers facilitate this. During this time staff are encouraged to voice their views about management issues. Presentations are delivered regularly so that staff are able to access all the information contained on a residents patient centred profile, study their medication, side effects, then present this to the group. Mandatory training is delivered by external agencies. Our residents and relatives know the staff by name. Staffing levels reflect the needs of the people and the rota is a skill mix to ensure that there is always a key worker in charge of the floor. Residents and relatives who were interviewed spoke positively of staff and indicated Care Homes for Older People Page 21 of 28 Evidence: that staff were competent, caring and responsive. The duty rota was examined. It indicated that in addition to the manager, there was normally a minimum of one nurse and four care staff during the day shifts and one nurse and two care staff on waking night duty during the night shifts. The manager is supernumerary. Ancillary staff working at the home comprise two kitchen staff a cleaner, a maintenance person and one part-time admin staff. We noted that the nurse on duty with the manager was administering medication throughout the morning. She informed us that she could not have a break as she was very busy. This was discussed with the manager. In view of this a requirement is made for the staffing arrangements during the morning shift to be reviewed to ensure that there is adequate nursing staff on duty. The manager agreed that this would be done. Four staff who were on duty were interviewed on a range of topics associated with their work. They were noted to be knowledgeable regarding their roles and responsibilities. There was documented evidence in staff records to indicate that staff had been provided with essential training relevant to their area of work. A staff training matrix was on display in the managers office showing at a glance which training staff have attended. The manager further stated that training profiles of staff were also available on computer. Staff stated that there is a good team spirit and they worked well together. The records of four staff were examined. These indicated that the required recruitment standards and procedures such as obtaining satisfactory CRB disclosures and references had been followed. Proof of identification was also evident in their files. There was documented evidence of regular formal staff supervision. This was also confirmed by staff interviewed. The supervision notes indicated that staff had opportunity to discuss issues related to the care of residents and their training. The issue of equalities and diversity was discussed with staff. Staff demonstrated an understanding of the need to treat all residents sensitively and with respect regardless of disability, gender, race, religion or sexual orientation. Care Homes for Older People Page 22 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. People living in the home can be assured that the home is well run and the manager has the skills and ability to manage the home and meet its stated aims and objectives. Equality and Diversity issues are given priority by the manager. Records are on the whole, well maintained. There is an effective system for maintaining health and safety. Residents and their representatives are consulted regarding the care provided and the management of the home. Evidence: The AQAA states: We design and implement new policies according to statutory and operational need. The manager looks at areas where change is necessary in order to prevent errors and makes improvements to policy and operations. It is considered that Fernbank pays a great deal of attention to the training of staff and management. Fernbank pays attention to medication policies and now has robust procedures in this respect. The care plans now have a new format with an index that makes it easier to follow. Matron Care Homes for Older People Page 23 of 28 Evidence: researched and produced a presentation on patient centred care which she delivered to the group. Records are now stored in a locked secure storage unit and staff are aware of confidentiality. Service users and their resentatives are involved in the care planning and sign to that effect. Feedback received from residents and their representatives indicated that the manager has been successful in fostering a caring and welcoming environment where residents are cared for with respect and dignity regardless of their background, race, religion, disability or sexual orientation. The manager was knowledgeable regarding her role and responsibilities. She is a registered nurse with experience of management in the care field. She is supported by an administrator. She is in the process of applying for registration us. There was evidence that residents had been consulted regarding the management of the home. Residents and relatives meetings had been held. The minutes of these meetings were available for inspection. A consumer survey had just been started and forms had been sent out. One completed survey form was received. Weekly fire alarm checks and regular fire drills had been documented. The home had an up to date fire risk assessment. Staff had been provided with training in fire safety and Health and Safety. The accident records were appropriately filled in. The home has a current certificate of insurance. The manager and administrator informed us that the home does not keep any money on behalf of residents or manage their finances for them. Care Homes for Older People Page 24 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 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The Statement of Purpose and Service User Guide must be amended to reflect the recent change in management and change in address of The CQC. This is to ensure that prospective residents and their representatives are fully informed 29/03/2010 2 7 12 The care and plans of care of the resident identified to the manager and in the section on Health and Personal Care must be reviewed with professionals involved and with the residents family. This is to ensure that this resident is well cared for. 22/03/2010 3 27 18 A review of staffing levels during the morning shift must be carried out to 22/03/2010 Care Homes for Older People Page 26 of 28 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 ensure that there are sufficient nurses on duty and the nurse responsible for the administration of medication is supported and able to have a break in the morning. This is to ensure the welfare of staff and residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 A review of the amount of social and therapeutic activities provided by the home should be carried out. This is to ensure that residents can be given more activities and stimulation. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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