Care Home: Georgina House Care Home

What the care home does well The Home has a friendly, relaxed atmosphere and many improvements have taken place in the environment since the random inspection of 12th October 2006. Residents are well cared for and all those spoken with stated they liked living at the Home and that the staff were kind and helpful; also they had choice in how they spent their day. "This is a good place to live", said one resident. Residents` views are sought in a number of ways. There is one-to-one support with key workers, care plans are drawn up following discussions with individual residents and residents are encouraged to play an active part in the activity and life of the Home. All members of staff have NVQ2 qualifications or above and are encouraged to take further training opportunities particularly tailored to the needs of the residents. The Proprietor/Manager has professional training qualifications, participates in further training herself and training for staff takes place both in-house and externally. People living in the Home stated that they enjoyed their meals and that personal choices are taken into account in drawing up menus. All records seen were organised and up-to-date. The Home has received a 5 star report from the Environmental Health Officer and "excellent" reports from the NHS Medication Inspection Team and Health and Safety Officer from their latest inspections. What has improved since the last inspection? A `wet room` with specialist fittings has been created, which promotes the dignity, privacy and independence of people living in the Home, although due to the limitations of the building, access is through a small office space, which could compromise confidentiality and the dignity of residents if not carefully managed. There has been redecoration internally and externally and several areas have been refurbished. A new, external `swing` sign for clearer identification of the Home has been fitted, having the emergency services in mind in particular. The Home has brought an advocacy service to the attention of a resident who needed this. A computer with broadband has been installed for residents, together with the purchase of a dart board, Wii games station, large TV with subtitles and digital photo frame. There has been Malnutrition Universal Screening Tool (MUST) training for all staff as well as other `special subject` training.Residents have access to local community groups including a Parkinsons Group, the Salvation Army and a `Green` group. Legislation changes are incorporated into the Home`s day-to-day running, e.g. Mental Capacity Act. There are new storage facilities for controlled drugs (although unused) and a fridge for medication. The Service User`s Guide has been updated together with contracts with terms and conditions of residence. What the care home could do better: Consideration should be given to regularly reviewing staffing levels to ensure these are sufficient to meet residents` changing needs. Although stored safely, consideration should be given to new containers for individual residents` personal monies within the secure storage area. Although the Proprietor/Manager asks at interview, consideration should be given to redesigning the application form for prospective staff showing details of gaps in employment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Georgina House Care Home 44 Crown Road Great Yarmouth Norfolk NR30 2JH     The quality rating for this care home is:   two star good 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: Jenny Rose     Date: 0 4 0 2 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 27 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Georgina House Care Home 44 Crown Road Great Yarmouth Norfolk NR30 2JH 01493853633 01493853633 mirander.telfer@btinternet.com 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) : Miranda Telfer care home 6 Number of places (if applicable): Under 65 Over 65 0 3 0 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 1 0 3 Georgina House is a mid terrace, Victorian property that is run as a residential care home providing care and accommodation for up to six, older people one of whom may have a mental health disability and six who may have physical disabilities. The home has four single bedrooms and one shared bedroom all of which contain a washbasin, one is located on the ground floor and the remainder are located on the first floor. There is a stair lift to the first floor and communal use of a bathroom, shower room, three toilets, a lounge and a dining room. The home has a small friendly dog and a cat and there is a small garden with seating to the front of the house but no garden to the rear of the property. Georgina House does not accommodate people with severe mobility difficulties due to the limitations of the building. The property is located in a quiet residential street in Great Yarmouth and is situated close to the seafront, local amenities and the town centre. Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was completed following evidence gathered from information that had been sent to the Commission after the last key inspection on 4th April 2006. The Home Manager had completed an Annual Quality Assurance Assessment (AQAA) on 12th July 2008 giving details of what the Service offers, what they have done to improve the Service and what barriers have caused the Service not to develop and improve. There had also been a random inspection on 12th October 2006 and an Annual Service Review on 22nd October 2007 and this information was taken into consideration. Notifications we received at the Commission were also looked at. There were no comment cards available for this Inspection. Care Homes for Older People Page 6 of 27 The site visit to the Home took place over a 6 hour period and during this time a partial tour of the building took place, care plans were seen, medication records were looked at, personnel files and training records were studied, financial and health and safety records were examined. Five people were in residence on the day of the Inspection, one person was out for the day, four were spoken with, two in private. The Proprietor/Manager was spoken with throughout the day. No other members of staff of a care team of three were on duty during the day of the Inspection. What the care home does well: What has improved since the last inspection? A wet room with specialist fittings has been created, which promotes the dignity, privacy and independence of people living in the Home, although due to the limitations of the building, access is through a small office space, which could compromise confidentiality and the dignity of residents if not carefully managed. There has been redecoration internally and externally and several areas have been refurbished. A new, external swing sign for clearer identification of the Home has been fitted, having the emergency services in mind in particular. The Home has brought an advocacy service to the attention of a resident who needed this. A computer with broadband has been installed for residents, together with the purchase of a dart board, Wii games station, large TV with subtitles and digital photo frame. There has been Malnutrition Universal Screening Tool (MUST) training for all staff as well as other special subject training. Care Homes for Older People Page 8 of 27 Residents have access to local community groups including a Parkinsons Group, the Salvation Army and a Green group. Legislation changes are incorporated into the Homes day-to-day running, e.g. Mental Capacity Act. There are new storage facilities for controlled drugs (although unused) and a fridge for medication. The Service Users Guide has been updated together with contracts with terms and conditions of residence. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving to this Home have relevant information available and can visit beforehand to help them make a decision. Their needs are assessed to ensure the Home can meet those needs and their agreement sought to the terms and conditions of living at the Home. Evidence: The Home has a Service Users Guide which has been updated to reflect changes in the Home and a Statement of Purpose available to all prospective residents. There is a step-by-step admission process and case tracking confirmed this. Three assessments were seen, together with Social Services assessments which form the basis of the care plans, to ensure that the health, personal and social care needs of residents could be met. Residents had signed a terms and conditions contract and the Manager said this had been discussed with the people concerned to ensure that they Care Homes for Older People Page 11 of 27 Evidence: understood and were happy to sign it. One resident spoken with confirmed that she had visited the Home prior to admission and before a decision was made. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good care plans written with residents, as well as good records and systems, particularly for the administration of medication, which show that the health, personal and social care needs of people living in the Home are met in a person-centred way and their privacy and dignity respected. Evidence: Three care plans were looked at, they were all holistic, person-centred, written with the individual to include the individuals preferences, were signed and up to date. They detailed healthcare needs, how these are met and contained risk, as well as MUST, assessments, details of lifestyle preferences and the support required for residents to live as independently as possible. Two people spoken with confirmed that they were involved in writing the plans and any changes in them. In one case changes to the care plan and daily record were being made on an as and when basis, particularly with regard to fluid and nutrition intake for a resident who was unwell. In addition there were other communication records completed by night staff, a handover book and a daily occurrence book drawing attention of the staff to changes in care plans and Care Homes for Older People Page 13 of 27 Evidence: other significant information, which were signed when read. There was evidence from care plans and from speaking with two residents that key workers actively provide one-to-one support, keep the care plan up to date and communicate with other staff so that they always know the persons current needs and wishes. All care plans were seen to be reviewed monthly, or sooner if required. The Home is supported by the local GP surgeries and there was evidence of regular visits from District Nurses, including a visit on the day of Inspection for a dressing and to another resident who needed support with a pressure area, and from other healthcare professionals. The medication is appropriately and securely stored, including a new controlled drugs cabinet, presently not in use, and a new fridge for storing medication. All staff have undergone training in medication, both externally and in-house and the Manager confirmed that there is a good relationship with the Pharmacy, who, on request from the Manager, have supplied the Home with special stickers to draw attention on records for three residents with the same first name and two whose surnames sound similar. Complex medication records for one resident were seen to be in separate written instructions from the GP, as well as in highlighted chart form to ensure accuracy. Each resident had a medicines profile explaining what each drug is for. The Home had recently undergone a medication inspection from the NHS Medicines Management Team, (see elsewhere in this Report under Management and Administration). Three care plans showed residents consent for the Home to administer medication, although one resident spoken with prefers the Home to administer his main medication, he collects and administers his own skin medication which he keeps in a lockable cabinet in his room. Throughout the day the Manager was heard to be speaking to residents in a respectful manner. The AQAA states that the advocacy service had been brought to the attention of one resident and it was noted on the day that the new wet room and its facilities further promoted the independence, privacy and dignity of the people living in the Home. However, due to the limitations of the building, the entrance to this shower room was through the office and access to this facility had to be carefully managed to preserve confidentiality and the dignity of the residents. Two residents spoken with confirmed that their privacy and dignity was respected. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home has a strong commitment to enabling people to develop or maintain their skills, including social, emotional, communication and independent living skills. Residents can and do maintain contact with relatives, friends and the wider community. Wholesome meals are served according to residents choices in a pleasant dining area. Evidence: There was evidence from keyworkers notes on activities in care plans, Minutes of residents and staff meetings, the notices in the dining area and from people spoken with on the day that residents have opportunities to exercise their choice in relation to leisure, social and cultural interests, as well as the routines of daily living and personal and social relationships. New equipment had been provided in the Home since the last inspection such as a dart board, a Wii games station, large TV with subtitles, a computer with broadband connection for all to use, as well as one person having a computer in his room and having taken courses in its use. There was also a digital photoframe in the hall showing various activities and outings which had taken place, which is used on a daily basis for reminiscence for residents and visitors alike. During the afternoon residents were heard enjoying and participating in a quiz. The people Care Homes for Older People Page 15 of 27 Evidence: living in the Home are supported to follow their own interests and skills and one person spoken with enjoys the responsibility for caring for the dog and cat which have lived in the Home for some years. One to one support was given in shopping outings as well as escorts to outings further afield by way of the Homes wheelchair accessible van. There were no visitors on the day but one person spoke of her family visiting on a regular basis and another of his network of friends locally and visits from his family. One resident was out for the day on a regular weekly visit to friends. Community contact according to residents choices were with the Salvation Army, the local Parkinsons Group and involvement in community issues involved in developing and maintaining the Green area in the Square close to the Home where residents enjoyed walking. Residents confirmed that they visited the resident who was confined to her room on that day when she indicated that she would like visitors. Two peoples rooms seen, by invitation, included personal possessions and were comfortably furnished. Residents confirmed they could see visitors in private and there was information available of how to contact advocates who would act in their interests if necessary. The meal in the dining area was lattice pie, mixed vegetables and croquet potatoes, with gravy as requested. This was followed by apple strudel and custard. The meal was well presented in a pleasant area and everyone said that they had a choice and had participated in a questionnaire, which was seen, for the summer and winter monthly menus giving their preferences. In addition the menu was displayed on a white board in the dining area in the morning, following the breakfast menu. It was seen that drinks were available continuously throughout the day. One person who was unwell was assisted to eat her meal, according to her preferences, during the Inspection and this was seen to be recorded. MUST assessments have been carried out. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home has an open door policy where people feel safe and supported to share any concerns and are protected by the care practice, policies and procedures carried out by staff members. Evidence: There is a clear complaints policy and procedure, which is also contained in the Service Users Guide. The records and monthly reviews, as well as Minutes of staff and residents meetings showed that problems were dealt with as they occurred and the Manager confirmed the information in the AQAA that there was an open door policy and that residents were listened to and their views, or concerns, were taken seriously. Two residents spoken with were clear as to how to make a complaint, but they said they had no reason to. They felt able to speak to the Manager or any member of staff. The staff files showed that staff have been police checked and have been through the procedure of POVA which is the Protection of Vulnerable Adults. The Manager is an Abuse Awareness trainer and all staff have received training and refresher training in safeguarding adults. In addition there was confirmation in the files that all staff had received training in the Mental Capacity Act and the Manager had recently attended Deprivation of Liberty training as it relates to care homes and the Mental Capacity Act. She intended to cascade this to the staff team following the proposed appointment of a new member of staff. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Given the limitations of the building, the standard of facilities in the Home have improved and provide the people living there with a homely, safe and well maintained environment in which to live. Evidence: The Home is well maintained and comprehensive maintenance records were seen. There is specialised equipment provided for the health and safety of residents and staff. At a previous inspection on 12th October 2006 there had been a recommendation for redecoration in all areas and this has been undertaken, together with refurbishment of carpets in some areas, the creation of a wet room with specialist equipment which further promotes the independence and dignity for residents. New equipment had been provided in the kitchen, also an evacuation chair, together with other fire safety equipment. Externally there is a new swing sign for ease of identification of the home, particularly for the emergency services. Risk assessments are in place for residents on the narrow stairs and also on window restrictors in one room where the resident wishes to open the window and for a locked, glazed door leading to a flat roof in another bedroom. There are plans for improvement, including painting the front of the house and upgrading the stairlift. The residents rooms seen were personalised with their own possessions. One resident Care Homes for Older People Page 19 of 27 Evidence: at present is occupying the double room as a single. All rooms have lockable facilities for safekeeping of valuables and possessions. There are limitations to the building, for example there is little external, general storage nor office space. In addition, access to the wet room and toilet on the ground floor is through the office. However, the Home has a homely and domestic character and there is creative use of small spaces, for example the siting of a computer with broadband connection and a digital photoframe in the hall, which suits the needs of those residents who are mobile. Two spoken with said they found their rooms comfortable. From the staff files it was evident that all staff have undergone training in infection control. All areas were seen to be clean and tidy. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home has good training opportunities to ensure that all staff have the correct skills and recruitment procedures are in place to ensure people are cared for by suitable staff. Evidence: There were no surveys from staff available for this Inspection and no members of staff were interviewed on the day of the Inspection as the Proprietor/Manager was working as a member of the care team, with a member of staff of the team of three due to take over in the evening. There were five people living in the Home, but four people only were in the Home during the day as one person was out on a regular weekly visit. Two people needed assistance, one of whose dependency needs have changed. The AQAA dated 12th July 2008 stated that the recruitment of one/two part time members of staff was an improvement which could be made. The Manager stated that she had advertised for staff earlier, but had not been satisfied with the calibre of the applicants. However, on the day of the Inspection she had interviewed a suitable applicant and was hopeful that this person would fit in well to the existing team. This was confirmed by one resident spoken with who had been involved in the interview process, which is good practice. The Manager said that she could call on any of the other members of staff in an emergency. She also confirmed the information in the AQAA that agency staff are not employed, as the Home is committed to the Care Homes for Older People Page 21 of 27 Evidence: consistency of care afforded by the small care team. Two people living in the Home said they were well looked after by the staff team. The three staff files examined showed that staff members had a mix of experience and skills. Each resident has a keyworker who spends one-to-one time with them and records these activities in the care plan. All staff members have NVQ2 qualifications or higher and one member of staff is undertaking her NVQ3 qualifications. The Manager delegates several administrative tasks to other members of the team, evidence of which was seen. Staff supervision and appraisals take place on a regular basis and were up to date. There were regular staff meetings, as seen by the Minutes, as well as a shift handover book and a Daily Occurence book which were all up to date and signed by staff members. The recruitment procedures were looked at. All files contained the relevant records for each staff member. Two references, POVA, CRB, forms of identification, such as passports and driving licences, contracts and application forms. It was noted that the application forms did not show particulars of gaps in employment, although the Manager said she always asked about these. The Manager is a qualified trainer in a number of areas relating to care, she is an NVQ Assessor and all staff received in-house and external training. All records showed that staff had completed an induction, basic and updated training. Training had also taken place in MUST, Care Planning and Documentation, Abuse Awareness, Mental Capacity Act and Equality and Diversity. In addition training certificates in specific issues relating to residents needs such as Epilepsy, Challenging Behaviour and Parkinsons Disease were seen and the Manager confirmed that plans were in place for training in Dementia and the Deprivation of Liberty, as relating to the Mental Capacity Act in care homes. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager provides leadership and direction to the staff team to ensure that the people living in the Home receive a good standard of person-centred care and the Home is run in their best interests. Evidence: The Proprietor/Manager has owned and managed the Home since 13th December 2005 and has over 18 years experience of working and five years of managing in care settings with adults and older people. She has NVQ4 in Management and a RMA Managers award, is an NVQ Assessor and a professional trainer for a wide range of subjects related to care. She said she had recently undertaken training in the Deprivation of Liberty as relating to the Mental Capacity Act and care homes and planned to cascade this to staff. Policies and procedures have been produced on all aspects specific to the Home. Records showed that staff members worked as a team and were supported and supervised by the Manager. Care Homes for Older People Page 23 of 27 Evidence: The Home has a quality assurance system and there are regular questionnaires to residents, particularly on the seasonal menus, which were seen and also confirmed by people spoken with. Questionnaires were also seen as completed by visiting professionals, staff and friends/relatives and an action plan was produced accordingly. The quality assurance file also contained a letter and a card of thanks for care given to a former resident. The AQAA contained clear, relevant information which was supported by evidence. The Home keeps small amounts of petty cash for four people living in the Home. These are kept, with receipts, in separate plastic wallets in a locked safe, together with records. Two wallets checked were correct, but two other wallets, were both well worn with gaps in the seams. It is recommended that new containers for residents monies are provided within the secure storage area. Up-to-date maintenance records were seen and, as stated elsewhere in this Report (Staffing), the Manager said that she delegates some administrative tasks to other members of staff and these records were seen to be up-to-date. The Home has received excellent reports from the Health and Safety Officer 20.11.06, the Environmental Health Officer 11.11.08 and the NHS Medicines Management Team of Gt. Yarmouth and Waveney 22.01.09. The servicing and testing of all equipment had been carried out and up-to-date certificates were held to ensure that the health and safety of residents can be seen to be protected. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 2 27 29 It is recommended that staffing levels should be kept under review to ensure that residents changing needs are met. Consideration should be given to the design of application forms showing details of gaps in employment for prospective staff. Consideration should be given to new containers for residents personal monies within the secure storage area. 3 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 27 of 27 - 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. 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