Care Home: Glastonbury Care Home

What the care home does well The home ensures that people are only offered a placement following appropriate preadmission procedures. Assessments from other health care professionals are obtained. This ensures that people are only offered a placement once all parties are satisfied that the home can meet their needs and aspirations. The home`s care planning procedures ensure that peoples needs are clearly set out and can be met by staff in a consistent manner. The home ensures that peoples` preferences are considered thus promoting a person centred approach to care. We were able to see that the home ensures that peoples` health care needs are met. Up to date assessments were seen to be in place and care plans contained evidence that people have access to a range of health care professionals. Safe procedures are in place for the management and administration of peoples medication. People have access to a varied and well thought out programme of activities. People are supported to make choices about their lives, independence is promoted and people are treated with respect. Up to date procedures are in place and followed so that people are protected from the risk of harm or abuse. Peoples` needs are met by a well trained workforce and effective management procedures are in place. What has improved since the last inspection? As required at the last inspection, quality assurance procedures in the home now ensure that all aspects are regularly reviewed so that people receive an improved quality of service. What the care home could do better: This was a positive inspection and no statutory requirements were raised. Key inspection report Care homes for older people Name: Address: Glastonbury Care Home Pike Close Sedgemoor Way Glastonbury Somerset BA6 9PZ     The quality rating for this care home is:   three star excellent 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: kathy McCluskey     Date: 0 1 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 27 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 27 Information about the care home Name of care home: Address: Glastonbury Care Home Pike Close Sedgemoor Way Glastonbury Somerset BA6 9PZ 01458836800 01458836809 jwhite@brunelcare.org.uk www.brunelcare.org.uk Brunelcare Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Joyce Anne White Type of registration: Number of places registered: care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: A suitable qualified and experienced clinical lead be in post whilst Joyce White is the registered manager of the service. The maximum number of service users who can be accommodated is 64 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender 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 The Glastonbury Care Home was first registered in July 2000 and is a purpose built Care Home. It is a two-storey building, set in accessible gardens on the outskirts of the Care Homes for Older People Page 4 of 27 Over 65 0 64 64 0 0 5 1 2 2 0 0 8 Brief description of the care home town of Glastonbury. Numerous car parking spaces are available in the grounds, close to the building. The ground floor accommodates service users requiring personal care (formally residential care), with one unit for those with mental health needs. The first floor is for those who require general nursing care. All rooms are single occupancy and have en-suite facilities. The home is owned by Brunelcare and the registered manager is Joyce White. We were informed that the current fee range is between £493 & £598 per week and is dependant on the individuals assessed needs. Additional costs include personal toiletries/items, newspapers, chiropody, hairdressing and some activities. Up to date information on fees should be obtained from the home. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over one day by regulation inspector Kathy McCluskey. We were given unrestricted access to all parts of the home and all records required for this inspection were made available to us. Staff and people using the service were more than happy to talk to us. The registered manager was available throughout this inspection. The term we used throughout this report refers to we the Commission. We would like to thank all those involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction Care Homes for Older People Page 6 of 27 with the whole of the report. Care Homes for Older People Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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 9 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. The home ensure that people are provided with appropriate information so that they can make an informed decision about using the service. Pre-admission procedures ensure that people are appropriately assessed before a placement at the home is offered. People can feel confident that their needs will be met by the home. Evidence: The home have produced a Statement of Purpose and Service User Guide which provides information about the home and services offered. The homes completed AQAA told us these documents are regularly reviewed to ensure that people are provided with up to date information about the home. The AQAA told us that people who are thinking about using the service are encouraged Care Homes for Older People Page 10 of 27 Evidence: to visit the home prior to making a decision. The home also offers a respite service. We were able to see evidence that the home ensure people are appropriately assessed before a placement is offered. Care plans examined contained documented evidence of detailed pre-admission assessments that had been carried out by the home. We were able to see that the home had obtained assessments from health care professionals where appropriate. These assessments help the home to formulate a plan of care for each individual. The homes completed AQAA told us that once a placement has been agreed, individuals and/or their representatives are given the opportunity to personalise the persons bedroom before they move in. A training matrix provided by the home demonstrated that the staff team have the skills needed to enable them to meet the needs of people using the service. We were able to speak with a number of staff who were positive about the training they received. Staff confirmed that they experienced no difficulties in meeting the assessed needs of people currently using the service. During a tour of the premises we were able to see that the home have a range of specialised equipment in place to meet peoples needs. Care Homes for Older People Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes care planning procedures ensure people receive a consistent and person centred approach to care. People can feel confident that their health care needs will be met. The home follows appropriate procedures for the management and administration of peoples medication. People are treated with respect and their right to privacy is upheld. The home ensure that people receive end of life care in line with peoples wishes. Evidence: We examined six care plans and found them to be well maintained and up to date. Care plans had been formulated from a range of risk assessments and provided clear information for staff on how peoples assessed needs should be met. Care plans also provided information on peoples abilities and how staff, where appropriate, could Care Homes for Older People Page 12 of 27 Evidence: support people to maintain a level of Independence. We were also able to see evidence that the home had included peoples preferences thus enabling staff to deliver a person centred approach to care. Care plans for people on the dementia care unit contained good information on peoples psychological needs and of the approaches that should be taken where an individual may become anxious or distressed. We were able to see evidence that the home ensures peoples health care needs are met. Care plans contained information regarding each persons contact with a range of health care professionals including doctors, district nurses, specialist nurses, opticians, chiropodists and dentists. We were able to see that the home had requested input from health care professionals where concerns had been identified. Some examples of this include a referral to a dietitian where there were concerns about an individuals weight loss and input from a mental health professional where concerns had been identified. There was documented evidence that the home ensure peoples relatives/representatives were kept well informed of all aspects regarding the wellbeing of people using the service. We looked at a care plan for an individual who was receiving treatment for a pressure sore. A clear plan of care was in place and there was clear information on the size and status of the wound and of the treatment prescribed. Regular entries made by registered nurses demonstrated a consistent approach to the delivery of care. Review dates were in place to monitor the effectiveness of the treatment. Photographs were also in place to monitor progress. We were able to see that appropriate pressure relieving equipment was in place for those with an assessed need. Turn charts were available in individuals bedrooms and we were able to see that people were being assisted to turn in bed in line with their plan of care. Diet and fluid monitoring sheets were seen to be in place for those with an assessed need. These contained appropriate information about peoples intake. The home monitors the weight of each person using the service each month. We were able to see that care plans had been raised where concerns had been identified. We spoke with a number of people using the service and they were positive about the care they received. They told us that staff responded to call bells promptly and that staff assisted them with their personal care needs in a dignified manner. People also commented on the kindness of staff. During the day we observed staff interactions with people to be relaxed and unhurried. Staff were communicating with people in a Care Homes for Older People Page 13 of 27 Evidence: very kind and professional manner. We examined the homes procedures for the management and administration of peoples medication on the general nursing and dementia care units. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). On the general nursing unit, medicines are only administered by the registered nurses on duty. On the dementia care unit, senior carers who have received training in the management and administration of medication are responsible for administering medication. We observed the lunch time medication round on the dementia care unit and were able to see that safe practices were being followed. We examined MAR charts and found these to be appropriately completed. Photographs were in place to aid identification. We have recommended that the home maintain protocol sheets with the MAR charts which provide information about the use of as required medication. We found all medicines to be securely stored with no excess stock. Appropriate records were in place for the receipt and disposal of medicines. We found that appropriate procedures were being followed for the management of controlled drugs. The home has procedures in place to support people to remain at the home during their final days. Care plans contained information about peoples wishes during their final days and following death. We were able to see an end of life care plan in place which had been agreed by appropriate parties. The home is planning to complete the Gold Standards Framework. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered a very varied programme of activities. The home ensure that people are supported to make choices about their lives and to maintain contact with their family and friends in line with their wishes. People are offered menu choices and the home ensure that the meal time experience is a pleasant one. Evidence: The home employs an activities coordinator for 24 hours a week. During this inspection we were able to meet with the activities coordinator and her commitment and her enthusiasm was very apparent. The home are in the process of completing detailed social history books for each person. Care plans examined contained information about peoples social preferences. A varied and interesting programme of activities was seen to be displayed in all areas of the home. This included a number of trips out and visiting entertainers. Local schools are also visiting the home to sing Christmas carols. Other regular events include exotic food tasting, holistic therapies, flexercise, shopping trolley, religious Care Homes for Older People Page 15 of 27 Evidence: services (all denominations), hairdressing, coffee/sherry mornings, music. A range of festive activities are currently under way and many people are involved in making Christmas decorations. The activities co-coordinator should be commended for her obvious commitment to organising fund-raising events and for accessing outside entertainment, the majority of which is at no cost to people using the service. People spoken with during this inspection were very positive about the activities of offer. They told us that there was always something going on. People had a copy of the activity programme in their bedroom. Photographs of recent events at the home adorned the walls of the home. During the afternoon we observed people on the dementia care unit enjoying a sing-along with a carer who was playing the keyboard. People were observed responding very positively to this. We were informed that carers are encouraged to spend quality time with people and this was very apparent during the inspection. On the dementia care unit the atmosphere was relaxed and inclusive. There was a good staff presence and people responded positively to staff interaction. People were observed moving freely around the home throughout the afternoon. People from each unit told us that they were able to make choices about their lives. People said that they decided what time they went to bed and got up in the morning. They told us that they could choose whether to remain in their bedroom or access the communal areas. We observed staff offering offering choices to those people who were unable to do so independently. People told us that their visitors were always made to feel welcome and were offered refreshments. The home welcomes visitors at any reasonable time in line with the wishes of people using the service. In line with fire regulations, all visitors to the home are required to sign in and out of the home. All meals are freshly prepared and cooked at the home by designated catering staff. We were informed that recently, the main meal of the day is now being offered at tea time. We were informed that people have responded positively to this in that people are generally eating more and sleeping better. We were told that the home is accommodating some people who still preferred to have their main meal at lunch time. During this inspection we were able to see lunch being served on the general nursing and dementia care unit. People were offered choices and we observed staff assisting people in a very relaxed and dignified manner. In both units, table had been attractively laid and seating appeared comfortable. People could choose from a Care Homes for Older People Page 16 of 27 Evidence: selection of drinks, including a hot drink. Menus were clearly displayed. The lunch time experience was relaxed and unhurried and appeared to be a pleasant experience for people. We spoke with a number of people and all were positive about the quality, choice and quantity of the meals offered. People also told us that drinks were regularly offered throughout the day. Care plans examined contained information about peoples dietary preferences. Care Homes for Older People Page 17 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. People can feel confident that their concerns will be appropriately responded to. The home have procedures in place to safeguard people from the risk of harm or abuse. Evidence: The homes complaints procedure is clearly displayed throughout the home. People told us that they would feel confident in raising concerns if they had any. No concerns were raised with us during this inspection. We examined records relating to three complaints received by the home this year and were able to see that appropriate procedures had been followed within agreed timescales. Records also contained evidence that the complainant had been satisfied with the investigation and outcome. The home has procedures in place to safeguard people from the risk of harm or abuse. A range of policies and procedures are in place for staff and the home have an up to date copy of Somersets Safeguarding Adults Policy. Staff training records indicated that all staff received up to date training in the protection of vulnerable adults. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained and comfortable environment. Each person has their own bedroom which they can personalise. The home ensures that people have access to a range of specialised equipment to meet their assessed needs. The home has procedures in place to reduce the risk of the spread of infection. Evidence: During this inspection we toured the premises and looked at all communal areas and a number of bedrooms. All areas appeared warm, comfortable and well maintained. The home employs maintenance staff and there is a programme of routine maintenance and renewal in place. Comfortable communal areas are available on each of the units and people have their own bedrooms which they can personalise. It was evident that people are able to bring items of their own furniture if they wish. One person told us that this really made it feel like home. The home has adequate assisted bathing and toilet facilities which are conveniently located for people. Bedrooms are fitted with en-suite facilities. Care Homes for Older People Page 19 of 27 Evidence: We were able to see that the home has a good supply of specialised equipment to meet the needs of people using the service. This includes, profiling beds, hoists, slings and slide sheets and pressure relieving equipment. Staff told us that sufficient equipment was always available. The home is purpose built. A shaft lift provides access to the first floor and grab rails are appropriately sited to assist people to mobilise. A nurse call system is installed throughout the home and people told us that call bells were answered promptly by staff. Systems are in place to monitor staff response times. To ensure the safety of people using the service, entry to the home is via a keypad lock and, in line with fire regulations, visitors are required to sign a visitors book on entering and leaving the home. The standard of cleanliness in all areas viewed was of a good standard and free from malodours. Staff hand washing facilities and sanitising gels were seen to be appropriately sited throughout the home. We were able to see that staff have access to a good supply of protective equipment. 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 ensures that staffing levels are appropriate to meet the assessed needs of people using the service. People benefit from a well trained workforce. The homes staff recruitment procedures ensure that people are protected from the risk of harm or abuse. Evidence: We spoke with a number of staff during this inspection and no concerns were raised regarding current staffing levels. Staff told us that they felt staffing levels were safe and that they were able to meet the needs of people currently using the service. We also spoke to people living at the home. They told us that staff were available when they needed them. During this inspection we noted a good staff presence and were able to observe staff spending quality time with people. We were informed that currently 28 people were receiving general nursing care and that minimum staffing levels consisted of three registered nurses, one of whom was the senior sister, and six care staff. We were informed that five carers were available on the residential wings. In addition to nursing and care staff, the home employs a team of ancillary staff. The registered manager works in addition to the care hours. Care Homes for Older People Page 21 of 27 Evidence: The home are currently recruiting for the clinical managers position. Staff spoken with during this inspection were positive about training opportunities available to them. Staff told us that they had the skills to enable them to meet the needs of people using the service. A training matrix made available to us indicated that staff receive regular updates in mandatory training and that a range of specialised training is offered. The homes completed AQAA told us that of the 49 permanent care staff employed, 35 have achieved a minimum of an NVQ Level 2 in Care. This equates to 71 which exceeds the recommended 50 of the National Minimum Standards. We looked at the homes procedures for staff recruitment. We examined the recruitment files for the three most recently employed staff. These contained all required documentation and we were able to see evidence that staff did not commence employment until the receipt of two satisfactory references and checks against the criminal records bureau (CRB) and protection of vulnerable adults register (POVA). One application form had some gaps in employment shown on their employment history. We have recommended that, where this is the case, the home discusses this with the applicant and records the reasons. Staff files contained evidence that newly appointed staff undertake a period of induction which follows the recommendations of the common induction standards. 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. Effective management procedures are in place and the home are taking steps to ensure the clinical nurse manager post is filled. The home ensure that the quality of the service offered is regularly monitored and reviewed. The views of people using the service and other stakeholders are sought. The home has up to date procedures in place to ensure the health and safety of people using the service. Evidence: The registered manager is Joyce White. The homes completed AQAA told us that she has achieved appropriate qualifications in management and that she has a diploma in a person centred approach to dementia care. As the registered manager is not a registered nurse, a condition of the homes registration with the Commission is that an appropriately qualified clinical manager is in post. This has been the case until recently when the post holder left. We were informed that the home are taking steps to fill this Care Homes for Older People Page 23 of 27 Evidence: post. The registered manager is also supported by a deputy manager who has achieved an NVQ Level 3 in care and is a trainer in person centred care and equality & diversity. We were informed that management support is also provided by the registered provider, Brunelcare. The home has systems in place to monitor and review the quality of the service provided. The AQAA told us that the registered manager, continually monitors the quality of care through spot checks and quality audits to ensure high standards and person centred care are being achieved. Quality questionnaires are sent to people using the service and visitors to seek their views on the quality of the service provided. We were able to see an analysis of the most recent survey. Responses were positive and we were able to see that areas for improvement had been identified. In line with the requirements of the Care Homes Regulations 2001 and as part of the homes quality assurance programme, a company representative carries out monthly visits to the home. Written reports are maintained at the home. People using the service and staff are provided with opportunities to attend regular meetings. Minutes are maintained and we were able to see copies of the minutes from the most recent service user meeting in peoples bedrooms. Staff told us that they felt well supported and that they received regular supervision sessions. Documented evidence was seen in staff files examined. The home assists people to manage small amounts of money where requested/required. Records of transactions are maintained on the computer. Each person has their own record which clearly identifies all transactions. Receipts are maintained. Statements are available for people using the service and/or their representative as appropriate. The home has appropriate procedures in place to ensure the health and safety of persons at the home. Records relating to fire safety, servicing, electrical and gas safety were found to be up to date. We have recommended that the home monitors the temperatures of bath and shower hot water outlets on a monthly basis rather than every two months. No concerns were identified during a tour of the premises. The homes completed AQAA told us that they have two health and safety representatives and two staff council members. 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 9 The home should consider developing information about the protocols for the use of as required medication. This information should be maintained with the individuals medication administration records (MAR). The home should ensure that any gaps in employment history shown on an application for employment form, are fully explored and the reasons documented. The home should ensure that the temperature of bath and shower hot water outlets are checked monthly rather than two monthly. 2 29 3 38 Care Homes for Older People Page 26 of 27 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. 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!