Care Home: Grenham Bay Court

What the care home does well There is a relaxed atmosphere with staff interacting well with the people living in the home. Staff were observed to be polite and caring and treated people with respect. People living in the home and visitors were very complimentary about the home and the staff. Everyone we spoke to said they were happy and felt well cared for. There is a stable staff group who enjoy a high moral and this transfers into the atmosphere of the home. One visitor told us that whenever he visited his relative in the home he always asked if he could have a room of his own. There is a varied and nutritious menu available with a choice of meals. Special diets are catered for. There are a range of activities for people to participate in and they are supported with individual choices. Healthcare needs are well met. People can be confident that any complaints or concerns will be listened, taken seriously and acted upon. What has improved since the last inspection? There have been improvements to the environment including the installation of a lift to the first floor. A new extension which houses a walkway / corridor on the first floor has been built and this enables people with mobility difficulties to be able to access the lift. There is ongoing improvement works to bedrooms and bathroom facilities. The program of activities has expanded to allow for the diverse interests of people living in the home and a second activities coordinator has been recruited. Care plans are becoming more person centered and people are encouraged to have a say. Quality monitoring processes have improved. What the care home could do better: The Statement of Purpose would benefit from containing clearer information about how the home will support people with any changing needs. Where care plans and assessments are reviewed, updated information needs to be transferred into the care plans to ensure that staff have up to date and relevant information. The auditing of medication and recording of any allergies in medication records needs to be reviewed to ensure all information is current and up to date. Medication would benefit from having dedicated storage space so as to further promote security.Ongoing refurbishment works will further improve the environment. More staff need to be trained as an appointed first aider so as to ensure that there is always a member of staff available with this qualification. Key inspection report Care homes for older people Name: Address: Grenham Bay Court Cliff Road Birchington Kent CT7 9JX     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: Anne Butts     Date: 0 1 1 0 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 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Grenham Bay Court Cliff Road Birchington Kent CT7 9JX 01843841008 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): vanessa.cornfoot@highmeadow.co.uk Grenham Bay Care Ltd Name of registered manager (if applicable) Mrs Marilyn Yvonne Brisley Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home The correct email address is: marilyn.brisley@highmeadow.co.uk The service provides accommodation and support for older people. Bedrooms are situated on the ground and first floors and a passenger lift is available for residents. A number have en-suite facilities. There are several lounge areas and residents may choose which to use. Residents have the use of a garden. The premises provides views Care Homes for Older People Page 4 of 29 Over 65 34 0 1 3 1 1 2 0 0 8 Brief description of the care home across the bay described by residents as relaxing and interesting. Car parking is available at the front of the premises. The service has a minibus to help residents get to local shops and other places of interest. Weekly fees range from £337.00 to £700.00 and additional charges are available upon request. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 was an unannounced inspection, which meant that the provider, staff and people living in the home did not know we would be visiting. Two inspectors carried out the visit and we arrived at the home at 10.00 am and left at 4.00 pm. Time was spent talking to the manager, staff, people living in the home and visitors who were in the building at the time of our visit. We had a look around the environment and a selection of service user and staff records. An Annual Quality Assurance Assessment (AQAA) had been sent to us. The AQAA is a self-assessment, required by law. This assessment focuses on how the service considers they are meeting the outcomes of the people using the service and where it feels it can make improvements. It also provides statistical information about the service. Information from the AQAA has been used in this report where appropriate. The AQAA gave us all the information we asked for. Care Homes for Older People Page 6 of 29 Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Care Quality Commission (CQC) to be able to make an informed decision about each outcome area. The owner has appointed a person to run the home on a day to day basis in the position of manager. They are not registered with the commission, but will be referred to as the manager within this report. The manager told us that she recently presented her criminal records bureau check to us (the Commission) and would be making full application to register. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose would benefit from containing clearer information about how the home will support people with any changing needs. Where care plans and assessments are reviewed, updated information needs to be transferred into the care plans to ensure that staff have up to date and relevant information. The auditing of medication and recording of any allergies in medication records needs to be reviewed to ensure all information is current and up to date. Medication would benefit from having dedicated storage space so as to further promote security. Care Homes for Older People Page 8 of 29 Ongoing refurbishment works will further improve the environment. More staff need to be trained as an appointed first aider so as to ensure that there is always a member of staff available with this qualification. 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they need to help them decide as to whether the home will meet their needs and expectations. People benefit from a full assessment and can be confident that they will have their needs fully assessed. People have the opportunity to visit the home prior to admission. The home does not provide intermediate care. Evidence: All services are required to provide information to people which tells them about the service that will be provided. This is to help people decide if the home will meet their needs. We looked at the Statement of Purpose and Service Users Guide and saw that these documents gave details of the services and facilities which are available. The manager told us that these are available in alternative formats such as large print, if Care Homes for Older People Page 11 of 29 Evidence: requested. The Annual Quality Assurance Assessment (AQAA) stated that there are plans to further improve this documentation by providing pictorial versions. Prior to people moving in, a full assessment of need must be carried out to ensure that the home can provide the care they need. The Statement of Purpose says that everyone will benefit from a full assessment of need and where appropriate the home will obtain an assessment from care managers or relevant healthcare professionals. We looked at the assessment process for four service users including the most recent person to move into the home. Records showed that each person benefits from a full assessment, which covers the areas of care and was in sufficient detail to ensure that the home could be confident that they could meet the persons needs. One person was staying in the home for a respite period of care and they had also benefited from a full needs assessment. The Statement of Purpose clearly identifies that the home provides residential care and does not provide care to people who have nursing needs or require specialist care such as Elderly Mentally Infirm (EMI) service users. However, it is not clear as to how the home will support people who needs change. For example there are people living in the home who have developed a level of dementia, and although the home is not registered to admit people with a diagnosis of dementia there are people in the home who have dementia support needs. This needs to be clear so that people can be confident on how the home will support them with any changing needs. Prior to moving in people and their relatives or representatives have the opportunity to visit and have a look around the home. We spoke to a visitor who said that prior to moving in his relative had been invited to visit the home and had the opportunity to stay for a meal and meet other people. The home does not provide intermediate care, which is where people are supported with rehabilitation support enabling them to return home. As previously stated they do, however, provide accommodation on an occasional basis for people requiring respite care. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is offered in a way that promotes and protects peoples dignity and privacy in their daily life. Medication is well managed but records need to ensure that they reflect individual needs and have a clear and robust audit trail. Evidence: We looked at the care plans for four people in the home. Care plans are important as they give guidance to staff on how to support each person with their individual and changing needs. We saw that each person had a plan of care in place and this identified daily living activity needs. Many parts of the care plans gave good guidance, although some areas would benefit from further development. We spoke to the manager about this who told us and showed us evidence that she was further developing the care plans so that they were more person centered and reflected what people can manage for themselves. We saw that care plans clearly took into account peoples preferences, likes and dislikes. Care Homes for Older People Page 13 of 29 Evidence: There are a range of risk assessments in place which identified how to support people through a risk management process. Each person has a Deprivation of Liberty check in place from the managing authority so as to ensure they are safeguarded. Both care plans and risk assessments were mainly reviewed on a regular basis. We saw that some areas had not been subject to a regular review, but the manager was aware of this and was addressing this as she developed the care plans. In other cases where the care plan had been reviewed any change in need had not been transferred to the care plan, which meant that staff did not have clear up to date guidance. We also saw in one file that some information was outdated and not relevant which gave a contradictory overview of the persons needs. The manager needs to ensure that all changes in need are clearly identified within current care plans so as to fully support staff in carrying out their care duties. Healthcare needs are well met with people having full access to healthcare professionals as needed. Care plans and records showed that peoples weights are monitored and any appropriate action taken. There are nutritional and skin integrity assessments in place and records showed that any concerns are acted upon. At the time of our visit the medication was kept in an office area which was also providing temporary access through to the kitchen and as such was being used as a walk through. Although the medication is stored securely in locked cabinets the area is limited on space. The home would benefit from having allocated dedicated space for the storage and management of medication. The home uses a pre dispensed system for managing medication and there were no gaps seen on the Medication Administration Record (MAR) sheets. There was lack of clarity on how the home ensures that there are robust records to maintain a full audit trail, as the amount of medication was not always carried for forward onto the MAR sheets. They were advised to refer to the Royal Pharmaceutical Societys guidance for the administration of medication to ensure that they were following best practice. We did see that one set of medication records identified the person as not having any allergies, yet their care plan stated that they were allergic to an antibiotic. It needs to be ensured that each persons medication needs are accurate. We observed staff treating people with respect and dignity. For example one person needed to be hoisted in the lounge area and staff spoke to the person and discussed what they were doing throughout. They also ensured that the person was not put into an undignified position. Staff were seen to knock on bedroom doors before entering and they took to listen to what people had to say. The home also supports people with ensuring their clothes are labeled in a discreet manner, by supporting people to Care Homes for Older People Page 14 of 29 Evidence: purchase small pre named labels and these are then sewn on by the laundry assistant. This ensures that people can be confident that they will always have their own clothes returned. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are well organised and provide stimulation and interest for people living in the home. People benefit from being encouraged to maintain contact with families and friends. The meals provided in the home are good and offer choice; variety and cater for special dietary needs. Evidence: The home employs two activities coordinators who between them work four days a week. They support people with a range of social activities both in the home and through trips out into the community. In house activities include a range of games, bingo and quizzes. On the afternoon of our visit the activities coordinator had arranged for a reminiscence session, and many of the people living in the home had chosen to take part. There was a lot of laughter and people were seen to be enjoying themselves. Entertainers are brought in on a regular basis and the home has a mini bus which takes people out to places of interest. The home also holds a summer and Christmas fayre. Care Homes for Older People Page 16 of 29 Evidence: Care plans indicated peoples preferred pastimes and the activities coordinator told us that time is also spent with people on an individual basis. People we spoke to were all complimentary about the home and said they enjoyed the activities which were arranged for them. The activities coordinator told us that she had good support from higher management in terms of accessing resources to provide a varied activities program. Relatives and friends are able to visit at any reasonable time and stay as long as they wish. One visitor told us you are always made to feel welcome and nothing appears to be too much trouble for the staff. People we spoke to all said that they were able to choose how they spend their day. Staff were seen to ask people what they wanted to do and took the time to listen to people. Care plans and records indicated that peoples choices were taken into account, for example preferred times of getting up and going to bed. The pace of daily life within the home was unhurried and relaxed. Menus showed that there was a balanced and varied diet on offer. The main meal always consists of three courses with a variety of starters including soup or prawn cocktail on offer, and a choice of main course and desert. For the evening meal there is an option of light cooked dish if people prefer. Special diets are catered for and we observed staff assisting people with sensitivity. Both people living in the home and relatives all said that the meals were of a good standard. One person told us I have put on weight since moving in and you cannot fault the food. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident any concerns or complaints they may have will be taken seriously and acted upon. People are safeguarded by the policies and procedures of the home. They will further be protected when all staff have completed their training. Evidence: There is written complaints procedure in place, which is on display. Copies of the procedure can also be found in the Service Users Guide and Welcome Pack provided by the home. It gives details on how to make a complaint or raise a concern. Records showed that there had been two complaints made to the home in the last twelve months. Both of these had been fully investigated with recorded actions and outcomes. The home had also reviewed procedures following one complaint thus evidencing that they operate in an open and responsive manner and take complaints seriously. We spoke to visitors and people living in the home and they all told us that they had no complaints. We (the Commission) have not received any complaints about the home. There is a policy and procedure in place for safeguarding vulnerable adults. Staff we Care Homes for Older People Page 18 of 29 Evidence: spoke to were all able to express an understanding of what action they would take if they suspected any form of abuse. A high proportion of staff have completed training in safeguarding vulnerable adults, although the training matrix did indicate some gaps in this. Records showed that all staff are subject to safeguarding checks prior to starting work. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a clean and largely well-maintained environment with safe access to comfortable indoor and outdoor communal areas. Ongoing refurbishment works will further improve facilities in the home. Evidence: Grenham Bay Court is located in Birchington, which is just outside Margate. It overlooks the coast with lovely views out to sea. The home is set in its own spacious gardens which are easily accessible by the people living in the home. There is ample car parking on the main road at the front of the building. Accommodation is over two floors with a lift to the first floor. There is a connecting walkway on the first floor which enables people with mobility difficulties to access the lift. There is a range of communal sitting and dining areas and people are free to choose where they prefer to sit. Some of the sitting areas are smaller and are more intimate where people can sit and relax and meet with relatives. The main lounge areas are spacious, light and airy. There are thirty two bedrooms, two of which offer shared accommodation. Twenty of the bedrooms have en-suite facilities. Many of the ground floor bedrooms have patio Care Homes for Older People Page 20 of 29 Evidence: doors to the gardens. We looked at a selection of bedrooms and saw that they have been personalized to individual taste with people being able to bring in their own possessions. In agreement with the home people can also bring in their own furniture is they wish. One person we spoke to said I was able to choose this room and the colour I wanted. She also told us that she had been able to bring in some of her own furniture. At the time of our visit there were some ongoing works to the first floor which included the refurbishment of some bedrooms and bathroom facilities. The Annual Quality Assurance Assessment (AQAA) stated that work is ongoing on a continuous basis to improve the internal environment. There is an environmental improvement plan in place to address the parts of the home which are in need of improvement. The home was clean and fresh smelling and there are allocated ancillary staff for domestic duties. On the day of our visit the laundry area was clean and well managed. There are industrial strength washing and tumble drying facilities, although we were told that the washing machine kept breaking down. It is the registered providers responsibility to ensure that the equipment is maintained so that it is fit for purpose. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their care and support needs are met by caring and competent staff, who respect their preferences and choices. Recruitment procedures serve to protect the people living in the home. Evidence: We looked at the rotas for the home for a four week period. These showed that there are sufficient number of staff on duty at all times. People living in the home confirmed that there was always a member of staff available should they need one. Many of the staff we spoke to had worked in the home for a number of years and the manager told us that they had a stable staff group and very rarely used agency or temporary staff. There are additional ancillary staff including catering and domestic staff and two part time activities coordinators. There is also a maintenance man available. We viewed the files for three members of staff and these all showed that staff are subject to a through recruitment procedure. They all contained the information as required by regulation including proof of identity, written references and evidence of a criminal records bureau (CRB) and protection of vulnerable adults (POVA) check being completed. A full employment history is obtained and any gaps explored. Care Homes for Older People Page 22 of 29 Evidence: We looked at the staff training matrix. This showed that nine of the sixteen members of care staff have achieved a National Vocational Qualification (NVQ) at level two or above. Staff records showed that new staff are supported with induction training. At the start of employment all staff also attend a weeks training course arranged by the larger organisation. This covers all the mandatory area of training needs including movement and handling, safeguarding vulnerable adults and fire awareness amongst others. Longer term staff also attend this training as part of their update requirements. The training matrix, however, indicated that not all staff had received up to date refresher training in the required mandatory areas. The registered provider needs to ensure that this happens. The Annual Quality Assurance Assessment stated that there was a need to ensure that more staff had been trained as an appointed first aider. Records we viewed showed that staff had been given first aid awareness training but not the full appointed first aider training. This needs to be addressed. The home is not registered to for admit people with dementia, but there are people in the home who have developed dementia needs. Staff have been supported in training in this area. Senior staff have completed a more in depth course in of a certificate in dementia care at level two. Two members of staff told us that they had recently completed the intensive weeks training course. The both said that they had found it beneficial. Staff were able to demonstrate a good understanding of the needs of the people living in the home and we observed supportive and caring interactions at all times during our visit. People living in the home and visitors all spoke highly of the people working in the home. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that is managed in their best interests. There are quality assurance systems in place which promote the health, safety and welfare of people living in the home. Evidence: The registered provider has appointed a person to manage the home on a day to day basis. They are not yet registered with us (the Commission). The manager has been in post since August 2008 and she told us that she recently presented her criminal records bureau check to us (the Commission) and would be making full application to register. It is the registered providers responsibility to ensure that full application is made within the timescales identified within the requirement section of this report. The manager has worked in the care sector for over twenty years and has the qualifications, skills and experience to manage a care home. She has completed her Registered Managers Award. Care Homes for Older People Page 24 of 29 Evidence: We saw that the manager operated the home in an open and transparent manner. Staff said that they felt well supported and people living in the home said the manager was approachable and available if they needed to speak to her. It is a legal requirement for the provider to make arrangements for the home to be visited once a month to evaluate the quality of the service. We looked at the records for these and saw that this was happening with recommendations and summaries of action taken in place. Surveys had recently been sent to the people living in the home and a report had been compiled which addressed any areas of concern that had been reported back to the home through this process. There are good auditing procedures in place and the manager was able to show evidence that the appropriate safety checks had been carried out in the home. There are environmental risk assessments in place and checks are carried out on equipment and water temperatures to ensure that the home is safe for the people living there. The manager told us that there is no one living in the home who is subject to Mental Capacity Act Deprivation of Liberty Safeguards. As part of the admissions process and through reviews the manager told us that this is regularly reviewed. Some staff have benefited from training in this area, but not all. The Annual Quality Assurance Assessment stated that there is a safe system for managing peoples money with regular audits carried out to ensure security. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. So that any identified individual needs such as allergies as identified within the medication records. 30/11/2009 2 30 18 The registered person shall, 29/01/2010 having regard to the size of the care home, the statement of pupose and the number and needs of the service users ensure that persons employed at the care home receive training appropriate to work they are to perform. So that staff have completed their mandatory training and there are sufficient staff trained as appointed first aiders. 3 31 8 Any person who carried on or 29/01/2010 manages an establishment or agency of any description without being registered under this part in respect of its (as an establishment or, as the case may be, agency of that description) shall be guilty of an offence. Care Standards Act 2000 (11 (1)) In that an application be Care Homes for Older People Page 27 of 29 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 made for a registered manager by date set. 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 1 it is recommended that the Statement of Purpose is clear about how the home are able to manage and support people if they have significant changes in need. Care Homes for Older People Page 28 of 29 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). 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