Care Home: Grosvenor House Care Home

What the care home does well The Company provide people with comprehensive information about the home and the services it provides. This includes the Statement of Purpose, Service User Guide and an informative website. Extensive improvements have been made to the home`s environment over the past months. It provides a pleasant, homely atmosphere for the people who live there and is very well maintained. One person told us, `very well appointed and kept very clean`. Others commented that it was always fresh and clean. Residents and relatives spoke highly about the care and support staff provided. A relative said, `we are grateful for the care and attention we have received from all at Grosvenor House, especially Barbara (the manager)`. Another person said, `they do the best they can for me`. Staff are knowledgeable about the people they support and interact with residents in a very positive manner. The home`s training programme offers staff a variety of courses including the opportunity to complete an N.V.Q. (National Vocational Qualification) in care. The home provides a good standard of care and has recently been accredited by the Gold Standard Framework, this is an independent body which assesses the homes ability to provide good quality end of life care. What has improved since the last inspection? This is the first inspection under the new registration. What the care home could do better: There must be a system in place that provides staff with regular, structured, supervision and appraisal. This will help to make sure that staff are adequately supported in carrying out their work. Other areas that would benefit from some attention included the following. Care plans should be developed further so that they include more information about how people prefer their care to be delivered and their abilities. This will give staff access to better information about how to meet peoples individual needs. The plans should also contain information about recent legislation that is designed to protect people`s rights and choices. This is so the home can show that they have looked at the effects the legislation has on the resident`s lives and planned their care accordingly. Staff should receive appropriate training in this subject so that they know their role in supporting people. Although activities take place, records about peoples preferences and participation in social and leisure activities should be developed so that they reflect what people like to do, and have done, in more detail. This will help to make sure that they have access to appropriate stimulation. Staff training should be reviewed to make sure that all staff have been provided with training to meet peoples differing needs, including specialist subjects such as physical disabilities. The staff induction programme should be reviewed to ensure that it demonstrates that all essential areas are covered in a timely manner and the detail that it entails. This will help to make sure that staff consistently receive all the information they need to do their job. Key inspection report Care homes for older people Name: Address: Grosvenor House Care Home Grosvenor House 19 Back Street East Stockwith Gainsborough Lincs DN21 3DL     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: Dawn Podmore     Date: 0 8 0 1 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: Grosvenor House Care Home Grosvenor House 19 Back Street East Stockwith Gainsborough Lincs DN21 3DL 01427616950 01427616950 barbara@grosvenorcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Grosvenor House Care Homes Ltd care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 37 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical Disability - Code PD Date of last inspection Brief description of the care home Grosvenor House Care Home is situated in the small village of East Stockwith, which lies 4 miles north of the town of Gainsborough. The home has recently re-registered as a Limited Company. Accommodation is provided on two floors in 37 single rooms, 24 of which have ensuite facilities. There are several communcal areas, which includes a large airy dining room, Care Homes for Older People Page 4 of 27 0 37 Over 65 37 0 Brief description of the care home these are situated on the ground floor. Access to the first floor is available using either a lift or the stairs. Since the completion of the new extention the gardens and parking areas have been landscaped and a patio area is available at the rear of the home. The home is currently registered for 37 residents, some who are older people and others who are younger and have a physical disability. Personal and nursing care are provided. At the time of the inspection the manager confirmed that the weekly fees ranged from two hundred and one pounds to five hundred and fifty five pounds a week depending on the residents assessed needs. This does not take into account any monies paid in relation to nursing care determination assessments, which would be deducted from the amount paid. Additional charges are made for services such as chiropody and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the reception area or the managers office. 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 key inspection was unannounced and took any previous information held by C.S.C.I about the home into account. Throughout this report the terms we and us refers to the Commission for Social Care Inspection (CSCI). Before the the visit the provider had returned an Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans for improvement over the next twelve months. We also sent out surveys to residents and staff, 2 of which were returned in time to be included in this report. The main method of inspection used was called case tracking. This involved selecting a proportion of residents and tracking the care they received through the checking of records, discussions with them and the staff who care for them, and observation of care practises. A partial tour of the home was also conducted, which included looking Care Homes for Older People Page 6 of 27 at some bedrooms, communal areas and bathing and toilet facilities. Documentation was sampled and the care records of the three people being tracked were examined. We spoke with 9 residents and three members of staff. They shared their views about how the home operated on a day to day basis and the care and facilities provided. The manager was available during the visit and the general outcomes of the visit were discussed with her. The owners were also available during the visit. On the day of the visit 29 people were living at the home. This was the first key inspection since the home re-registered as a Limited Company. 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: There must be a system in place that provides staff with regular, structured, supervision and appraisal. This will help to make sure that staff are adequately supported in carrying out their work. Other areas that would benefit from some attention included the following. Care plans should be developed further so that they include more information about how people prefer their care to be delivered and their abilities. This will give staff access to better information about how to meet peoples individual needs. The plans should also contain information about recent legislation that is designed to protect peoples rights and choices. This is so the home can show that they have looked at the effects the legislation has on the residents lives and planned their care accordingly. Staff should receive appropriate training in this subject so that they know their role in supporting people. Although activities take place, records about peoples preferences and participation in social and leisure activities should be developed so that they reflect what people like to do, and have done, in more detail. This will help to make sure that they have access to appropriate stimulation. Staff training should be reviewed to make sure that all staff have been provided with Care Homes for Older People Page 8 of 27 training to meet peoples differing needs, including specialist subjects such as physical disabilities. The staff induction programme should be reviewed to ensure that it demonstrates that all essential areas are covered in a timely manner and the detail that it entails. This will help to make sure that staff consistently receive all the information they need to do their job. 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions procedure includes an initial assessment, which helps to make sure that the home can meet the needs of the people admitted. Evidence: The home used various methods to provide potential and existing residents with information about the home and how it operates. This includes a very descriptive brochure, which is available within the home and displayed in all doctors surgeries. They have also set up a web site, which includes colour pictures of the home, which can be expanded for people with poor eyesight. The web site also includes a home page which tells people about the history of the home and what it offers to its residents. The owners said that they also include reports about the home and peoples opinions of the home on there. There are also direct links to key outside agencies, such as the District Councils, the Commission and Environmental Health. A review of all information available prior to the visit to the home, and the content of Care Homes for Older People Page 11 of 27 Evidence: peoples care records, showed that the home does not admit residents without an assessment of their needs being completed. A relative and staff spoken with confirmed this. Information about the home can be found in the Statement of Purpose and on the Company website. A relative told us that they had a very positive experience when they came to look at the home. She said, very good brochure and very open and informative tour and assistance. Although the home has not admitted people for intermediate care in the past, the manager told us that they had recently submitted an application to Lincolnshire County Council to provide this service. 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. Peoples needs are being met by staff who understand their needs and deliver care in a respectful manner. However some care plans do not contain enough information to make sure that individual needs and preferences are always fully met. There are systems in place to make sure that medications are administered safely. Evidence: We looked at the care records of 3 people living a the home choosing people with different needs. They contained detailed information about peoples main care needs and the level of support they required. However some lacked detail about all of the residents individual preferences and abilities. For example one plan said that the resident needed assistance with all their hygiene needs, but did not tell staff about their dental care or specific information about bathing arrangements. A daily record of how people were progressing had been maintained and care plans had been evaluated regularly. Assessment for potential risk areas, such as manual handling and risk of pressure damage, had been carried out and the information used to formulate care plans to minimise any identified risks. Care Homes for Older People Page 13 of 27 Evidence: The home has not yet included the content of the Mental Capacity Act into the care planning process. This is new legislation that is aimed at protecting peoples rights and choices. Records and peoples comments indicated that residents had access to outside health professionals such as doctors and specialist nurses. Peoples health care was being monitored and equipment such as specialist beds and pressure relieving mattresses were in use. The home has recently been accredited by the Gold Standard Framework, this is an independent body which assesses the homes ability to provide a good quality end of life care. Staff were knowledgeable about the people they supported and how they preferred their care delivering. During a tour of the home, and at lunchtime, they supported people in a cheerful manner and were responsive to peoples needs and preferences, as well as respecting their privacy and dignity. The residents we spoke to, and people who returned surveys to us, said that they were happy with the level of care and support provided. One person said, I worried at first but they are very good. Another told us, very good care here, they really helped me to get back on my feet. Records and observations demonstrated that the home has satisfactory policies and procedures concerning the receipt, storage, administration and disposal of medications. A discussion with the nurse in charge confirmed that medications were being handled safely. 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 provides a varied activities programme which people enjoy, but documentation is inadequate. Residents are enabled to maintain and develop links in the local community and relationships of their choice. People receive a nutritious and varied diet that meets their individual preferences and health requirements. Evidence: The home has employed an activities coordinator who is employed 3 mornings a week to provide stimulation for the people who live at the home. The activities programme for the month was displayed outside the dining room, but it did not detail what the activity person intended to do on the mornings she was there. It did include other activities such as a weekly bingo session, church services and visits from patting dogs and the hairdresser. Records and peoples comments indicated that other stimulation had taken place including, baking, one to one talks and films. When we visited the hairdresser was there and a manicurist was providing nail care. Stimulation from outside the home is also encouraged. This includes Fit as a Fiddle, which is a programme that introduces movement and exercise as well as training the staff to continue the sessions. Motivation sessions take place and entertainers have visited the home. The home has also joined NAPA (National Association for Providers Care Homes for Older People Page 15 of 27 Evidence: of Activities for older people); which gives providers ideas for managing behavioural issues and provided support to the home. The files we looked at contained a social care plan, but the information did not clearly tell staff how they could support and stimulate people. From speaking to the activities coordinator it was evident that that she was facilitating activities, but records did not support that these were the things that people wanted to do. People we spoke with and those who returned surveys told us that they were happy with the activities that took place and said that they could choose not to join in if they preferred not to. They said that relatives could visit at anytime and that they were always made welcome by the staff. At lunchtime the atmosphere in the dining room was calm and relaxed, with staff serving the lunch and assisting some people to eat in an unhurried manner. Alternatives to the main menu and special diets were also available. People commented, the meals are good, plenty of choice at breakfast and lunch, but the sometimes not so much at teatime and a good choice and variety. The dining room and kitchen have been refurbished to a high standard. At the last visit by the Environmental Health Officer the kitchen was awarded a 5 star rating, the highest rating available. 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. Residents are protected by clear policies and procedures for handling complaints and allegations of abuse. Evidence: The home has a complaints procedure, this is displayed in the home and included in the Service User Guide, which is given to people when they come to live at the home. The AQAA said that no areas of concern had been raised, but a system was in place should any complaints be made. People said that they knew how to make a complaint and would be comfortable highlighting any issues. Residents and relatives said that they had no complaints. The home has procedures concerning the protection of vulnerable adults. Staff demonstrated a good knowledge of what to do if they suspected abuse could be occurring. Most staff had received training in this subject and the manager said that further training was planned. Care Homes for Older People Page 17 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 excellent 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, clean, comfortable and homely environment, which offers a good standard of decor and furnishing. Evidence: We took a tour of the home which included looking at the bedrooms of the people being case tracked and some communal areas and bathing facilities. Bedrooms had been personalised by the resident or their relatives with photographs, mementos and small items of furniture. The home has been decorated and furnished to a high standard with new areas, such as the dining room and sitting rooms, being airy and modern while retaining a homely atmosphere. There are several sitting areas and a large dining room, where a snack area has been built. This enables residents and relatives to help themselves to drinks and purchase things like chocolate and crisps. Corridors have been redecorated and provide wide access for wheelchairs. The bedrooms in the new part of the home are spacious and airy with en suite toilets, some also have showers. Most of the existing bedrooms have been redecorated and some have been remodelled so that they have en suite facilities. The home now has 24 en suite rooms and the management team said that there were plans to eventually upgrade all the bedrooms to this standard over the next 18 months. The majority of bedrooms have internet, sky and analogue television facilities and Care Homes for Older People Page 18 of 27 Evidence: there is also a loop system available to assist people with hearing difficulties. Other specialist equipment is available, for example over 80 of the bedrooms have specialist electrically adjustable profiling beds with integrated side rails. Bathing facilities were well appointed and included a hydrotherapy bathroom with a ceiling hoist and mood lighting. Other specialist equipment and aids were also available to help to keep people safe and comfortable. People told us that they were happy with their rooms and the general facilities. Two people who returned surveys said that the home was always fresh and clean. One person commented, very well appointed and kept very clean. The garden and car park were well maintained and included a patio area with seating. The manager said that they planned to build raised flowerbeds so that people in wheelchairs could access them. Ramps had been provided to enable easy access to all areas. Care Homes for Older People Page 19 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. Residents are safeguarded by the homes recruitment procedure, which helps to ensure that staff are suitable to work with vulnerable people. Residents receive care from staff who are knowledgeable about their needs and have access to appropriate training. Evidence: The manager monitors the number of staff on duty at all times of the day and night against the current dependency levels of the people who live at the home. Residents and relatives who returned surveys and spoke to us said that there was enough staff on duty to meet the needs of the people currently living at the home. One person said, they are always busy, but come when you need them. The staff spoken with said that they felt that the current staffing levels were satisfactory, although one person said that it would be nice to have additional time to spend with residents. Observation showed that staff supported people in a calm and relaxed manner. They were sat talking to people and never appeared too busy to see to their needs. They were visible in communal areas and responded well to peoples requests. Recruitment of new staff was being carried out correctly with essential checks, such as written references and C.R.B. (Criminal Records Bureau) checks, being undertaken. Records and staff comments showed that new staff received an adequate induction to Care Homes for Older People Page 20 of 27 Evidence: the home. However the documentation about the information they had received and their capabilities was basic and so failed to demonstrate the depth each area had been covered and the staff members competency. The home has a training programme which includes essential subjects such as manual handling, infection control, protection of vulnerable adults from abuse and basic food hygiene. More specialist areas such as dementia awareness had also been provided to some staff. The training plan for the coming months, and staff comments, showed that some staff would have access to training in sensory deprivation, palliative care and physical disabilities. Staff said that they felt well trained and supported and they demonstrated a good knowledge of the people they were caring for. Basic training had been provided to staff about the Mental Capacity Act, which is aimed at protecting people rights and choices. Although this had been completed the manager acknowledged that more training would be required, especially about assessment and recording procedures. The company encourage staff to complete an N.V.Q (National Vocational Qualification) in care. Information provided showed that out of 19 care staff 9 have attained an NVQ and another one is currently doing the award. The manager said that five new staff were to register on the course by the end of the month. Care Homes for Older People Page 21 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. Leadership and guidance is provided to staff to ensure that care is delivered in a consistent manner, but staff have not consistently received formal supervision sessions or appraisals. The home is managed in the best interest of the of the residents. There are systems in place to make sure that the health, safety and welfare needs of the residents are met. Evidence: Mrs Barbara Bussey has been the manager at the home for over 8 years. She is a qualified nurse with management experience. She has completed the Registered Managers Award, as well as a management diploma. Comments from residents and relatives indicated that they felt that the home was well run and that the manager was helpful and supportive. One relative told us, we are grateful for the care and attention we have received from all at Grosvenor House, especially Barbara (the manager). Another person said, they do the best they can for me. Care Homes for Older People Page 22 of 27 Evidence: The staff we spoke to said that the manager was approachable and listened to their ideas. When asked what the home did well one said, involving residents and relatives in care planning to provide the best possible care and support for the whole family. Another commented, it provides a family atmosphere, residents get what they want, its as much like home as possible. Someone else told us that they were very happy working at the home. Although staff said that they felt supported in their work, records and staff comments failed to show that they were receiving regular formal supervision and appraisal sessions. The management team confirmed that these had not taken place consistently but they intended to address this shortfall as soon as possible. The home has a quality assurance system so that they can gain the views of the people who use the service. The manager said that this included surveys, meetings and care reviews. Surveys had been sent out in July 2008 and the ones sampled contained very positive answers to the set questions. The results had been summarised so that the owners could use the information to improve the service offered, but this had not been feedback to all residents. The financial records for the person allowances of the people being case tracked were examined and found to be accurately documented, including receipts. However two entries had not been double signed, this would make the the system safer. A monthly visit by the person representing the company had been carried out and a report provided which outlining his findings and what people had told him. The content indicated that people were happy with how the home was operating. The reports also highlight areas that needed attention and what was being done to address them. The home has health and safety polices and procedures to guide and instruct staff. There is also a programme in place to service and maintain equipment in the home on a regular basis. Information provided in the AQAA and sampling on the day of the visit demonstrated that regular checks on equipment, such as hoists and fire equipment, had taken place. Care Homes for Older People Page 23 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 24 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 1 36 18 There must be a system in place for staff to receive regular supervision and appraisal. This will help to ensure that staff are adequately supported in carrying out their job. 02/03/2009 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 7 Support plans should include reference to the Mental Capacity Act, 2007 and the effects it has on resident lives. This is to help to make sure that their rights and choices are protected. Care plans should contain better information about peoples individual preferences and abilities. This will help to make sure that all their needs are met in a more person centred way. The plans and records regarding peoples preferences and participation in social and leisure activities should be developed so that they reflect what people like to do and have done in more detail. This will make sure that they Page 25 of 27 2 7 3 12 Care Homes for Older People 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 have access to appropriate stimulation. 4 30 The recording of the staff induction programme should be reviewed to ensure that it demonstrates that all essential areas are covered in a timely manner and at what depth. This will help to demonstrate that staff have received a comprehensive induction to the home. The training programme and staff training needs should be assessed to make sure that all staff have been provided with training to meet peoples differing needs, including specialist subjects such as physical disabilities. 5 30 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. 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