Care Home: Hafod Residential Home

What the care home does well Pre admission assessments are undertaken so that the home and prospective people know that their individual needs can be met before they move in. People can see their visitors as they choose so that they can continue to have relationships that are important to them. Meetings are held so people are involved in some decisions about how the home is run. People can personalise their own bedrooms to reflect their preferences and tastes. What has improved since the last inspection? Medication storage and practice has improved so that people receive their medication safely. Activities have been improved so there are more things for people to do. Staff have received more training so they have the skills and knowledge to do their job and meet peoples needs. Care plans detail peoples individual needs more clearly so their needs can be met by staff. Risk assessments are in place so staff know how to keep people safe. Staffing levels at night have increased so people`s needs can be met safely. What the care home could do better: More staff should be available at weekends so peoples needs are met in a way that they prefer. The layout and the condition of the laundry should be organised to minimise the risk of infection. Arrangements for managing peoples laundry should be improved so people are satisfied that they clothing will be cared for. Key inspection report Care homes for older people Name: Address: Hafod Residential Home Hafod Care Organisation 14 Anchorage Road Sutton Coldfield West Midlands B74 2PR     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: Donna Ahern     Date: 1 9 0 4 2 0 1 0 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) © 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 27 Information about the care home Name of care home: Address: Hafod Residential Home Hafod Care Organisation 14 Anchorage Road Sutton Coldfield West Midlands B74 2PR 01213556639 01213555688 hafodltd@aol.com Hafodlimited@aol.com Mr Alan Pearce Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Janet Lillian Taylor Type of registration: Number of places registered: care home 16 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 who can be accommodated is: 16 The registered person may provide the following category of service only: Care Home Only (Code 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) 16 Date of last inspection Brief description of the care home Hafod Residential Home is registered to provide personal care for sixteen people aged 65 years and above for reasons of old age. The Home does not provide nursing care. Accommodation is provided in a large adapted Victorian building situated at the junction of Anchorage Road approximately one mile from the centre of Sutton Care Homes for Older People Page 4 of 27 Over 65 16 0 0 8 1 0 2 0 0 9 Brief description of the care home Coldfield. There are good bus links from Birmingham and Lichfield. There are 14 bedrooms, two of which are shared rooms however the home utilises these as single rooms, and the majority have en-suite facilities. Bedrooms are located on the ground and first floors and a passenger lift gives access to these areas. Communal areas are available on both floors, these were spacious and in keeping with the age of the property. A conservatory leads off the dining room looking out on to a well-maintained garden. Assisted bathing facilities are located on each floor offering a choice of bath or shower facilities. There is limited off road parking at the front of the premises. There are notice boards located throughout the home displaying forthcoming events and other information of interest to people who live there and their visitors in a large print format. A copy of our report was available on entering the home. Information relating to the services and facilities provided was available in individual bedrooms. Fee levels for the home range from five hundred and forty five pounds to six hundred and eighty five pounds per week. Additional charges are made for hairdressing or chiropody. 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: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. The visit to the home was undertaken by one inspector over one day. We, the commission were assisted throughout the day by the acting manager. The home did not know that we were visiting that day when there was 14 people living there. Information was gathered from speaking to five people who live at the home and from watching the care they received. Two staff and a senior manager were also spoken to. Three peoples care was case tracked. Case tracking involves discovering individual experiences of living at the home by meeting or observing them, discussing their care with staff, looking at medication and care files and reviewing areas of the home Care Homes for Older People Page 6 of 27 relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experience of people who use the service. Staff files and health and safety records were looked at. Prior to our visit we sent out random surveys to 10 people who live at the home and 10 staff. Five people who live at the home returned the surveys and Four staff. Comments we received are included in the report. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home thinks they are doing well and where they need to improve. It also gives us some numerical information about the staff and people who live at the home. Before our visit we reviewed any notifications received about the home, these are reports about things that have happened in the home that they must tell us about. 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. People have the information they need and can be confident that their needs will be met if they decide to live at the home. Evidence: The home provides long term and short term care. Before anyone comes to live at the home, pre admissions assessments are completed so that the person and the home know that their individual needs can be met before they move in. A new pre assessment format has been introduced since our last visit. We looked at the completed assessment for the person who had recently moved in and found it to be comprehensive. People told us in completed surveys that they received enough information about the home to help them decide if the home was the right place for them. One person said moving into the home was arranged for them by relatives so they didnt have the opportunity to find out about the home before they moved in. The service user guide was available in the entrance of the home and in peoples Care Homes for Older People Page 10 of 27 Evidence: bedrooms and had been updated since our last visit. It had details of fees and additional charges so people living in the home have the information they need. The certificate of registration and public libility insurance were on display in the reception area of the home , which enables anyone to view these when visiting. Although the home is registered for 16 people the owners choose to provide a service to 14 so that all the people living there can be offered a private room. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health needs are met so ensuring their well being. Evidence: Each person living there has a written care plan. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order that their needs are met. We looked at three peoples care plans. Care plans provided staff with information about how they should assist people to meet their needs in a way that they prefer. There was information about peoples likes and dislikes and how peoples Independence should be promoted. Staff spoken to knew about peoples needs and we saw staff encourage people to be independent during the visit. People were encouraged to walk independently or use walking aids, staff were encouraging and people were not rushed. Risk assessments were in place for sore skin, falls, mobility and nutrition. This should ensure that individual needs are met. Risk assessments had also been completed for fire safety and room safety so other potential risk to people are identified and action Care Homes for Older People Page 12 of 27 Evidence: taken to promote their safety. Healthcare professional including general practitioners, district nurses, physiotherapists visit the home to give advice for individuals as required. At the previous visit to the home we found that information about visits from professionals was difficult to track. It was pleasing to find that improvements had been made and information was easy to track so we could see that individual needs were being met. People had been well supported by staff to choose clothing appropriate for the time of year, which reflected individual culture, gender and personal preferences. People did raise some concern with us about the care of their laundry. sometimes my clothes dont come back The arrangements for the care of our laundry is disorganised My relative does my laundry for me so I know its okay. We read in the minutes of residents meetings that people had raise concern about their laundry at these meetings. We saw good interactions between people living there and staff. Although staff were busy during our visit they were caring and respectful towards people at all times. People told us. Staff are very good and caring Comfort and caring The staff are lovely and warm and helpful and very professional in their work my relative loves being at the home. We looked at the arrangements in place for the management of medication. A random inspection by a specialist pharmacy inspector took place in September 2009 following an anonymous complaint made to us about poor administration of certain medication. We did not find evidence to support the concerns however we did make requirements about improving how medication is transported around the home, to introduce a quality assurance system and to ensure accurate balances of medication is kept so that correct audits can be made. It is pleasing to report that all of these matters had been dealt with. All of the audits undertaken were correct. Medication Administration Records (MAR) had been completed accurately ensuring people had received their medication as required. A concern was also raised with us about the adminstarion of controlled medication. The matter was reported and investigated appropriatly by the home. At the time of this visit there were no controlled drugs being stored. Staff have received training so they have the skills and knowledge to manage medication safely and the manager completes carers competence assessment Care Homes for Older People Page 13 of 27 Evidence: ensuring their continued ability to give out medication safely. The manager told us that a new medication system is to be introduced and new storage arrangements. This should further improve the arrangements for medication admisinstaion. 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. People have a choice of meals and activities to participate in so they experience a meaningful lifestyle. Evidence: The manager is very much involved in the planning and organising of activities and events. There is no dedicated staff member responsible for planning activities. The home has a monthly service user meeting and people are asked what activities they would like to do. Each Monday the weeks activities are displayed in poster format so people know what is happening. There is also a monthly newsletter advertising activities for the month. On the day we visited there was a birds watching session from the homes conservatory. A poster of different birds and information about them was on display to inform people who choose to take part. Other activities include games afternoon and cooking. A going around the world session takes place on Friday teatimes. This has involved tasting food from around the world and has included tasting French, Russian and German food. The recent introduction of chickens in the garden created much lively discussion Care Homes for Older People Page 15 of 27 Evidence: during our visit. We saw some people supported to go out into the garden to check on the chickens and they seemed to really enjoy this. They have also just started growing some lettuce in the greenhouse. Two theatre trips have also been planned one at the local town hall and to a performance in Birmingham city centre. People told us they are looking forward to these trips. People told us I love watching the birds in the garden. I love watching the chickens they are great. The activities have got better since the change of manager, there is more to do. I would like to go out more just for some fresh air. There is an open visiting policy so that people can see their visitors as they choose. This means people can maintain relationships that are important to them. People were seen to freely access their bedrooms and communal areas. There is a good choice of communal space for people to use including a spacious lounge on the first floor. The food for lunch and evening meal is cooked at the organisations nursing home located across the road and is transported in heated trolleys. Breakfast is prepared and served in the home. There is a four week rotating menu with a choice of meals which are ordered on a weekly basis. We saw that although people had made a choice in advance they were offered a choice between the main and alternative option at the meal time. We joined people for the main meal which was minted lamb or mushroom pasta. Staff served people their meal from individual dishes of vegetables and potatoes so people could choose what and how much they wanted. Tables was nicely laid with table clothes and napkins. Drinks including alcoholic beverages were served and music was playing quietly in the background so it was a relaxing and sociable occasion. 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. Arrangements are in place to listen to and act upon peoples views and to safeguard people from harm. Evidence: The complaints procedure is displayed in the home and included in the service user guide so that people know how to make a complaint if they need to. At the previous inspection we were concerned that information had not been documented in the complaints log. A system is now established so that there is an audit trail of information detailing how complaints have been dealt with. A complaint received by CQC several months ago before the present manager was in post, was sent to the home to investigate. The home informed us that they dont recall ever receiving the letter from us. A copy of the original complaint letter has been resent to the home to follow up through their procedures. The manager had made a safeguarding referral, details of this and related information was available for us to see and it was ongoing. The safeguarding procedures were available for people to refer to in the event of an allegation being made. Staff we spoke to during the visit were aware of what to do to keep people safe from harm. Staff have received training in safeguarding people so they are aware of their responsibilities. 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 adequate 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 comfortable environment that meets their needs. Some areas of the home are not hygienic which could put people at risk. Evidence: The home is a detached three-storey building with off road parking for a small number of cars in a residential area. Two of the people living there said their relatives have difficulty taking them in a wheelchair out of the homes main entrance as there is a steep step. They have to be bounced down the step which they find uncomfortable. The AQAA told us that some bedrooms have been decorated and some new carpets fitted since our last visit. It said that the home plans to continue with its programme of refurbishment. Accommodation is provided over the ground and first floor. Communal accommodation consists of a conservatory and dining room on the ground floor and a spacious lounge on the second floor which gives people a choice of places to spend their time. Some people prefer to stay in their own bedrooms and this choice is respected by staff. Since our last visit a call bell has been fitted in the conservatory so people can summon help from staff if needed. Care Homes for Older People Page 18 of 27 Evidence: There is a bathroom on each floor with assisted bathing facilities so peoples personal care needs can be met. The majority of bedrooms have en suite facilities consisting of a toilet and a wash hand basin. We looked at bedrooms of the people whos care we case tracked. All had a call bell system to enable assistance to be summoned when required. Bedroom doors had locks and lockable facilities were in place, so enhancing the arrangements for people privacy. People are encouraged to personalise their bedrooms and can take their own belongings to make their rooms as homely as possible. One of the people told us that they would like some items moved around in their bedroom to improve access to their personal items. Another person said they like to keep their bedroom door open but it was closed at the moment as they are going to fit fire closures to the doors. This will ensure that fire regulations are followed and peoples safety is promoted. There were a number of aids and adaptations provided including raised toilet seats, grab rails near to toilets and handrails in corridors which helps to maintain peoples independence. Access to the first floor is by a passenger lift enabling everyone to access all ares of the home. A hoist is available if required and staff have been trained to use it. The garden is accessible via a ramp for people who use a wheelchair. The garden is generally well maintained. People have been encouraged to take part in planting some lettuces in the green house. We saw people going out to the greenhouse with staff support and they seemed really keen to do this. The ground leading to the greenhouse is a little uneven and could be difficult for people with walking difficulties to manage. The manager said they she would like to improve access from the home to the greenhouse so people can access the greenhouse safely. The manager told us that they had recently disposed of some items that were being stored in the laundry room. The room was in need of a thorough clean as there was dust and dirt in parts of the room. Clean and dirty clothes were stored close to each other which could be a potential risk of cross infection. The tumble drier was out of use, the manager told us that the home will be renting a new commercial one. The location of the current drier just inside the door entrance is a potential safety hazard to anyone using it. There was a friendly and relaxed atmosphere at the home. The housekeeper had to go off duty for personal reasons so a member of staff from the organisations nursing home arrived to carry out the domestic tasks. The home was generally clean and tidy. Care Homes for Older People Page 19 of 27 Evidence: There was an odour in one area of the home which was brought to the mangers attention during the visit. The second floor of the home is used as offices for the domiciliary care agency that the organisation runs. This arrangement could impact on peoples privacy. The owner told us that there are plans to move the offices to their other care home when their plans for an extension go ahead. There is currently no time scale for this. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive the support they need to do their job however, arrangements in place for staffing levels may not always ensure peoples needs are met in a way that they prefer. Evidence: We looked at the rota for the week of the inspection and the three previous weeks. This indicated that there are two care staff on each shift during the day and the manager who helps with care tasks. In addition to the care staff there is a housekeeper who works mornings. At night there is one staff member working and one on call doing a sleep in shift. At weekends there is two care staff on duty and the staff member who works nights stays on until 10.00 am to help with breakfasts. Interactions between staff and the people living there were very positive. Although we saw that staff were very busy in their duties they took time to speak to people. Staff were friendly and professional in their approach to people. We received five completed surveys from staff members. Four of them raised concern about staffing levels at the weekend. Staff who we spoke to during the visit were very positive about the home but also raised concern about staffing levels at the weekend. When we spoke to people living in the home they were very positive about all of the Care Homes for Older People Page 21 of 27 Evidence: staff they told us Staff are lovely and Staff are great they are very kind. However they also raised concern about the staffing levels at times and said it was worse at weekends. People told us; So short of staff at weekends Medication can be as late as 11.00 am. Staff are so busy you ask them something and it takes a long time for them to come back to you. At meal times the staff have to take you down to the dining room early and then after dinner because there is only two staff. You have to wait a longtime before you are moved back to your room. You do have to wait a while when you ring the call bell especially at the weekend. The AQAA told us that all staff have completed or are doing a National Vocational Qualification (NVQ) level 2 in care. This should help towards ensuring that staff have the knowledge and skills to care for people individually and collectively. Two staff files were looked at and these were found to contain all the required information to ensure that people employed were safe to work with vulnerable adults. We looked at the staff training matrix and saw that recent training updates had taken place on fire safety, health and safety, medication, manual handling and safeguarding. The AQAA told us that due to some new staff starting they have not completed the full range of training for each person. We saw that an induction package is in place that should ensure that staff fully understand their role and the aims and values of the home. 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. Arrangements in place ensure the home is run in the best interest of the people who live there. Evidence: The manager is not yet registered with us. She has worked for the organisation for a number of years in different positions and returned to take up the position when the registered manager was retiring. She has a number of years of experience of working with older people. Staff spoken with told us that the manager is very approachable and supportive. We saw that the manager interacted well with the people living in the home. She was able to tell us about peoples needs and provided us with all the information we asked to look at. Since our last visit a number of improvements have been made. Records are more organised, improvements have been made to care planning, medication practice, staff training and activities in the home. People told us the atmosphere is more friendly and welcoming. Care Homes for Older People Page 23 of 27 Evidence: Much of the improvements are down to the current manager who also coordinates the activities in the home, supports the care staff and does a number of sleep in duties each week. Its important for the ongoing development of the home that these improvements can be sustained for the benefit of the well being of the people living there. Monthly staff meetings take place and the minutes of the meetings indicated that practice issues are discussed. Residents meetings take place on the same day. The manager told us that this is so any issues raised can be followed up on. A senior manager completes a report about the quality of the home each month and looks and identifies any areas that require improvement. Satisfaction surveys have been sent out to people living there and their relatives. Information from the surveys had been collated into a report which we saw on display in the home. This generally reported on people being satisfied with the home. However people had raised some concern about the care of their laundry. Prior to the inspection the manager completed the AQAA. This was completed to a satisfactory standard and information in the AQAA was generally consistent with our findings on the day of the visit. The AQAA tells us how the home think they are performing, gives us information about the home and tells us plans for future improvements. We looked at how the home looks after small amounts of peoples money. Records of transactions are made so there is an audit trail. Some personal items are also kept as requested by people. However there was no inventory of these items kept which does not fully ensure there safety. We looked at a sample of health and safety and maintenance checks to ensure that equipment is safe and in full working order. Staff attend fire safety training and take part in fire drills so they know how to keep people safe in the event of a fire. The work place fire risk assessment had been reviewed but action hadnt been taken on some of the findings. An action plan was in place by the end of our visit confirming what action will be taken and by when, to ensure the safety of people living in the home. 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 1 26 16 Arrangements must be in place to ensure the laundry room is clean, safe. and organised. So the risk of infection is minimised. 31/05/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 10 19 Peoples personal laundry should be cared for in a way that they prefer. Consideration should be given to exploring how access to and from the main entrance can be made more accessible to people who use a wheelchair. All areas of the home should be free from bad odours so the home is hygienic and pleasant for people. Staffing levels should be reviewed to ensure that peoples needs can be met in a way that they prefer. An inventory of items should be in place for items kept for safe keeping. 3 4 5 26 27 35 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. 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