Care Home: Harehills

What the care home does well Harehills is homely, comfortable, safe and well maintained and provides residents with both private and shared space where they can spend their time. Gets good information about the care and support needs of people who wish to use the service so that everyone is sure they can be met. Aids to daily living and adaptations have been carried out and are available throughout the home to make life easier and safe for the people who stay their. Respects the privacy, dignity and differing needs of the people who stay in the home, and treat them in a senstive, warm but professional way. Has systems in place for the acceptance, recording, investigation and reporting of concerns, complaints and allegations, for the protection of residents and staff. Encourages staff to speak out if they witness practice that they know is unsafe or unacceptable for the protection of residents. Provides people with a good choice of food that is nutritious and inviting. Makes sure that staff receive training and support to help them do their job. People who use the service said: "All the staff at Harehills care, very well, for my husband who visits for respite care". "Make you welcome, friendly. I have always been well looked after when in respite, its like home from home and everyone is so kind". "Staff are always polite and friendly. Staff arrange activities regularly but they are not pushy if I do not want to participate. The staff are always nearby - you don`t need to go looking for them. Meals are always hot and well presented. Accommodation is always kept clean". "Clothes laundered daily, friendly staff - all know me by name. Accommodating eg., when visitors arrive they will keep meals back until the visitors have left. Arrangements are always smooth for each stay. Bus drivers to and from are excellent staff very good and helpful". What has improved since the last inspection? Medication competency checks have been introduced to support the safe ordering, receipt, dispensing and disposing of medication. There is a programme of on-going environmental changes and improvements for the comfort of residents. New lounge chairs, dining chairs and tables have been purchased for the comfort of residents. What the care home could do better: The admissions process must be reviewed so that people come into the home in an organised and timed way and are able to have their records updated and checked in a calm and relaxed way. Staffing levels must be reviewed, considering the admission process, so that sufficient staff are on duty and available at all times helping to keep people who stay in the home safe and well. When asked what the home could do better, people who use the service said: "I know it is expensive but regular trips out in the mini bus does lift your spirits". "Be specific about what time a bath is being offered and the time being appropriate eg., before my bedtime". Key inspection report Care homes for older people Name: Address: Harehills Burnfoot Way Kenton Newcastle upon Tyne NE3 4TL     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: Elaine Charlton     Date: 0 8 0 9 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) 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 29 Information about the care home Name of care home: Address: Harehills Burnfoot Way Kenton Newcastle upon Tyne NE3 4TL 01912852832 01912840773 simon.mulligan@newcastle.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Newcastle City Council Social Services Department Name of registered manager (if applicable) Mr Gary James Gilchrist Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Up to 3 beds can be flexibly used to accommodate service users aged 55 to 64 years old, or service users over pensionable age. Date of last inspection Brief description of the care home Harehills Resource Centre is a registered care home that provides respite/short stay care to older people and older people with dementia. The home is located in Kenton, Newcastle Upon Tyne. Accommodation is over two floors and there is a passenger lift. All bedrooms are single and there are a variety of communal lounges and dining rooms throughout the home and a patio garden is accessible to the service users. There is access by public transport. Local amenities and shops are not within easy walking distance. Care Homes for Older People Page 4 of 29 Over 65 8 22 0 0 1 7 1 0 2 0 0 8 Brief description of the care home The home does not provide nursing care. Fees are £259 per week for respite care. Emergency admission fees are separately assessed and dependent on the length of stay. Information about the home and inspection reports are readily available. 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: The quality rating for this service is two star, this means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 8 September 2009, with a follow up visit on the 14 September. A total of six and a half hours were spent in the service. The manager was present throughout the inspection. Before the visit we looked at Information we have received since the last visit on the 17 October 2008. The Annual Quality Assurance Assessment (AQAA) that gives CQC evidence to support what the service says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any complaints and concerns since our last visit. The providers view of how well they care Care Homes for Older People Page 6 of 29 for people, and the views of people who use the service, their relatives, staff and other professionals who visit the service. We have also reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We also arranged for an inspection of medication systems and medication held in the home to be carried out by a CQC Pharmacy Inspector. His findings are included in the body of this report. During the visit we Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building/parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since our last visit. We told the manager what we found. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Medication competency checks have been introduced to support the safe ordering, receipt, dispensing and disposing of medication. There is a programme of on-going environmental changes and improvements for the comfort of residents. New lounge chairs, dining chairs and tables have been purchased for the comfort of residents. Care Homes for Older People Page 8 of 29 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their differing and diverse care and support needs properly assessed so that everyone is sure they can be met. Admissions are sometimes compromised by staff not having control about how and when people can be admitted to the home which could place people at risk. Evidence: Six people who use the service sent back our questionnaire Have Your Say. All said they got enough information before they moved in. There is no clear admissison policy or procedure. Staff use a combination of systems and procedures produced for Napier House and Harehills. The home has 13 emergency beds and referrals are received through the single entry point referral system. Previously, emergency admission were managed through the Napier Resource Centre, which is now closed, and where the manager of Harehills was Care Homes for Older People Page 11 of 29 Evidence: based. This gave the Resource Centres a degree of control over admissions. We looked at the records for someone who had been admitted as an emergency. There is an admission checklist, care action plan, practice encounter form and a range of professionally recognised assessment formats that staff use. We also saw evidence of assessments being carried out to find out whether people using the service have capacity to make decisions on a day to day basis. Information had been properly collected and well documented. The process of admitting people to the home is compromised by the staff team having little control over how and when people are admitted. 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. People who use the service receive the care and support they need and expect. They are able to tell staff how they wish to be supported, by whom and receive their medication at appropriate times of the day. Evidence: People who sent back questionnaires told us that they got the care and support they needed, that staff listened to what they said and acted upon it, and were able to see healthcare professionals as and when they wished. They also said all the staff at Harehills care, very well, for my husband who visits for respite care, makes you welcome, friendly, I have always been well looked after when in respite, its like home from home and everyone is so kind, staff are always polite and friendly, they arrange activities regularly but they are not pushy if I do not want to participate, the staff are always nearby - you dont need to go looking for them, meals are always ot and well presented, accommodation is always kept clean. Clothes are laundered daily, friendly staff, all know me by my name, accommodating Care Homes for Older People Page 13 of 29 Evidence: when visitors arrive, they will keep meals back until the visitors have left. Arrangements are always smooth for each stay. Bus drivers to and from are excellent, staff very good and helpful. When asked what the home could do better one person said be specific about what time a bath is being offered and the time being appropriate (eg., before my bedtime). We saw the records for three other people who use the service for respite care. These are kept in a standard way and were up to date. Risk assessments and moving and transferring guidance were in place. Staff have access to a wide range of equipment to help people move around the home, be transferred from their beds or take a shower/bath. Once people have had an intial stay of respite care they are able to telephone the home to make their own bookings for future visits. Throughout the inspection staff were seen to treat residents with a great deal of care and respect. Relationships were warm and friendly and it was obvious that both residents and staff knew each other well. There are good facilities within the treatment room for the storage of medicines although the medicines fridge was iced up and temperature monitoring records were incomplete. We were informed that a new fridge had been ordered. There was no date of opening on a bottle of chloramphenicol eye drops. This means that there is a risk that medication with a short use once opened may be used beyond the date recommended by the manufacturer and may not be safe to use. The current medication records of all 12 service users were looked at. There were no gaps on the charts and no significant discrepancies between the quantities of medicines received, the number of doses recorded and the quantities of medicine remaining. This indicates that people are getting there medicines as prescribed. All entries on medication administration record (MAR) charts are handwritten. All entries were complete with full prescription details recorded on the MARs, quantities of medication received and a witness signature to confirm their accuracy. Receipt of medication and any subsequent disposal of unwanted medicines is undertaken by two staff working together and a comprehensive audit trail is maintained. Care Homes for Older People Page 14 of 29 Evidence: The administration of some morning medicines by two senior carers was observed. The process was well managed and generally followed good practice guidance although some medicines were directly handled by a carer and no disosable gloves were worn. This practice is unhygienic and may lead to contamination of the medicines and possible infection. At the end of the administration round all MAR charts were checked to confirm that all medicines had been administered and recorded. The controlled drug cupboard appears to meet safe custody requirements although there were no controlled drugs currently in use. Entries in the controlled drug register were all fully completed with witness signatures and there was evidence of regular stock checks being undertaken when controlled drugs were in use. When service users arrive at the home a full, up to date list of mecines and doses to be taken may not always be available at the time of admission. Senior carers then contact the GP practice or hospital, whenever possible, to obtain written confirmation of current medication prior to any administration taking place and we observed this process during the inspection. All staff handling medicines have received appropriate safe handling of medication training and receive annual updates. Not all of these staff have been formally assessed as being competent to administer medicines but this process is now well underway and comprehensive documentation is being maintained for those staff who have been assessed. Daily and weekly audit of MAR charts is undertaken and this includes a full count of all medicines in stock. This helps identify any possible medication errors or omissions promptly, helps in confirming that staff are following the medicines policy, and highlights any medicines which are running low and need reordering. A daily communication book is used effectively to pass on information about medicines which need to be ordered. 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. People who use the service are able to join in activities and events that are interesting and stimulating. They are able to choose from a varied and nutritious menu at meal times. Evidence: People we spoke to during the inspection and those who sent back questionnaires said that the home arranges activities an events they can join in, but that no pressure is put on them to take part if they choose not to. We were told that people who use the day centre at Harehills share some activities and outings with people who are staying for respite care. Or, if someone attending for day care does not want to go on an outing they can join respite residents for their meal. The home is run in a very flexible, relaxed way, and pays attention to the wishes of people who use the services provided. We saw people visiting their relatives and were told that staff were very accommodating when friends or relatives did arrive. Care Homes for Older People Page 16 of 29 Evidence: In the day centre dining room there is a £1 table, card stand and tuck shop, where people can buy things they may have forgotten or run out of. Activities and events vary and are planned to meet the needs/choices of the people who are coming in for respite care. Entertainers visit the home at different times of the year, and the home is decorated to celebrate some themed days such as St Patricks Day, Easter and Halloween. The home has a three week rolling menu that was last revised in January this year. Breakfast choices include a cooked breakfast, on request. Lunches are varied, interesting and nutritious and there are two choices at teatime - one hot and one cold. The kitchen is small for the number of meals provided but very well organised. In addition to meals eaten in the home staff cater for meals on wheels and lunch clubs. Over 250 meals a day are prepared. Lunch choices on the day of the inspection were chicken fillet and stuffing or vegetable lasagne with roast potatoes, mixed vegetables and green beans, followed by rhubarb crumble and cream. Teatime choices were fish cake, oven chips and mushy peas or egg and tomato sandwiches followed by iced orange sponge. A vegetable broth with wholemeal bun was being served for supper. Everyone we spoke to or heard from said the choices were good and the meals were excellent. 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 who use the service are protected through policies, procedures and staff training in complaints and safeguarding adults, they know they can speak up and will be taken seriously. Evidence: People who use the service and sent back questionniares said that they knew who to speak to if they were unhappy and how to make a complaint. The City Council has comprehensive policies and procedures in place that support the acceptance, recording, investigation and reporting of concerns, complaints and allegations. All staff have attended Newcastle City Council multi-agency safeguarding adults training. No complaints had been received by the home or CQC. The home notifies CQC about events and/or incidents that may affect the well being of a resident promptly. Where appropriate events and incidents are brought to the attention of the safeguarding team. The manager takes incidents seriously and works hard to make sure that systems, Care Homes for Older People Page 18 of 29 Evidence: procedures and training are put in place to minimise the risk of a recurrence. Leaflets that people can use to raise a concern or complaint are displayed in the home and other City Council services. All staff are required to have a Criminal Records Bureau (CRB) check at an enhanced level before they are able to work in the home. Everyone is also employed in accordance with the General Social Care Council (GSCC) Code of Conduct. There is a whistle blowing policy that encourages staff to speak out if they witness practice or behaviour they know to be unacceptable. 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 stay in a home that is warm, homely, comfortable and safe where they are able to spend time in private or with others. Hygiene routines are good and the home is kept exceptionally clean. Evidence: We were shown around the premises by the deputy manager. The home is warm, comfortable and clean and provides people with the opportunity to spend time privately in their bedroom or in a range of shared areas on both floors. Bedrooms are located at ground and first floor levels and their is a passenger lift for people who may experience problems with their mobility. All the bedrooms were seen to be spacious and nicely decorated. There is room to move furniture around to meet individual needs and televisions can be wall mounted or placed at a lower level as each resident wishes. A great deal of equipment is available in the home, including profile beds, hoists, tracking system, turntables and handrails, to assist people who have difficulty with their mobility. Bathrooms and toilets are located close to bedrooms and communal areas so residents Care Homes for Older People Page 20 of 29 Evidence: can get to them easily. Improvements and changes are being made to bathroom and shower facilities for the comfort of residents. Lounges and dining areas are located on both floors, in addition to quite rooms and a smoking room on the ground floor. A dining room on the first floor had just been redecorated and new tables and chairs were purchased, it is a lovely room overlooking the town moor. All areas of the home were seen to be extremly clean, tidy and odour free, and this is a credit to the staff who work hard to maintain these standards. There is no dedicated handyman, but staff from City Works attend to carry out repairs and replacements. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected through recruitment and selection procedures and staff training but their care and support can be compromised by the number of staff on duty and the tasks they have to carry out. Evidence: Newcastle City Council has comprehensive and robust policies, procedures and systems for the recruitment and selection of staff. The main personnel files are kept at the Civic Centre and these were not inspected on this occasion. We looked at the staff files kept in the home. These are kept in a standard way and include evidence that each person has received clearance from the CRB at an enhanced level. The staff team is stretched at the moment as they have been covering for staff vacancies, sickness and holidays. Expected staffing levels are 4/5 betweeen 07:30 and 14:45, and five staff between 14:45 and 21:00. Two waking night staff support the team. In additional to senior care and care officers, domestic staff are on duty but they also act up as care officers. Care officers carry out laundry tasks in additional to personal Care Homes for Older People Page 22 of 29 Evidence: care and support duties. Off duty rota planning is compromised by historical issues of fixed days off for staff and not being able to change staff duty times. There is an annual training programme in place and we saw that dates when staff training needed to be reviewed had been identified. Staff training in medication, safeguarding adults, fire, first aid and moving and transferring is up to date. Twenty staff have completed training on the Mental Health Capacity Act. Staff have also been undergoing competency observations/training for the safe handling of medication. Records of this were good. On the second day of the inspection in addition to the manager there was a senior member of staff, two care officers and a domestic on duty. Three admissions and two discharges were planned for the day as well as two staff being needed to administer medication. A review needs to be carried out to look at staffing levels in conjunction with the admission and discharge procedure to make sure that sufficient people are on duty to allow admissions to be carried out in a safe, calm and relaxed way, as well as meeting all the other requirements expected of staff. It was the opinion of the inspector and pharmacy inspector that staffing levels, systems and procedures worked well when there were up to 12 residents in the home. As the number of residents increases errors begin to be made. We looked at staffing levels, the number of residents in the home, admissions and discharges on four occasions in June, July and August when medication errors had taken place. On each occasion between 13 and 16 residents had been staying at Harehills as well as admissions and discharges taking place. All the staff we met were welcoming, friendly and well able to talk about the needs of people staying in the home. All the residents who spoke to us or sent back questionnaires said they were treated with respect and liked the staff. 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. The home is run in an open and inclusive way and in the best interests of the people who visit. People are kept safe through policies, procedures and checks on health and safety that are regularly carried out. Evidence: The manager is qualified and experienced. He works hard to maintain systems and the professionalism of staff to make sure that people who use the service receive the care and support they need and expect. CQC is notified of events and incidents that may affect the well being of people who live or work in the home. We carried out a random check of the systems in place for the safe keeping of money held on behalf of residents. Records were well kept, up to date and complete. We selected the wallets of two residents at random and found that these were correct. Care Homes for Older People Page 24 of 29 Evidence: The fire log and accident records were up to date and properly completed. Servicing and maintenanced contracts are in place protecting people who stay in the home. Repairs are carried out by the City Works Team. Newcastle City Council has a comprehensive range of policies and procedures that are accessible to all staff on the intranet. Staff receive regular, planned supervision that is well documented. Additional sessions take place if someone is working to meet a performance management plan. Competency checks are also carried out and recorded as part of the supervision and appraisal system. 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 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 3 13 The admission process must be reviewed so that the process is safe, timely and unhurried. This will mean that staff have proper guidance to follow and have some control over the timing of admissions for the protection of people who use the service. 08/11/2009 2 27 12 Staffing levels in the home 08/11/2009 must be reviewed taking into account the number of people services are provided for and how they are admitted to the home. This will mean that there are sufficient staff on duty to make sure that people are safely admitted to the home in a relaxed and stress free way. Care Homes for Older People Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The temperature of the medicines fridge should be recorded daily to ensure that medicines are stored within the temperature range recommended by the manufacturer. 2 9 The availability of a telephone and a fax machine within the treatment room would improve communication between senior carers and GP practices and help management of medicines. Disposable gloves should be worn during the administration process to prevent direct handling of medicines. The date of opening of medicines with limited use once opened should be recorded so that they are not used beyond the date recommended by the manufacturer. 3 9 4 9 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). 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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