Care Home: Haunton Hall Nursing Home

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What the care home does well Haunton Hall provides a homely environment for all our service users, promoting person centred care. All staff are trained to a very high standard, including NVQ training. Individuality and choice are promoted at all times. An open door policy is promoted so service users and relatives can discuss issues as required. A well-balanced and appetizing menu is provided which is all freshly prepared. Monthly audits are completed to ensure high standards of care are monitored. A comprehensive activity programme is provided for all service users. What has improved since the last inspection? Weekly trips in the minibus to local places of interest. More varied menu plans have been implemented. Monthly regulation 26 visits by Senior Management. Regular 3 to 6 monthly reviews for all Service users. Comprehensive training has been provided for all staff. Implementation of advanced directives. Increase in Care staff registered for NVQ training. Professional development of Home Manager. Outside training for all key staff example syringe driver and phlebotomy training for qualified nurses What the care home could do better: The manager confirmed the following improvements are planned... Arrange for service users to go to the local public house for lunch. Continue to provide person centred care by staff training and regular meetings. More involvement of service users, relatives and friends during the assessment process. Greater evidence of activities that service users have been involved in. Further development of life stories for all service users. Continue to ensure high training percentages are maintained. Key inspection report Care homes for older people Name: Address: Haunton Hall Nursing Home Haunton Hall Nursing Home Haunton Tamworth Staffordshire B79 9HW     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: Joanna Wooller     Date: 0 3 1 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: Haunton Hall Nursing Home Haunton Hall Nursing Home Haunton Tamworth Staffordshire B79 9HW 01827373631 01827373696 hauntonhall@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashbourne Homes Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 105 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 105 The registered person may provide the following category 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 (OP) 105 Dementia (DE) 40 Physical Disability (PD) 44 Date of last inspection Brief description of the care home Haunton Hall Nursing Home is situated in the hamlet of Haunton Nr Tamworth. The premises, formerly a converted Georgian farmhouse and a convent school, are in a rural setting amongst open countryside in seven acres of well-maintained grounds. Care Homes for Older People Page 4 of 27 40 0 44 Over 65 0 105 0 Brief description of the care home The nearest centre for local services, shops, and entertainment is Tamworth. The local bus serving the home operates four times a day. The home is currently registered to provide care for 105 elderly people. Nursing care is provided for up to a maximum of 44 people, and personal care is delivered to 61 people. Up to 39 people may receive care for dementia related conditions, and other people may have needs associated with old age. Within the home, which is on four floors, there are six separate units corresponding to the differing needs. Facilities comprise the following; six dining rooms and nine lounges, 75 single bedrooms (72 ) and 15 shared rooms, smoking room, and hairdressing facility. Service facilities, including kitchens and laundry, are adequate to meet the needs of the home. Registered managers assisted by nurses and teams of care assistants provide care. Doctors from a GP practice in Tamworth service the home along with district nurses, community psychiatric nurses and a pharmacist. Other NHS services and facilities are accessed as required. Activities, hobbies and entertainment take place with transport provided as required. 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 quality rating for this service is 2 star. This means that that people who use this service experience good quality outcomes. This unannounced inspection took place on 3rd November 2009 by three inspectors over one day. The Manager was in the home and participated in the inspection process. The inspection included the following elements, a walk around the building, observation and inspection of records relating to provision of care, discussions with people, who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health and safety. One inspector carried out a Short Observational Framework for Inspection (SOFI) to assess Care Homes for Older People Page 6 of 27 interaction between people in the home and the staff. We were made welcome in the home and all assistance was given to gain the evidence required for the report. We had dealt with no complaints since the last inspection. People who use the service were very complimentary about the service and the care their relatives received. The home manager sent us their annual quality assurance assessment (AQAA) when we asked for it. This document was completed to a good standard and gave us all the information we asked for. 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 moving into the home do so having had their needs fully assessed and assurances are given that they will be met. The home does not have intermediate care places. Evidence: The Aqaa told us Enquiry forms are completed following the initial enquiry. A visit to the home is then offered to enable informed choices to be made by prospective relatives, which can then be followed up by a visit from the prospective resident. Potential service users are also offered to spend the day at Haunton to see if they would like staying here. We also offer longer trial respite stays for those who prefer more time to choose their place of residence. Once the placement is accepted a full assessment is completed prior to the service user being offered a placement to ensure that all their needs can be met. A copy of the homes most recent CQC Inspection report is always on display in the reception area or via the internet. The Statement of Purpose and Service User Guide that are also on display in the reception offers written Care Homes for Older People Page 10 of 27 Evidence: evidence of what type of care is offered at Haunton Hall. We saw that the people moving into the home did so following a pre-admission process and full individual assessment. People that use the service told us that they were invited to visit the home prior to admission, and they were able to look at the bedrooms, communal rooms and meet with the staff. One man told us I looked at quiet a lot of homes for my Father and this one ticked all the boxes for us. It was not the nearest or most convenient but we were and have been very impressed with the care and attention offered here. We saw that the information about the home which is available for all visitors, relatives and people that use the service had been updated and was relevant to the care being delivered. 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. People that use the service have their health, personal and social care needs set out in an individual care plan. They are able to make decisions about their care including the assistance required with medication administration. People living in the home feel that they are treated with respect and their right to privacy is upheld. Evidence: The Aqaa told us All staff is trained in Care planning, tissue viability, POVA, Customer Care and all aspects of health and personal care. We involve all Service users and relatives in completion of all care plans, based on the activities of daily living and evidenced by their signatures. All care plans ensure person centred care is evident. All Service users have a nominated named nurse and key worker and are aware of their individual needs. Service users are reassessed monthly or as required and the care plan updated. Service users, relatives and other professionals are invited to 3 to 6 monthly reviews. Boots supply all medication products and blister packs together with MAR sheets that are completed as per Company policy. Locked cabinets are available for any resident who decides they would prefer to self medicate following a risk assessment. Team Leaders in place for each House to ensure effective prioritising and Care Homes for Older People Page 12 of 27 Evidence: improvement of quality patient care. Team Leaders will also improve the communication links between families, residents and other members of the care team. We saw that on admission peoples individual assessments were well documented and individualised. We saw that care plans were based on activities of daily living, individual preferences and safety assessments. Through case tracking we saw that some care plans were evaluated more frequently than others. Some care plans seen had not been updated for the previous two months. One gentlemans condition affected his speech and through case tracking it was seen that he did not have a communication care plan. Care records seen were not signed by the person receiving care or a relative and this must be addressed as soon as possible. The manager told us he had written to relatives asking them to read and sign the care plans on their next visit. People spoken to were very happy with the care they received and were complimentary about the staff attending to their needs. One lady told us The staff are very respectful to me, they are kind and considerate. They give me time to do things without feeling rushed. We saw that care staff were trained to assist individuals with their personal hygiene needs and mobility. Nurse specialists and the GP are called to the home for advise and guidance when needed. We saw that access to NHS services and hospital appointments was arranged by the home and generally support was offered by relatives when attending appointments. One man told us My mother could not be in a better place, she is well looked after and the staff are compassionate her and the family. Medication administration, storage. disposal and stock are checked by the manager monthly - to ensure safe handling is carried out at all times. Staff medication training is given but in the future this will be monitored through individual staff supervision. When we asked some of the staff about medication their knowledge was not as good as expected. The manager assured us that work in this area will be addressed. Care Homes for Older People Page 13 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 living in the home find that their lifestyles match their expectations, they maintain contact with family and friends and have choice and control over their life. People receive a wholesome, appealing balanced diet in pleasing surroundings at a time convenient to them. Evidence: The Aqaa told us Haunton Hall has a full time Activities Co-ordinator who provides a daily comprehensive activity programme. Residents are encouraged to maintain links with family, friends and community clubs. Hairdressing, chiropody, dentistry and optician services are all provided at Haunton Hall. External entertainment productions are provided on a regular basis and can be enjoyed by the whole home. The minibus is used each week for residents to go out into the community to visit local places of interest. Service users are offered a choice at all mealtimes and flexibility. All dietary needs are catered for, following assessment. We saw that every week the home had a good range of activities available for all individuals including trips out to the local garden centre or Tamworth Castle. The staff told us that everyone is given an opportunity to go on trips out. There was evidence of many activities taking place such as concerts, bingo, weekly coffee mornings, music Care Homes for Older People Page 14 of 27 Evidence: and videos sessions. The hairdresser visits twice a week. The home prides themselves on celebrating occasions such as birthdays, Christmas and other annual events including Halloween. Halloween masks had been made and were seen in the communal room, and a fireworks display was planned for later in the week. Holy Communion takes place once a month and a Songs of Praise service once a month. Families are invited to join all the events and many do attend. We saw that each unit was provided with staff time and equipment to undertake activities and we evidenced this on the dementia care unit where staff were playing games with two people. The SOFI did show a need for staff to be more aware of need to interact with people even if they do not wish to take part in more formal activities. The home need to look at activities for people that cannot take part in traditional activities but could sit and talk, sing or enjoy a hand massages. We felt that more interaction was needed as part of the day to day care. The service did tell us that it was aware of a need to develop its service to people with dementia care needs and had a plan in place to address this issue. People we spoke to told us that there was plenty to do, that they took part in most things and really enjoyed bingo. One lady told us she enjoyed the church services and attended for communion and went to the Songs of Praise service. One lady told us that there are Resident Meetings held in the home and that the manager always attends. She told us that she feels that she is listened to and that they service act on what they say at the meetings. We spoke to people about the meals and food choices in the home and they said there was always a choice or main and pudding. Observation in the EMI unit did not show that choices were always provided eg everyone was having the cherry sponge however the staff said they know peoples preferences so order a meal they knew they like. We did feel that choices for meals needs to be addressed for people with dementia as part of the dementia care strategy perhaps using pictures or showing people the choices. We saw that drinks were provided with meals and the staff confirmed that people have fruit and that there is biscuits and toast and jam available during the night. There was evidence that the service provides for specialist diets including diabetic and pureed meals. Records show that peoples weight is monitored and people that need help eating are provided with it. The kitchen had been awarded a 5 star rating by the Environmental Health Department inspector. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: The Aqaa told us All complaints both written and verbal are taken seriously and a full investigation completed with a response sent within 28 days. A copy of the Southern Cross complaints procedure is prominently displayed in the reception. Southern Cross has written policies regarding abuse. All newly appointed staff are checked with POVA and CRB prior to starting employment. All staff are trained in whistle blowing and prevention of abuse. We looked at the homes Complaints Procedure that was displayed in the reception hallway and contained in the Service Users Guide and Statement of Purpose. We saw that the home had a complaints folder in place that contained guidance and information including, a sample letter and response to complainant. Information identified that staff had attended a complaints management day to demonstrate good practice that staff should aspire to. We looked at the formal complaints procedure in this file and noted that the last recorded complaint was 2006. We saw that the complaints procedure is available on audio cassette, and discussed with the manager the need to make the procedure available in various formats, large print, and Braille. This will ensure that the complaints procedure is accessible to all people using the service. We talked to two members of staff who told us they knew how to make a Care Homes for Older People Page 16 of 27 Evidence: complaint, and how to refer complaints or concerns that people using the service may have and who to refer them to. We talked to one person using the service who told us they knew who to talk to if they were unhappy about something. We observed staff talking to people using the service and discussing different options and choices. One person was very outspoken and told us they did what they wanted and when they wanted. We were told by the Deputy Manager that people using the service generally make postal votes however, if someone wanted to go out to vote then arrangements would be made for them to do so. We were told that the service had no people registered on Deprivation of Liberties Register. We were told by the Deputy Manager that there had been no staff referred to POVA. We saw the records of the last four staff employed that told us staff have received training in Safeguarding, Protection of Vulnerable Adults and Abuse. The training matrix identified that other staff had completed this training. We saw policies and procedures in place for managing abuse. We talked to staff who were able to identify areas of abuse. We saw that all people using the service had a personal allowance file that is managed by admin staff at the home. Some people manage their own finances. There is a full transaction history of money coming in and out including interest allocated individually. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service live in a safe, well maintained environment that is clean, pleasant and hygienic. Evidence: The Aqaa told us Haunton Hall is a listed building originally a Manor House later used as a Convent which was also used as a Convent school. It is situated in a rural setting amongst open countryside in seven acres of grounds. It became a Care Centre in 1989 and transferred to Southern Cross Health care in 2006. Haunton Hall is separated into five different units, thereby creating a more homely feel. We employ full time maintenance and housekeeping staff who take great pride in their work. Haunton Hall provides safety and comfort for all Service users that live here. We saw that the home was clean and tidy, personalised and homely. The ambiance of the home was warm and friendly. Domestic staff took pride in their work ensuring the communal spaces and bedrooms were clean and hygienic. Corridors were free from obstruction and warning signs were used when cleaning was taking place. Storage of cleaning equipment was correct and staff were aware of COSHH legislation. Much work had been instigated following a health authority audit and action plans were being followed and follow up meetings and audits were planned. Evidence of these action plans was seen at this inspection. Care Homes for Older People Page 18 of 27 Evidence: One relatives told us The home is beautiful, always tidy and clean. The staff work hard to keep it looking like this. The grounds are really coming on now, the plants are lovely. One person that uses the service told us I like my bedroom, its always very clean and tidy. The staff make it feel like my home. 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. People that use the service have their needs met and are kept safe by the number and skill mix of staff. The homes recruitment policy and practices protect the people living in the home. The staff are trained and competent to do their jobs. Evidence: The Aqaa told us Haunton Hall has a combination of qualified nursing staff and trained carers. The ratios of these are always compliant with safety standards. We have three home trainers in house to ensure all staff are trained to Southern Cross high standards. Care staff are provided with NVQ training via a local provider. Heads of department meetings are carried out on a weekly basis and minutes distributed to all areas. We source outside Trainer for key staff eg. Syringe Driver - Nurses We discussed the staff rota for the day with the deputy manager; the staff identified on the rota were on duty in the home with the exception of one person who had telephoned in sick. We saw that there is 55 clinical staff employed and 17 ancillary staff, this means that staffing to person ratio is satisfactory. We saw catering staff discussing food with people using the service before lunch was served. We saw records that told us 80 of staff are trained to National Vocational Qualification Levels 2 and 3. The homes Manager and Deputy Manager both have the registered Managers Award. The homes Manager is currently going through the process of applying to be Registered with Care Quality Commission. We were told that the home does not use agency staff any shortages are covered by the existing staff. We were told by the Care Homes for Older People Page 20 of 27 Evidence: Deputy Manager that the home recruits staff via the recommendations of existing staff, Job Centre, and the local newspaper. The service provides transport for picking up and dropping off staff. We looked at the files of the last four members of staff employed. Files contained two references, Criminal Records Bureau and Protection of Vulnerable Adults checks. This means that staff had been appropriately recruited. We saw that staff had received a statement of their terms and conditions and job description. We were told that the home does not use volunteers. We saw that there is a staff training programme/plan in place for the development of staff. We saw in staff files records of induction and individual training records. There is also a training matrix that gives an overall picture of training completed and training due. Staff told us that they were given plenty of opportunities to attend training and keep updated. 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. People live in a home which is well managed by a person of good character. The home is run in the best interests of the people living in it and their financial interests are safeguarded. The health, safety and welfare of people who use the service and the staff are promoted and protected. Evidence: The Aqaa told us Southern Cross have a comprehensive monitoring system which identifies each section of a well run home i.e. Fire, health and safety, kitchen, accident audits, pressure relief audits, medication audits and care plan audits. Monthly heads of department meeting are held to discuss development within the home. Service users views and opinions are sought wherever possible. Any money that is retained for safe keeping for any service user is kept individually and a comprehensive record kept. Written records of transactions always require two signatures, thereby maintaining a suitable audit trail. All staff receive health and safety training and health and safety meetings are held monthly. We have a well maintained staff supervision matrix. Care Homes for Older People Page 22 of 27 Evidence: The manager is yet to be registered with the CQC, however he demonstrates strong leadership skills and a high level of professionalism. The manager told us that the home is run in the best interest of the people who use the service. The policies and procedures are read by the staff and used within staff training. The quality of care delivered in the home is audited by the managers of southern cross on a regular basis. Thank you cards and relatives comments, confirmed that the standard of care in the home is of a good level. Relatives and resident meetings are held to discuss the satisfaction levels of the people living in the home and those who visit. We saw that systems are in place to safeguard individual financial affairs. We saw evidence of safe working practices within the home. Manual handling, Fire safety, First aid, food hygiene and infection control were all included in the staff training, risk assessments and internal audits. We saw that health and safety issues in the home are given priority, maintenance of the home is well organised and appropriate tests are being recorded. Legislation compliance is adhered to by the homes policies and procedures, along with risk assessments and the recording of accidents or untoward occurrences. We saw that staff induction is completed to a good standard and staff told us that they had completed the induction within a time frame set by the home. 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 7 15 Care plans must be kept under review and evaluated at least monthly. To ensure health and personal care needs are appropriate care plans must be reviewed and evaluated to ensure individual needs are being met. 09/12/2009 2 9 13 Staff must have appropriate knowledge of medication being administered in the home . To ensure the safety of the people using the service, staff must have the knowledge to administer medication safely, and also be able to look for side effects and contra indications. 09/12/2009 Care Homes for Older People Page 25 of 27 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!