Care Home: Hazeldene House Residential Home

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What the care home does well Since the home`s new owner took over the running of the home a level of stability and consistency has been introduced which was starting to diminish under the previous regime. People living at the home have continued to be cared for by staff who are knowledgeable about their needs and who are very committed to making sure that the best care is provided. The documentation that supports staff to care properly has been reviewed and instances of poor practice have been responded to and put right. People`s needs are assessed when they come to live at the home and the actions staff need to take to care for them properly are laid out in detailed care plans. The day to day lives of people at the home have been enhanced by a range of activities and leisure pursuits, and individual preferences have been looked at by the activities coordinator to make sure that things are right for everybody. The home has continued to provide a choice of meals and people told us that they are very satisfied with the food provided and that their individual preferences are recognised and respected. Morale amongst the staff group is continuing to improve, even with the recent departure of the last registered manager, and staff told us that their working day is less hurried, better planned and they have time to talk to people. What has improved since the last inspection? This is the first inspection carried out under the new ownership regime so this section does not apply. What the care home could do better: Because of the impending changes in the legislative framework that governs this home, we have not made any legal requirements at this inspection. However we have recognised that a new manager needs to be appointed and to register with us as is required by law. We have made a recommendation for good practice that indirectly affects the care of people living at the home. Key inspection report Care homes for older people Name: Address: Hazeldene House Residential Home 21 High Street Clay Cross Chesterfield Derbyshire S45 9DX     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: Brian Marks     Date: 1 9 0 5 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 26 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 26 Information about the care home Name of care home: Address: Hazeldene House Residential Home 21 High Street Clay Cross Chesterfield Derbyshire S45 9DX 01246862415 01246250302 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Akshay Chandrakant Barot Name of registered manager (if applicable) Mrs Yvette Minns Type of registration: Number of places registered: care home 21 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 21 The registered person may provide the following category of service only Care Home only - Code PC. To service users of the following gender: Both, whose primary care needs on admission to the home are within the following category: Old Age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Hazledene House is a care home registered to provide personal care and accommodation for up to 21 people in the category of older persons. The home is located in the village of Clay Cross and is on a main bus route. The home provides comfortable and homely accommodation with mostly single accommodation, many of which have en-suite facilities. There are 2 double bedrooms. 3 lounges are provided Care Homes for Older People Page 4 of 26 Over 65 21 0 Brief description of the care home and a separate dining room. A quieter lounge provides privacy for visitors. Pleasant and mature well maintained gardens are to the front, side and rear of the building. Car parking space is provided to the front of the building. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a Key unannounced inspection that took place at the home over one day. Time was spent in preparation for this visit, looking at key documents such as records held by us, and the written Annual Quality Assurance Assessment document (AQAA). This was prepared and returned to us by the previous Registered Manager before the inspection. We also received a number of written surveys completed by a majority of the people living at the home, sent back to us before the inspection. All of the above material assisted with the preparation of a structured plan for the inspection. At the home, apart from examining documents, files and records, time was spent speaking to the homes owner and the acting manager who were there throughout the visit, and with a number of staff working on the day shifts. We looked at the care records of two people living at the home in detail, as part of a process we call case tracking and interviewed the individuals concerned, as well as others and a relative who was at the home during the inspection. The assessment was made against the key Care Homes for Older People Page 6 of 26 National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. Care Homes for Older People Page 7 of 26 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 26 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 26 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 coming to live at the home have their needs clearly identified but a more person centred approach to care for everybody would be achieved if more attention is paid to their social world and background history. Evidence: In the AQAA we were told that a pre-assessment of all new residents is undertaken by the manager or senior member of staff and includes an assessment of their social and cultural care needs and their medical condion, with any recent changes to their health. At the time of this inspection there had been no admissions to the home since the new owners took over. However within the care records that we looked at we saw the documentation that had been previously used with people who had been at the home for some time.These assessments had been carried out by the previous manager and, in the case of one person admitted in 2009, also included an extensive document from a care manager working for the Councils Adult Social Care Department which clearly Care Homes for Older People Page 10 of 26 Evidence: identified how residence at the home could help the person concerned. All the phyical care needs were clearly identified in all of the records we looked at, although the social world and background histories had only briefly been touched on. All of care records looked at contained a recent photograph of the person concerned, as well as personal information and signed consent forms, which indicate personalisation of peoples records. All of the care records looked at contained a set of assessments of the general and specific areas of risk that are relevant to the individuals concerned, such as bed safety, safe manual handling, skin breakdown and pressure areas, falls and nutritional difficulties. Where these indicated high levels of risk, they were directly linked to actions for staff to take when providing care and described the detail of how staff work safely and consistently. The latter had been looked at regularly to make sure that the information being used by staff is current and that the level of risk has not changed. Care Homes for Older People Page 11 of 26 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. The people living at the home have care that supports safety and consistency and is planned in ways that reflect their individual preferences and abilities. Their personal and health needs are dealt with in a satisfactory way, and they continue to have access to local services like everybody else. Evidence: In the AQAA we were told how residents opinions and choices are involved in all aspects of their care and that their care plans are reviewed and evaluated monthly. Within the delivery of personal care choice, dignity, autonomy and independence are maintained. All the care records that we looked at contained descriptions of the areas where people need help or where they experience risk, as well as the areas in which they are independent, and the care activities to be carried out by staff are identified in a number of key areas. Within the records we looked at these amounted to at least fourteen areas; these were proportionately extensive documents. In all of the records examined the various elements of the care plans had been looked at monthly and the Care Homes for Older People Page 12 of 26 Evidence: acting manager described a more detailed review process that would involve family members and any outside professionals involved. We were told that the documentation in place within everybodys care records had been completely overhauled during the past two months. The staff we spoke to supported these changes and told us that the new records were more user friendly, that the summaries are more accurate and get you up to speed quickly and that all of the documentation is easier to use and better organised. As referred to above, the descriptions of social interests and life histories were generally brief in all the records we looked and, although the care plans were comprehensive and well laid out, they were traditional in style and much of the activities of staff were described in terms of problems and needs rather than in ways that promote a person centred approach to care. The care files we looked at indicated the medical and health needs of people living at the home being regularly monitored, and also of visits by outside professionals such as G.P, chiropodist, physiotherapist and spech therapist. We also noted specialist support being arranged with visits to local hospital clinics and one of the residents we spoke to told us about an appointment she had later in the week. Additionally in the written records, from the direct observations of the communal areas and from what people living at the home told us, it was clear that the staff at the home work hard to care in sensitive ways, and within the confines of the home to keep people independent. Staff told us that we try and treat people as you would your own. All the staff we spoke to said that they carry more responsibility and are more accountable for their actions and that this is particularly true with maintaining records. One of the care staff told us we all work well together, there is better communication with a new keyworker system and the shift handovers in particular have improved everything. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these were satisfactory, and there were clear protocols in place for staff to use when they administer irregular (PRN) medicines. General medication was stored securely, and a Monitored Dosage System was in place for the dispensing of most of the medicines in use and entries in the written records had been made properly. Similarly the additional arrangements for the management of controlled drugs was in order. The staff involved in medicines administration had all received appropriate training and there was an indication of audit checks being regularly carried out by the homes pharmacist. Care Homes for Older People Page 13 of 26 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 at the home enjoy lifestyles and routines that suit them and have opportunities to take part in organised leisure and social activities. Evidence: In the AQAA we were told about the range of activities that take place at the home and how contact with family members is maintained and they are encouraged to join in with the life of the home. Special occasions and events are regularly celebrated. During the inspection we spoke to the homes activities coordinator who works on five afternoons a week. A schedule of events for the week which anyone could take part in was on display . During our visit a skittles (soft material) activity was held which people told us they enjoyed, and the activities organiser told us about what else had been occuring; this included reminiscence, bingo, chair based exercises, music and table top activities. She was planning some collage artwork for later in the week and was planning for the annual Summer Fair, which is good for fundraising. She also told us that she has been asked to launch a Newsletter about the home. We were told that peoples religious needs were met by a monthly service in the home and that one of the residents leads a small activity every Sunday. A hairdresser also visits the home each week, and this service was said to be very popular. Care Homes for Older People Page 14 of 26 Evidence: There were photographs on a board which showed people at the home enjoying Halloween with the staff, and there was an orientation board in place which informed people of the daily menu. Staff told us that peoples birthdays were always celebrated with a cake and a gift. We noted that the home had a regular visit by a staff member with her pet dog, and this occurred during the time we were at the home. One resident told how much she enjoyed this and how others made quite a fuss of him. We spoke to some of the poeple living at the home about their lives there. They told us that Im happy with the lifestyle here and join in with things as I want to, although I like to read a lot, that I like the activities provided and have enjoyed outings to the shopping centre in Sheffield and to garden centres in the summer and that I particularly like music and we occasionally have somebody in from outside. We spoke to a relative who visits every day and she told us family members come every day and are always made welcome. The staff here at the home are very friendly and they communicate well with us if there had been any accidents or illness. We observed lunch being served where a choice was offered to people and, where help in the home was needed, staff were seen to individually sit with them with them to offer the assistance. A brief visit was made to the kitchen and the cook described current arrangements, working to a four week menu. We noted from a sample of these that there was a variety of traditional style meals on offer and that a choice at the main meals of the day is available, with a hot option available at teatime. People were positive in their feedback about the standard of food at the home, with several mentioning good quality and quantity. We were told that I like everything they serve up and at the weekend we have Fish and Chips brought in on a Saturday and a good Sunday lunch every week, that they serve brilliant meals, I like all the food here and that the food is very good for quality and quantity. Arrangements for storage and stock control of food supplies were satisfactory, and we saw evidence that food safety is well managed. The cook deals with people who have special dietary needs, these have included diabetic and softened diets. Her arrangements for these indicated a careful approach to individual needs. Care Homes for Older People Page 15 of 26 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 living at the home are protected by having their rights to complain upheld and by staff who understand their responsibility to report concerns and to safeguard vulnerable people from harm. Evidence: In the AQAA we were told that the complaints procedure is displayed in the home and a copy is given to everybody to keep in their room. We were also told that hey are also given the opportunity to speak out about their concerns and staff are trained to respond to concerns properly. We were told by the homes owner that there had been two formal complaints recorded and investigated since re-registration and these had also been referred anonymously through the Commission. The outcome of the investigation was properly responded to by the homes owner and we were able to check these as being true during the inspection. The people we spoke to told us they knew who to approach with any concerns and that they were confident they would be listened to. We noted that details of the complaints procedure were on display in the entrance hall and included in the homes Service Users Guide. Since re-registration there has also been five referrals made to the Adult Social Care Department of Derbyshire Couty Council under safeguarding procedures, and these were fully investigated by officers from the statutory agencies with the full cooperation Care Homes for Older People Page 16 of 26 Evidence: of the homes management. Three were found to be substantiated but also that no significant harm had occurred and involved failures in care practice. We were able to check that all of the required outcomes from the multiagency meeting had been carried out; this had already been reported back and checked, to enable the investigations to be closed. The staff we spoke told told us they would report any concerns they had to the homes management and staff training records indicated that everybody will shortly have completed refresher training about the abuse of vulnerable people and their responsibilities to safeguard them. The policies and procedures in place within the home are in line with the statutory procedures on safeguarding vulnerable adults. Care Homes for Older People Page 17 of 26 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 living at the home have continued to benefit from a homely domestic style environment that is equipped to meet their needs. Evidence: In the AQAA we were told that the home is a welcoming safe environment and that the handyman carries out regular checks around the building to keep things safe and carry out repairs as required. We were also told about a number of improvements that have been made and about plans to continue with the homes refurbishment. During this inspection we noted that the home is a converted large family home with an extension at the rear. At the present there is only stairlift access to the small number of upstairs rooms but the owner described how they are investigating the possibility of a shaft lift being installed. We were also told of immediate plans to rearrange the dining area to the lounge towards the front of the building and to return the room in the rear extension as a lounge overlooking the garden. This will allow for everybody to conveniently use the same dining room and the people we spoke to commented favourably about this as being a positive use of staff time. During our brief tour of the building with the owner we saw that one bathroom had been refurbished and modernised, new mattresses had been bought for a number of beds and some new carpets have been bought for bedrooms and communal areas. Care Homes for Older People Page 18 of 26 Evidence: The owner described imminent plans to replace all the windows and outside doors in the older part of the building, and to repaint the outside. Each persons bedroom that we viewed had personal possessions in them to make them homely. We saw one specialist bed in use, as well equipment to aid mobility on both floors. One of the bedrooms we visited had bedrails and a risk assessment for this had been retained on the care records of the person concerned. From our tour of the building we found the home to be clean and odour free, and all the residents and the relative we spoke with told us they found the home to be always clean and fresh. Staff told us that gloves and aprons were routinely available for them to use. From the records we examined the last report from the Fire Officer was satisfactory and actions have been taken to comply with the last report from the Environmental Health Officer. The laundry was equipped with a satisfactory range of functioning equipment and we were told by staff that all of the laundry was completed each day. All residents observed in the home were seen wearing clean and well presented clothing and nobody we spoke to had any concerns about this aspect of the homes activity. Care Homes for Older People Page 19 of 26 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. The home has adequate numbers of staff to carry out the physical care needs of the people living there and they have been recruited and trained to do their jobs properly and in a professional way. Evidence: In the AQAA we were told about arrangements for the homes staff regarding their induction, training and supervision. We were also told that the homes staff go out of their way to meet individual needs and that some staff take residents on outings in their own time. From our examination of the homes roster for the current and previous weeks we established that three carers, including at least one senior carer were on duty for the day shifts and two carers were in place for each night shift. The acting manager was available for five days and we saw that she made herself available to staff and residents in the communal areas throughout the day. The people living at the home that we spoke to told us that there is always enough staff when theyre needed. The staff we spoke to also told us that the way they are organised to work has resulted in better continuity and a more satisfactory way of working. One new carer had been appointed since the new owners took over the home, and the core of longstanding staff has been retained with a good level of experience and skill mix. There has been little use of agency staff and members of the carers team usually cover each other for Care Homes for Older People Page 20 of 26 Evidence: periods of holiday and sickness. The staff we spoke to demonstrated a good knowledge of the people in the home and their needs. Staff also said that opportunities for training had been substantial since the new owners took over the home and the staff training record indicated up to date achievements in all the key subjects with the programme finishing for everybody by the end of July. The AQQA told us that the national target for care staff achieving the National Vocational Qualification (NVQ) level 2 has been reached and this was confirmed by the records, which indicated that all care staff had either passed or were signed up for this level, and also a good number had completed at level 3. The file of one recently appointed carer indicated that they had been subject to a basic programme of induction with plans to introduce the more substantial training programme from Skills for Care. The files of the same recently appointed staff that we looked at also supported that their recruitment had been carried out in systematic way and checks by the Criminial Records Bureau (CRB) had been carried out. We were impressed by the attitudes and honest reporting from the homes staff that we spoke to and how they had dealt with the change of the homes ownership and the more recent departure of the long established manager. All those that we spoke to were positive about the current operation of the home and how its now about accountability and responsibility being taken on board by everyone. They told us that the homes new management team were very approachable and that sharing is the order of the day because theyre now listening to us. Care Homes for Older People Page 21 of 26 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 management of the home is improving but systems need to be put in place to ensure that quality of the homes services are managed properly and the health and welfare needs of the people living there are to be safely met. Evidence: The Annual Quality Assurance Assessment (AQAA) document that we have been quoting from throughout this report was prepared by the previous Registered Manager and is perhaps less relevant to this section, which aims to describe current arrangements for the running of the home. The current owner has operated the home since February 2010 and at the time of this inspection was being supported by a registered manager from another of his homes in London. Between them they have carried out the review of all of the care plans of people living at the home and have addressed communication systems between staff so that care practices have been consistenty followed and continuity maintained. We were told that a replacement manager is actively being sought and that two candidates will be invited back for final interviews. The homes owner also told us that he will shortly be promoting one of the Care Homes for Older People Page 22 of 26 Evidence: current senior care staff to a newly created post of Deputy Manager and that the person will be carrying responsibility for the home until the new management arrangements are settled. In the short time that the new owner has been at the home he has made a positive impact and was seen throughout the inspection with staff and residents and demonstrating a very involved approach. Staff told us that we now have better leadership and management is more approachable, that they have been very flexible with my working arrangements when I have needed support, that they treat you like a normal human being, things are more open and straightforward, and that we are all very positive about how things are now, everything feels more settled. A family member we spoke to was also very positive and told us that its been a smooth transition with the new owner; theyre around the home a lot of the time if you want to talk to them. There was also a planned meeting for people living at the home during our visit and we saw completed comment cards which we were told would be the way that they would find out about peoples opinions in a more relaxed way. Although staff told us that day to day suppport with problems was good, they had only recently had individual meetings with the managers. The latter indicated that that the redevelopment of a formal system for meeting with staff (supervision) would now go forward on a two monthly basis. The systems in place for looking after residents money were found to be satisfactory at previous inspections and remain unchanged, so a full assessment of this was not carried out. Similarly, standards of health and safety activity and regular servicing of equipment had been maintained, and a full audit of health and safety matters was also not carried out. Observations made around the building and a sample of fire safety activity and equipment records supported that the home was hazard free at the time of the inspection. Care Homes for Older People Page 23 of 26 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 26 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 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 36 All staff should receive formal 1 to 1 supervision from the homes senior staff, at intervals of every two months. This will ensure the opportunity for regular consultation about and monitoring of their work. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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