Care Home: Highgrove House

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What the care home does well Residents needs are assessed before they move into the home. This means the home is aware of new residents needs before they move in and can take any necessary action to ensure they can meet these. The health and care needs of residents are met safely and consistently. One resident informed us `I have had the best of care and help from the manager and his staff, who have been supportive and most of all caring in solving many of the problems which i had`. Residents rights to privacy and dignity are promoted. A variety of activities are in place to ensure that residents have opportunity for stimulation and interest. Visitors are made welcome. Good quality, fresh home cooked meals are provided. Residents complaints and concerns are treated seriously and acted upon. The environment is comfortable and well maintained. Infection control practises promote good hygiene. Residents are supported by a committed, kind and caring staff team and are protected by robust recruitment processes. As at previous inspections residents were full of praise for the staff team. Comments include "staff are very kind and considerate and treat me with respect" "all staff are very caring and most helpful and i have been very happy with everything" and "staff treat me with respect and nothing is too much trouble for them". The home is run by a capable and committed manager, who ensures effective quality monitoring takes place, which benefits residents. The health and safety of residents and staff is promoted. What has improved since the last inspection? Residents have been offered more chances to undertake individual shopping trips. Improvements to the environment have taken place. These include several bedrooms being redecorated and fitted with new carpets and curtains, a ramp installed to the front of the home, all external windows, doors and the conservatory being refurbished and bedroom doors having been fitted with automatic door closures that are linked to the fire detection system. Greater numbers of staff now hold a National Vocational Qualification (NVQ) at level 2 or above. Also all full time staff have completed Asset Level 2 Certificate in Dementia Care and Safe Handling of Medicines. What the care home could do better: Care plans must be put in place for the use of `as and when required` (PRN) medication, that include guidelines for use and evaluation of effect. This must happen to promote consistency and safety. The registered manager has informed us that since visiting the home care plans for the use of PRN medication have been compiled. Key inspection report Care homes for older people Name: Address: Highgrove House 32-34 Winchester Road Worthing West Sussex BN11 4DH     The quality rating for this care home is:   three star excellent 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: Lesley Webb     Date: 0 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 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 28 Information about the care home Name of care home: Address: Highgrove House 32-34 Winchester Road Worthing West Sussex BN11 4DH 01903230487 01903203811 care@highgrove-house.net www.heaton-house.net Mr Clive Neil-Smith,Mrs Sally Mary Neil-Smith Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Clive Neil-Smith Type of registration: Number of places registered: care home 20 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: 20 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Highgrove House is a care home providing care and accommodation for up to twenty older people over the age of sixty five. It is situated close to the town centre of Worthing, West Sussex with easy access to the seafront, shops and other amenities. The home is a two storey, detached house with eighteen bedrooms all of which have en-suite facilties. There is a passenger lift to the first floor which makes the home Care Homes for Older People Page 4 of 28 Over 65 20 0 Brief description of the care home accessible to all residents. A large, well maintained garden is available for residents use. Fee currently charged for living at the home range from £612.50 to £682.50 per week. Interested parties should contact the registered person direct for further information regarding fees. Care Homes for Older People Page 5 of 28 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: three star excellent 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: We visited this home on Thursday 8th April 2010, arriving at 09.30 am and staying until 3.30 pm. The purpose of this inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The registered manager was present during this inspection and offered assistance by supplying documentation and answering questions we raised. During our visit to the home we examined the records of three residents and three staff. We also looked at other documentation such as training records, medication records, minutes of meetings and quality audits. While at the home we also spoke with eight residents and two staff. We also indirectly observed care practises and sat and ate lunch with some residents in the dining room. Prior to our visit the home supplied us with copy of its Annual Quality Assurance Assessment (AQAA). This document gives the home the opportunity to say what it does well and provide evidence of that. It also gives them the opportunity to say what they feel they could do better and what their future plans are, how it dealt with any Care Homes for Older People Page 6 of 28 complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of the people who use the service, their relatives and staff who work for the service. Before we visited the home we received thirteen residents and eight staff questionnaires. Information from all of the above sources was assessed and used to help us form judgements on the quality of service people receive from the home. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Residents have been offered more chances to undertake individual shopping trips. Improvements to the environment have taken place. These include several bedrooms being redecorated and fitted with new carpets and curtains, a ramp installed to the front of the home, all external windows, doors and the conservatory being refurbished and bedroom doors having been fitted with automatic door closures that are linked to the fire detection system. Greater numbers of staff now hold a National Vocational Qualification (NVQ) at level 2 or above. Also all full time staff have completed Asset Level 2 Certificate in Dementia Care and Safe Handling of Medicines. Care Homes for Older People Page 8 of 28 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 28 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 28 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. Prospective residents needs are assessed before they move into the home. This means the home is aware of new residents needs before they move in and can take any necessary action to ensure they can meet individuals needs. Evidence: Prior to our inspection the home sent us its Annual Quality Assurance Assessment (AQAA). With regard to assessment processes it states prospective residents needs are assessed with dignity and in privacy. Visits by the prospective resident and their relatives area actively encouraged to view the facilities and have the opportunity to meet the staff and other residents. On admission a plan of care is agreed with the resident and relatives/carers enabling participation in making decisions relating to their care and treatment. During our visit to the home we spoke with the registered manager and residents. All confirmed that the practises described in the homes AQAA are applied. Care Homes for Older People Page 11 of 28 Evidence: We sampled pre admission documentation for three residents. The areas covered in the assessment include mobility, daily care, lifestyle, physical health and emotional needs. Care plans are then completed for needs identified through the assessment process. Thirteen residents completed questionnaires and returned them to us before we visited the home. All state they received enough information about the home to help them decide if it would be the right place for them. Highgrove House does not provide intermediate care. Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and care needs of residents are met safely and consistently. Medication systems offer protection to residents. Residents rights to privacy and dignity are promoted. Evidence: With regard to health and personal care the homes AQAA states all residents needs are set out int their care plans, reviewed, evaluated and changed as their individual care needs change. This is a person centered approach which enables all staff to be sensitive to the wishes of the people they are supporting with dignity. All health needs are met with the assistance of the individuals GP and district nurse services. Each is protected by the homes medication policies and procedures. With individual residents agreement we work with and involve relatives or friends and carers in their care to provide the best outcomes for the individual. Where residents indicate they wish to manage their own health care, we enable this to be done with such assistance and support as necessary. Care plans and risk assessments are in place to identify those at risk and action is taken to reduce or eliminate any risks if possible e.g provision of pressure relieving facilities to prevent pressure damage, facilities and support to Care Homes for Older People Page 13 of 28 Evidence: prevent falls. We sampled three residents care records and found all to have a comprehensive plan of care in place that guides staff to the needs of the individual they are supporting. As at previous inspections we found that plans contain background information, likes and dislikes, hobbies and interests and details of health care needs. Risk assessments were also in place and recent reviews of the plans had been undertaken. Thirteen residents completed questionnaires and returned them to us before we visited the home. All state they always receive the care and support they need. Throughout our visit we observed residents being treated with dignity and respect. Staff were heard to address residents by their preferred names, seeking their permission before offering assistance, knocking on bedroom doors before entering and and talking to individuals in a polite and respectful manor. As at previous inspection records show that the home works with a variety of health care professionals including local doctors and district nurses and a chiropodist. Thirteen residents completed questionnaires and returned them to us before we visited the home. Eleven state that the home always make sure they get the medical care they need and two state they usually do. Additional comments were recorded of I have had the best of care and help from the manager and his staff, who have been supportive and most of all caring in solving many of the problems which i had and they have helped me arrange transport for hospital visits and with queries with my doctor. One resident that we spoke with during our visit confirmed that they access their own GP independently, with staff arranging transport when needed. The home uses a local pharmacy to supply medication and a monitored dose system is in place. Medication is safely stored in a locked cupboard in the office and Medication Recording Sheets were current and in good order with no discrepancies found on those sampled. For residents who self administer, risk assessments were in place. The registered manager agreed that for one individual this should be reviewed to include further information regarding the residents choice of times of taking. Since visiting the home we have been informed that this area has been addressed. Some residents were seen to be prescribed as and when required medication (PRN). The registered manager confirmed care plans or protocols were not in place for these. Care Homes for Older People Page 14 of 28 Evidence: Drug information sheets supplied by the dispensing pharmacy give information regarding what particular medication is used for, when it should be given and actions if a reaction to the medication occurs. However records currently maintained by the home do not demonstrate how decisions are arrived at when residents are given PRN medication. We found no evidence that residents had been placed at risk when given PRN medication, however the use of PRN medication must be included in individual residents care plans in order that staff have enough information to promote safe practise. The registered manager agreed to ensure this was put in place for everyone. Since we visited the home the registered manager has informed us that care plans for the use of PRN medication have been implimented, which also include guidelines for use and for the evaluation of effect. Care Homes for Older People Page 15 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of activities are in place to ensure that residents have opportunity for stimulation and interest. Visitors are made welcome. Good quality, fresh home cooked meals are provided. Evidence: With regard to daily life and social activities the homes AQAA states we provide a variety of activities and entertainment to ensure there is stimulation and interest for all the residents, ensuring individual choice when participating. We maintain a relaxed, happy atmosphere in the home and ensure staff on duty have time to spend with residents on a one to one basis every day. We support and provide facilities for all residents to enable each to maintain their Independence within their individual abilities. As at our previous inspection we found an abundance of evidence that the home provides a variety of activities to ensure that there is stimulation and interest for the people living there. For example records and discussions with residents confirm Tai Chi and exercise classes are offered every week, visiting musicians are provided every two weeks and a Care Homes for Older People Page 16 of 28 Evidence: monthly non denominational service is held. Some people also have visits from their own vicars or priests. During our visit residents were indirectly observed reading, taking part in a church service and preparing for a birthday party that was being held later in the day. There was a relaxed, happy atmosphere in the home and the staff on duty had one to one time to spend with people. One resident informed us that the cook bakes a cake decorating it specifically with the individual in mind when it is their birthday. On the day of our visit we observed the cook decorating a birthday cake for one resident with icing formed to represent fruit and vegetables. We were told this reflected the residents past employment. Thirteen residents completed questionnaires and returned them to us before we visited the home. Ten state the home always arrange activities they can participate in, two stated they usually do and one sometimes. Additional comments were recorded of good activity programme available and plenty to do. Visitors are made welcome at any time. One resident informed us, they always offer my family a cup of tea, they make them very welcome. The homes AQAA informs us that since our last visit residents have been offered more chances to undertake individual shopping trips. Records we looked at when visiting, confirm this. During our visit we sat and ate lunch with residents in the dining room. All those that we spoke with expressed satisfaction with the meals provided. For example one person said, the meals are very good, at lunch we have choice of fruit juices, main meals, sweets and drinks. Another resident informed us that they have their breakfast served on a tray in bed at 10.00 am as they prefer it at this time. Thirteen residents completed questionnaires and returned them to us before we visited the home. Ten state they always like the meals provided by the home and three that they usually do. Additional comments were recorded of we have an excellent cook who provides interesting menus and plenty of food the food is excellent, nourishing and well cooked and i like the food and have a choices always. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that any complaints and concerns will be treated seriously and acted upon. The homes safeguarding procedures are designed to protect residents. Evidence: With regard to complaints and protection the homes AQAA states we have a clear and accessible complaints procedure, which residents and their relatives are confident with, and any complaint, concern or comment is taken seriously and dealt with promptly. Staff are trained to fully support residents to express their views at all times in privacy and with dignity. Staff are trained appropriately in adult protection procedures and are aware of their responsibilities to report even a suspicion of any abuse taking place. As at our previous inspection there is a complaints procedure in place, a copy of which is placed on the notice board in the home. The registered manager informed us that no complaints have been received by the home over the last twelve months. Thirteen residents completed questionnaires and returned them to us before we visited the home. All state they know someone they can speak to informally if not happy and that they know how to make a formal complaint. Care Homes for Older People Page 18 of 28 Evidence: Residents that we spoke with during our visit told us they would be happy to raise concerns if needed. For example one person said, i have no complaints, staff are lovely, i can talk to them and another, i know my rights, can complain but never have to. You tell the manager what you do not like or are unhappy about and he sorts it straight away. The majority of staff have attended protection of vulnerable adults training. As at previous inspections there are safeguarding procedures in place and the staff on duty were aware of their responsibilities under these. Care Homes for Older People Page 19 of 28 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. Residents live in a home that is comfortable and well maintained. Infection control practises promote good hygiene. Evidence: With regard to the environment the homes AQAA states we ensure that the home environment is well maintained and offers residents a homely place in which to live. The home is maintained appropriately to reduce any risk of infection and cross infection. Staff are trained in infection control so that they are aware of the importance of prevention. The home complies with the fire protection requirements and those of the local environmental health service. Facilities within the home provide for and are available to meet the needs of all residents as set out in the National Minimum Standards. We ensure the home is clean and hygienic at all times. The home has outdoor space available which is accessible to all residents including those with mobility problems. The home provides private accommodation for each resident furnished to a comfortable standard, where adapted equipment is provided for those with limited ability. We ensure that residents are able to personalise their rooms as they choose. During this visit to the home we found, as at previous visits that Highgrove House offers an attractive and comfortable environment for the people who live there. There are well furnished lounge areas, a dining room, large conservatory and an easily Care Homes for Older People Page 20 of 28 Evidence: accessed landscaped garden, which residents said they especially enjoy. Private bedrooms were all attractively decorated and had been personalised with furniture and belongings brought to the home by residents and people said they were very happy with their personal space. The AQAA informs us of improvements that have been made to the environment over the past twelve months. These include several bedrooms being redecorated and fitted with new carpets and curtains, a ramp installed to the front of the home, all external windows, doors and the conservatory being refurbished and bedroom doors having been fitted with automatic door closures that are linked to the fire detection system. Thirteen residents completed questionnaires and returned them to us before we visited the home. All state the home is always fresh and clean. Additional comments were recorded of everyday we are able to send clothes to the laundry, they are returned clean and ironed in twenty four hours and cleanliness within the home is excellent. Care Homes for Older People Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by a committed, kind and caring staff team and are protected by there being a robust recruitment process in place. Evidence: With regard to staffing the homes AQAA states residents in the home are supported by a committed, kind and caring staff team and are protected by the application of a robust recruitment process and continuing staff training. We ensure residents needs are met by providing more than adequate numbers of staff on duty at all times and are appropriately trained and supervised. We maintain a staff duty rota to ensure an appropriate mix of care staff skills in addition to a cook and domestic staff, and the managers hours being supernumerary. Our recruitment policies and practises ensure support and protection of our residents. All staff receive appropriate induction, and training as necessary and regular updates. At this visit the registered manager informed us that three carers are on duty during the day shifts. In addition to this a cook and domestic staff are in place. The managers hours are in addition to the rota. Thirteen residents completed questionnaires and returned them to us before we visited the home. Twelve state staff are always available when needed and one that they are usually. All state staff always listen to and act on what they say. Care Homes for Older People Page 22 of 28 Evidence: As at previous inspections residents were full of praise for the staff team. Comments include staff are very kind and considerate and treat me with respect all staff are very caring and most helpful and i have been very happy with everything and staff treat me with respect and nothing is too much trouble for them. The staff on duty during the visit had time to spend with people on a one to one basis and there was a happy and relaxed atmosphere. The homes AQAA informs us that over 75 of the staff team hold a National Vocational Qualification (NVQ) at level 2 or above. It also informs us that the common induction standards are used for all new members of staff, all full time staff have completed Asset Level 2 Certificate in Dementia Care and Safe Handling of Medicines. There is a robust recruitment process in place, three staff files were seen and all contained the required documentation including current Criminal Bureau Checks and references. Eight staff completed questionnaires and returned them to us before we visited the home. All confirm they are given up to date information about residents and that they have received an induction and training appropriate to their roles and responsibilities. Additional comments were recorded that indicate staff gain satisfaction from working at the home. For example one person wrote the home provides a comfortable and excellent quality of service to our clients. We also work as a team and provide a happy environment for both clients and visitors alike and another staff have very good teamwork, residents are well cared for. We give residents a high quality service, the food is excellent, the cleaners are brilliant, the management are approachable, we maintain a homely and happy environment for residents. Care Homes for Older People Page 23 of 28 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 by a capable and committed manager, who ensures effective quality monitoring takes place, which benefits residents. The health and safety of residents and staff is promoted. Evidence: The homes manager Mr Neil-Smith is qualified, capable and committed and undertakes further training and development to update his skills and knowledge. As at our previous inspection the home has a quality assurance system in place that includes a survey seeking the views of residents and relatives. The home sent us its AQAA when requested. The contents of this are detailed, informative and demonstrate quality monitoring and reviews undertaken by the home. Most of the people living in the home either manage their own financial arrangements or are supported by legal advisors. A small amount of money is kept in the home on behalf of one resident. Records indicate that staff receive support both on a one to Care Homes for Older People Page 24 of 28 Evidence: one basis and in group settings. Information within the homes AQAA states that checks on services and equipment have been undertaken within recommended timescales. We sampled a number of health and safety records, finding all to be in good order and up to date. Care Homes for Older People Page 25 of 28 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 28 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 9 13 The registered person must ensure care plans are in place for the use of PRN medication, that include guidelines for use and evaluation of effect. This must happen to ensure consistency and safety. 08/05/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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