Care Home: Hill House Nursing Home Limited

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What the care home does well People who may use the service and their representatives have the information needed to choose a home that will meet their needs. All new people receive a comprehensive needs assessment before admission. This is carried out by staff with skill and sensitivity. The home consults people using the service about their satisfaction with the service they are receiving. It acts upon the results of consultation with residents and their representatives and makes sure that good practice is modelled and developed throughout. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet people needs. People who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. The management and administration of the home is based on openness and respect, and has an effective quality assurance system. What has improved since the last inspection? The home has been awarded an excellent and beacon status from the team responsible for the Gold standards Framework and continue to work to this achievement. They attend meetings regularly to share their knowledge of the Gold Standards Framework with other homes. They have also received recognition from St Christopher`s health care professionals and bereaved relatives. The call bell system was replaced and the new wireless system has proved to be very succesfully after a few initial teething problems. The call unit is highly visible and user friendly with large pressure colour coded pads or a small extendible pressure call pad unit, whichever the resident is more comfortable in using. New television aerials have been installed, new flat screen televisions have been purchased and aerial adjustments made with some televisions being bracketted to walls for ease of viewing and freeing up surface space. The staffing level has been reviewed and increased. More staff have been recruited. The home has reviewed their "Prospective service user`s guide" and "Statement of Purpose" and these have updating with the Care Quality Commission information, address and contact numbers. Staff continue to attend lectures regarding the Mental Capacity Act and the Deprivation of Liberty Safeguards. The home has completed and submitted relevant information as requested for the inclusion onto the London Procurement Programme (LPP) and have been accepted and included as suitable care providers for continuing care, palliative and physically frail residents. What the care home could do better: There are no requirements or recommendations from this inspection, however the registered provider/manager must ensure that the home continues to provide a good standard of care. Key inspection report Care homes for older people Name: Address: Hill House Nursing Home Limited Hill House Nursing Home 48-50 Park Road Kenley Surrey CR8 5AR     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: Mohammad Peerbux     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: Hill House Nursing Home Limited Hill House Nursing Home 48-50 Park Road Kenley Surrey CR8 5AR 02086609336 02086680210 hillho@freenetname.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hill House Nursing Home Limited Name of registered manager (if applicable) Mrs Elana Pamela Follwell Type of registration: Number of places registered: care home 65 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: A maximum of 10 service users in the category of Terminally Ill aged over 40 years. A variation has been granted to allow day care to be provided for one specified service user. Eight intermediate care places provided in rooms 102, 108, 110, 111 and 112. Date of last inspection Brief description of the care home Hill House provides personal care, including nursing care, for older people but does not provide care in other categories such as dementia care or people with mental illness. The hotel-style home comprises 35 single rooms and 15 shared rooms. There are 4 dayrooms plus bathrooms, shower-rooms and there are toilets sited throughout the Care Homes for Older People Page 4 of 28 Over 65 65 0 0 10 Brief description of the care home home. There is a library, a hairdressing salon plus the usual facilities, including a laundry, offices and staff rooms. There is a garden to the rear and an enclosed courtyard plus off-street parking to the front of the home. 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: This unannounced visit to the home was undertaken as a part of the inspection process for the year 2009/2010. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. The registered manager and providers facilitated this inspection. Some of the people were spoken to and they commented positively on the care they are receiving. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. All registered adult services are now required to fill in an annual quality assurance assessment (AQAA).It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from the AQAA is included in the report. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The home has been awarded an excellent and beacon status from the team responsible for the Gold standards Framework and continue to work to this achievement. They attend meetings regularly to share their knowledge of the Gold Standards Framework with other homes. They have also received recognition from St Christophers health care professionals and bereaved relatives. The call bell system was replaced and the new wireless system has proved to be very succesfully after a few initial teething problems. The call unit is highly visible and user friendly with large pressure colour coded pads or a small extendible pressure call pad unit, whichever the resident is more comfortable in using. New television aerials have been installed, new flat screen televisions have been purchased and aerial adjustments made with some televisions being bracketted to walls for ease of viewing and freeing up surface space. The staffing level has been reviewed and increased. More staff have been recruited. The home has reviewed their Prospective service users guide and Statement of Purpose and these have updating with the Care Quality Commission information, address and contact numbers. Staff continue to attend lectures regarding the Mental Capacity Act and the Deprivation of Liberty Safeguards. The home has completed and submitted relevant information as requested for the Care Homes for Older People Page 8 of 28 inclusion onto the London Procurement Programme (LPP) and have been accepted and included as suitable care providers for continuing care, palliative and physically frail residents. 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. The residents who use this service can feel confident that they will be properly assessed prior to the decision being taken about whether their needs can properly be met by the home. Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. For residents who are self-funding and without a care management assessment, a skilled and experienced member of staff always undertakes an assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Prior to admission prospective residents are asked to visit the home if they are able to do so, and so as to make their own decision as to where they wish to be cared for. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Care Homes for Older People Page 11 of 28 Evidence: New residents are provided with a statement of terms and conditions. These are set out in a simple and concise manner, and issued to the individual or their chosen advocate for agreement. Fees, annual increase, extra charges along with the bedroom to be occupied are clearly stated. The contract is normally reviewed when the persons circumstances change. The Financial Director is readily available to explain any queries that may arise on funding or contractual issues. Intermediate care for rehabilitation and return to the community is no longer provided by this home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home maintains care plans and assessment documents designed to ensure that the expressed needs of residents are met in a focused and individual way, with their rights to individuality and self-expression being protected. Evidence: The home has a strong belief that it is essential to involve residents as far as possible in the planning of care that affects their lifestyle and quality of life. Residents have a plan that has been agreed with them where they are able to do so. This is written in plain language, is easy to understand and considers all areas of the individuals life including health, personal and social care needs. The plan also includes a risk assessment. Areas have been identified where staff are willing to support residents to take some risks, which may have an impact on their rights. The home actively promotes the residents right of access to the health and remedial services that they need, both within the home and in the community. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Individual care plans are reviewed regularly Care Homes for Older People Page 13 of 28 Evidence: and are updated with health care professionals feedback and involvement as a continuous and on-going process. Domiciliary visits for dental, optical and speech & language therapist are all available as required. Chiropodist, Physiotherapist, Exercise teacher and alternative therapeutic therapists all visit the home regularly attend to residents personal requirements. All residents are registered with the National Health Service/Primary Care Trust on admission so that an independent nurse advisor can conduct an assessment of their health needs which can be monitored. The home has a medication policy which is accessible to staff. Medication records are generally up to date for each individual. The staff are reminded that the medication administration records need to be completed accurately including codes to ensure there are no gaps. Last year the home received three visits from the NHS pharmacist in line with their guidance. As a result of these inspections the service reviewed, rewrote and devised further policies and procedures as required, and these form part of their Medicines Management. Staff responsible for administration, ordering, storage and disposal have been trained in the new policies and procedures. Those residents that wish to self administer are risk assessed and given the necessary facilities to do so safely. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. The home arranges for residents to enjoy the privacy of their own rooms. Residents who were spoken to stated that they are happy with the way that the staff deliver their care and respect their dignity. One resident stated, I am happy here and the staff are helpful. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly. The service has completed the accreditation process for the Gold Standards Framework in end of life care and uses advanced care plans and priorities of care and it has been awarded Beacon Status . All residents have completed an advanced care plan where their views on their end of life care are recorded and respected. There are detailed policies and procedures to support staff dealing with death. Through the Gold Standards Framework (GSF), Advance Care Planning (ACP) and the recognised Liverpool Care Pathway (LCP), the home provides an exceptional service to terminally ill, palliative care residents, their families and friends. The staff ensure that the residents last days are sensitively and well managed by constantly monitoring their symptoms of pain, agitation or distress, respiratory secretions, nausea and vomiting and any other relevant symptoms through a variance analysis so leading to a peaceful and pain free conclusion. The home works closely with external professionals and specialists for advice and support to help the resident, their family and the homes Care Homes for Older People Page 14 of 28 Evidence: staff. The Commission recognises the good work that goes into achieving this standard and the hard work of management and staff. 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. The home tries to be flexible and attempts to provide a service, which is as individual as possible. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: Staff are aware of the need to support people to develop their skills, including social, emotional, communication, and independent living skills. People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. The Activity Organiser welcomes all new residents and makes a point of introducing herself and finding out their past interests and leisure pursuits to incorporate them into the homes current activities, so creating meaningful experiences both in the home and the wider community. There is also an art therapist who provides weekly classes which are very much enjoyed by the more artistic residents. The home has also started a new exercise class with a young and lively teacher who combines choreographed exercises to well known and favourite songs. This class is proving to be very enjoyable and popular by all those who attend. The home has purchased further flat screen televisions with freeview for residents bedrooms. Some residents now have laptops with internet access and one resident has sky plus with high definition. There is also a computer for residents to use in the Care Homes for Older People Page 16 of 28 Evidence: library if desired. Relatives who have had their loved ones living at the home still visit and help out with residents activities. Residents are welcome to receive visitors at any time they wish. The home feels that mealtimes should be protected and if residents wish to receive visitors at these times, the staff suggest that they also partake of a meal with them making the whole visit a more enjoyable social event. All policies and procedures in respect of Autonomy and Choice are current and reflect the need for residents to maintain their right to freedom, choice and control over how they wish to live their lives. Empowering them to live with as much independence as possible. The staff practises promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. The home holds a food hygiene rating of 5 stars, excellent, for very high standards of food safety management and fully compliant with food safety legislation. Scores on the Doors a pilot scheme supported by the Food Standards Agency and was presented to the home by the Director for Environment, Culture and Public Protection of Croydon Council in January 2008. The Head Chef/catering manager takes great pride in his presentation and hygiene of all meals prepared in the kitchen. He makes a point of visiting all new residents to ascertain their likes and dislikes, any favourite foods, allergies, dietary, cultural or religious requirements and whether there are any medical needs. These are taken into account when menu planning. Menus are reviewed seasonally using fresh fruit, vegetable and salad produce appropriate to that time, the only frozen products being used are chips and peas. Each resident receives a menu so as to choose their preferred meal. Hot and cold drinks and snacks are offered regularly and are readily available as required. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. Evidence: The home has an open culture that allows people to express their views and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and easy to understand. Unless there are exceptional circumstances the service always responds within the agreed timescale. The service appreciates and recognises that complaints will always occur and rise to the challenge to deal with them quickly and as efficiently as they are able to. They want all residents to feel confident that they have the right to tell them when things are not correct without fear of retribution. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. All current residents have been registered onto the electoral role and are given the opportunity to vote, either in person or to have a postal vote or a proxy as they desire. Residents rights are displayed in the Residents charter, throughout the home. There are policies and procedures for safeguarding people who use the service. The manager stated that most of the staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert. Staff working Care Homes for Older People Page 18 of 28 Evidence: at the service know when incidents need external input and who to refer the incident to. Access to external agencies or advocacy services is actively promoted. All staff are made aware of the policies and procedures in reporting any form of abuse. Staff are also made aware of the whistle blowing policy and in particular towards a more senior member of staff. 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. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the individuals health and emotional well-being. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides specialist aids and equipment to meet their needs. People who live in the home are encouraged to personalise their bedrooms. Residents are encouraged to make suggestions as to the decor and running of the home at their meetings. There is a selection of communal areas both inside and outside of the home, this means that people using the service have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. There is in-house training sessions for staff on infection control and the importance of hand-washing. Posters are displayed by washhand facilities as constant reminders to all staff, residents and visitors within the home. Monthly audits on infection controlled are carried out. The management has a proactive infection control policy and they work closely with their own staff and external specialists, such as NHS infection control staff, to ensure that infections are Care Homes for Older People Page 20 of 28 Evidence: minimised. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can rely on the home providing adequate staff in sufficient numbers, and being duly competent and well trained, to provide a service that seeks to meet their individually identified needs effectively. Evidence: There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for residents. There are enough qualified and experienced staff to meet the health and welfare of people using the service. The majority of staff in senior roles have been with the company for over 10 years. Staff photos are displayed on boards for the benefit and recognition of residents and their visitors and appropriate to the floors where staff work. The registered manager informed that more than 50 of staff have an NVQ level qualification at level 2. According to the AQAA, over 75 of Health Care Assistants have obtained NVQ 2 and with 45 having NVQ 3 with four additional new staff enrolled on NVQ2 and four on NVQ3 commencing in this month. We met with the NVQ assessor during our visit and she commented positively on the staff competencies and the general running and management of the home. Recruitment procedures seemed appropriate. Staff files were examined at random and Care Homes for Older People Page 22 of 28 Evidence: found to contain the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. The service has recruited several staff that are qualified in their own country and who are currently working towards NVQ 3 & 4 so as to be recognised as registered practitioners. The service ensures that all staff within its organisation receives relevant training that is targeted and focused on improving outcomes for residents. The home puts a high level of importance on training. Training are provided on site as well as staff are encouraged to attend external training beyond the basic requirements to the benefit of all. Training needs are identified through the supervision and appraisal processes. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides guidance and direction to staff to ensure individuals receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. Evidence: The manager has the required qualifications and experience to run the home. She has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. There is a strong ethos of being open and transparent in all areas of running of the home. The manager leads and supports a strong staff team who have been recruited and trained to a high standard. She is aware of current developments both nationally and plans the service accordingly. Hill House is managed in accordance with its stated aims and objectives. The Directors are available at all times and are closely involved in the day to day running of the home. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives Care Homes for Older People Page 24 of 28 Evidence: and statement of purpose of the home. The annual quality assurance assessment (AQAA) was received on time and contains clear and relevant information. The AQAA lets us know about changes the home has made and where they still need to make improvements. It shows clearly how they are going to do this. The service puts a strong emphasis on getting it right for the people they provide a service to by listening to their requests and comments and acting accordingly. Residents are encouraged to manage and take responsibility of their own financial affairs if able and small safes are available as required. The service does not manage any residents finances. There is a safe if required for valuables and the manager has a safe-keeping cabinet to hold small amounts of cash etc. Receipts are issued and individual accounting books are in place. Certificates relating to health and safety were up to date servicing certificates. In October 2008 the service upgraded their health and safety system and documentation with the assistance of Croner who manage their employment and health and safety specifications. This covers all aspects and compliance with the current relevant legislation. The home is inspected annually by a competent person from Croner Consulting to ensure they maintain high standards of care, they offer help and assistance with any areas of weakness or difficulties they may encounter. 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 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. 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