Care Home: Hill Top Lodge

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Ashcroft Hollow Nursing Home

What the care home does well The home gives people clear information about the service they offer and what people can expect when they move into the home. Each person will have their needs assessed in full prior to admission to the home. The manager will visit people before they agree to move in to discuss their needs. Each person will have a care plan and risk management plan that is tailored to their needs. People living in the home told us "I am very happy here", "I am very comfortable and very content in this home". The home has good systems in place for dealing with people`s concerns and complaints. One person told us "I have made a complaint about something and it was dealt with very well", another person said "the staff try their best to sort any problems out". What has improved since the last inspection? The quality of the care plans has improved since our last visit. Each person has a care plan that reflects their needs. Meal times were more organised and we did not see any people waiting for unnecessarily long periods for assistance. There has been some attempt to add more decoration to the home, in the form of pictures on the walls in the corridors. Staff knowledge and understanding of people`s needs was better and we were confident that they knew what care people needed. What the care home could do better: The home has made improvements to the activity provision it has. We have seen that there is still room for more improvement particularly for those people living on the ground floor. The home needs to be able to demonstrate the preventative care it gives to people in relation to pressure area care. A review of the quality of beverages should be conducted. Alot of people told us during this inspection the quality of the tea was poor. The home could respond in a more timely manner when routine maintenance works need attention. Key inspection report Care homes for older people Name: Address: Hill Top Lodge 93 Hill Top West Bromwich West Midlands B70 0PX     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: Mandy Beck     Date: 0 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Hill Top Lodge 93 Hill Top West Bromwich West Midlands B70 0PX 01215563322 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): phaik@pressbeau.co.uk www.pressbeau.co.uk Pressbeau Ltd Name of registered manager (if applicable) Ms Phaik Lim Type of registration: Number of places registered: care home 85 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 85. The registered person may provide the following category of service only: Care Home with Nursing Only (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 28 Dementia (DE) 57 Date of last inspection Brief description of the care home Hill Top Lodge is registered to provide personal and nursing care for older people. The home has three floors and each one has their own living and dining area. There are bathrooms and toilets on each floor. People who live at this home do not have to share bedrooms. Each room is furnished appropriately and with prior agreement from Care Homes for Older People Page 4 of 30 Over 65 0 28 57 0 0 8 0 1 2 0 0 9 Brief description of the care home the manager people are encouraged to bring their own possessions with them when they move in. Each bedroom has a partial en suite facility, a toilet and hand basin. This home operates a non-smoking policy. It is situated close to the town of West Bromwich and is accessible via public transport. The fees for this home are included in the Statement of Purpose and the Service User Guide and range from £390 and £560 per week for residency. Other fees not included are extras such as newspapers and magazines, hairdressing service and non NHS chiropody. People are also expected to provide their own toiletries. People are requested to contact the home directly for the most up to date information on fees. Care Homes for Older People Page 5 of 30 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 an unannounced inspection to the home. One inspector and a local area manager carried out this inspection over a period of one day. We looked at all the information that we have received, or asked for, since the last inspection of this home in January 2009. This included the annual quality assurance assessment (AQAA) that was sent to us by the home. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We looked at the information we had about how the home has managed any complaints or safeguarding issues. We looked at what the home has told us about things that have happened in the home, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 30 The previous key inspection and the result of any other visits that we have made to the service in the last 12 months. We have taken into consideration information from other organisations. We spent time talking to people who live in the home and to the staff who support them. We have also a random sample of surveys to the home for people to complete. Comments from surveys have been included into the report where appropriate. We looked at the care of six people in depth. This is part of our case tracking process and helps us make judgements about the homes ability to meet peoples needs. Care Homes for Older People Page 7 of 30 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 Care Homes for Older People Page 8 of 30 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 30 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 30 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 are given all of the information they will need in order to make a choice about living in this home. They can feel confident their needs will be assessed in full prior to admission Evidence: The home has both a Statement of Purpose and Service User Guide that give people all of the information they will need to know about the service the home provides. It includes the range of fees people are expected to pay and the additional extras that will not be included in the weekly fee. Before people agree to move into the home the manager will spend time with them completing an assessment of their needs. This is done to make sure the home is able to meet peoples needs and that it will be the right place for them. We looked at the needs assessments of six people during this inspection and found that each one had been completed and provided a sound basis for staff to be able to plan care for Care Homes for Older People Page 11 of 30 Evidence: people. People choosing to live here are given ample opportunity to sample the service before they agree to move in. We were told that people are encouraged to spend time in the home on trial visits. One person told us I had been to several places but chose this one. The home does not provide intermediate care facilities at this time. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have the assistance they need in order to meet their personal and health care needs. Medication practises are good and mean that people have their medication as prescribed. Evidence: Each of the people living in this home has their own set of care plans and risk assessments. These documents should detail the care and support people need and the risk associated with that. We looked at the care plans and risk assessments of six people during this inspection. We saw that there had been an improvement in record keeping and peoples care plan on the whole did reflect their current needs. One person told us I am well cared for and very comfortable thank you. We looked at how the home manages peoples need for pressure relief and pressure area care. We have recently been made aware of concerns about how the home does this. We saw in each persons care file a risk assessment that determines a persons risk for developing pressure sores. Where a risk has been identified the home has completed a care plan that details actions staff should take in order to reduce the risk Care Homes for Older People Page 13 of 30 Evidence: of pressure sores developing. We noted that people living on the top floor of the home are supported by the nursing staff in meeting any pressure area care. People living on the ground and first floor have their treatment for pressure area care prescribed by the district nursing service. The home does need to improve upon its prevention of pressure sore development care. It was evident once a pressure sore has developed the home records turns, when dressings are changed and the involvement of the district nurses, however there was very little evidence to show us what the home was doing in preventing pressure sores developing in the first instance. We were particularly concerned about the people living on the ground floor. We observed most of the people seated for over two hours without a change in position to relieve pressure. We did note that people were sat on pressure reducing cushions but this does not negate the need for additional pressure relief. The manager was informed of our findings during the inspection, she has told us she will address this. We also looked at how the home manages peoples weight and what they do when people experience unexplained weight loss/gain. Each person is screened using a nutritional risk assessment. Those people deemed to be at risk have a care plan that shows how the home will address this. Some people need more specialised help and are referred in a timely manner to the doctor or the dietitian for further assessment. People are weighed on a regular basis, this helps the staff to monitor peoples weight and take action when problems occur. We saw staff using lifting equipment throughout this inspection. We saw that people were moved safely using the hoist or lifting belts. We spoke to staff who told us they had completed moving and handling training recently. As with pressure areas and nutrition people are assessed for moving and handling requirements. These risk assessments are kept under review by the home. People who answered our surveys told us we always get the care and support we need, the staff here are wonderful and nothing is ever too much trouble for them, I am never rushed by them, they always take their time and give me the support I want. We spent time talking to staff during this inspection and they were able to give us a good account of peoples needs and the support they wanted. They told us We are told by the seniors who needs what care, we dont get much time to read the care plans but every shift we have a handover where information is told to us. The home is also supported by community services such as doctors, psychiatrists and district nurses. People also have access to dentists, chiropodists and opticians, as they Care Homes for Older People Page 14 of 30 Evidence: need it. People told us I feel I am very well cared for. We looked at the systems in place for the ordering, safe storage and administration of medication. We found the home has good systems in place and medication is administered as the doctor has prescribed it. There are safe systems in place for the storage and administration of controlled drugs. Since our last inspection the home has changed pharmacy supplier. This means that there will be more frequent audits of medication, more staff training and consistent supplies of medication for people. We spoke to some of the people living in the home during this inspection. They told us staff here are very good. We asked if staff paid particular attention to their dignity and need for privacy. They said, Oh most definitely they are very caring. We saw staff talking to people in a polite manner and when they were giving assistance to people they did so sensitively and did not rush people. Care Homes for Older People Page 15 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by the home to take part in some activities. People are not satisfied with the meals on offer but arrangements are being made to improve this. Evidence: The home does provide some activities for people to take part in. There is one activities coordinator responsible for this. We saw records of activity and notices of forthcoming events. Bingo, sing alongs and hair and beauty days were all included. More recently the home has just hosted their Christmas party. Staff told us the place was packed, people l really enjoyed it. We noted that one person was still wearing their Christmas hat some five days after the event. They said I like it on its pretty. We spent time on all of the floors during this inspection. We found that those people living on the ground floor were more dependent than other people living in the home. We also noted that at times there was little in the way of interaction or activity for them. Although one person did tell us I really like looking out of the window most of the people we observed spent the morning until lunch time asleep in their chairs. The manager told us that she was aware this is an area for improvement. People are encouraged to have visitors when they like. We saw plenty of people visiting throughout this inspection. One visitor said I am very satisfied with the care but Care Homes for Older People Page 16 of 30 Evidence: sometimes I think the home could be a bit brighter. Another person told us my friend has been here for twelve months now and she is much improved and I have lots of visitors they come when they want to, we are always made to feel welcome and offer us a drink. We saw some peoples bedrooms as part of our case tracking process. We saw that each person had taken the opportunity to decorate their rooms with their own personal belongings in some cases this made the rooms feel very welcoming. People who responded to our surveys told us they would most like to improve the standards of the meals in the home. They said the food could be better, more choice would be better. The biggest complaint from people during this inspection was the quality and taste of the tea on offer. We heard people saying this tea is vile, I dont like this its horrible. We tasted the tea and agree that the tea did not taste very nice. We did raise this with the manager during the inspection. A meeting was held in October 2009 with people who live in the home. One of the recommendations from that meeting was for the home to review the menu so that there was more choice on offer, particularly at tea time. The home has not yet produced an action plan to show how they will address these requests. The manager did tell us that they will be addressed and people will be told how the home plans to manage this at the next meeting. The dining rooms were all pleasantly decorated and were clean. This was an improvement upon our last inspection. We also noted that people were able to have their meals in the privacy of their own rooms should they choose to do so. Care Homes for Older People Page 17 of 30 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 using this service should feel confident their views would be listened to and acted upon. Staff have the knowledge and skills to keep people free from harm and abuse. Evidence: The home has a complaints policy that is available to all people. A copy of the complaints policy is in the service user guide. Since the last inspection in January 2009 there have been sixteen complaints recorded. The manager told us that she is always there to talk through any concerns that people have and will always act upon them. Those people who answered our surveys told us I would always speak to the nurse in charge and I know who to speak to I needed to make a complaint. Other people commented no I dont know who to talk to, I think I would ask for the person in charge. We have been made aware of some concerns about the home in relation to peoples care. We have referred some of these concerns to the Local Authority to look at under their safeguarding systems. The home has policies in place for dealing with allegations of abuse and keeping people safe from harm. We call this safeguarding vulnerable adults. We spoke to staff about this. All of the staff we spoke to were able to tell us what different types of abuse there were and how they would recognise the signs of abuse. Generally most of Care Homes for Older People Page 18 of 30 Evidence: the staff knew who to refer to if an allegation was made to them or they had witnessed an act of abuse. The manager of the home understands what is expected of her in relation to reporting of incidents and allegations to the safeguarding team. The home does use bed rails for some people in order to keep them safe whilst in bed. We have seen the home has improved upon its recording of bed rails safety and is currently using the guidance from the Health and Safety Executive to manage peoples safety. All of the bed rails we have seen in use are integral to a profiling bed. There are no individually fitted bed rails in the home. We looked at recruitment practises and found the home is taking steps to prevent unsuitable people from working with vulnerable adults. This had included required checks against the Protection of Vulnerable Adults list (PoVA) and a Criminal Records Bureau disclosure (CRB). The PoVA list has now been replaced by the new vetting and barring scheme from the Independent Safeguarding Authority (ISA). Any new recruits to the home will need to be checked against this list before they are employed. Care Homes for Older People Page 19 of 30 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 live in a home that is well maintained and free from odours. People have the equipment they need to meet their needs. Evidence: We looked at most of the home during this inspection. We could see that it was clean and tidy. Staff had taken the time to decorate the home in preparation for Christmas and the home felt very welcoming. There has been some effort made by the home to add more pictures and decoration in corridors and the home felt less stark than in our previous visits. There is still no signposting/way finding markers around the home but there are pictures of toilets and bathrooms on appropriate doors to aid peoples recognition. Each of the floors has its own communal areas but people can choose whether or not they want to spend their time in the comfort of their own rooms as well. We did note that some of the furniture in the communal areas was in need of cleaning. The arms on some of the armchairs were stained and in need of a deep clean. Bathrooms and toilets were clean and tidy, we did however notice a lack of toilet roll holders in each toilet. Toilet rolls were being stacked on top of the cistern. The manager told us that new toilets roll holders have been ordered and would be installed Care Homes for Older People Page 20 of 30 Evidence: as soon as they receive them. We looked in peoples bedrooms as part of our case tracking process, we could see that people have the opportunity to personalise their rooms wherever possible. The supply of pressure relieving equipment was also satisfactory. We were told by one person I like my room its really comfortable. Got my own things. Another said to us come on in you will like my room. The home does have some infection control guidance in place but we noted that some small improvements could be made. We have recommended the home introduce an infection control audit so that shortfalls in practise can be identified and actioned by the home. We also noted in the sluice mop heads were dirty and not stored as recommended, this too will need to be actioned by the home in order to reduce the risk of cross infection to the people living in the home. There are plenty of gloves, aprons and liquid soap available for staff to use, this again will help reduce the risk of cross infection to the people living in the home. Care Homes for Older People Page 21 of 30 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. There are appropriate numbers of staff on duty to meet peoples needs. Staff are trained and have the knowledge and understanding to meet peoples needs. Evidence: The home has a skill mix of both trained nurses and care workers on duty to meet peoples needs. In addition to the care staff there are housekeeping, kitchen, laundry and maintenance workers all working hard to keep the home running smoothly. One person said The staff are wonderful there is never anything that is too much trouble, another person told us They care for people very well, they are always there to attend to their needs, staff always take on any comments we have to say and keep us informed but most of all they are caring supportive in every way possible. The home supports all care staff through training in National Vocational Qualifications. Staff we spoke to confirmed that they had completed both their level 2 and 3 NVQ training in Health and Social Care. This means that staff have the knowledge and understanding to be able to meet the peoples needs who live in the home. We looked at the recruitment processes in the home. We saw the staff files of three people. All of them contained the required information and security checks such as previously mentioned Protection of Vulnerable Adults (PoVA)first, and CRBs. This means the home has systems in place to prevent unsuitable people from working with Care Homes for Older People Page 22 of 30 Evidence: vulnerable adults. We looked at the training records for some staff; the home has supplied us with information of training that has been arranged. It is clear that staff will be trained as required. We spoke to several staff on duty during the inspection who confirmed they regularly take part in training and keep their knowledge and skills up to date. New workers are supported through an induction that meets the Skills for Care common induction standards. This induction will provide staff with the basic skills needed for completed their NVQ training. Care Homes for Older People Page 23 of 30 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 managed well and is run in the best interests of the people who live there. Peoples health and safety is promoted in this home. Evidence: There has been no change in the management of the home since our last inspection. the manager is continuing to work hard to improve the service for the people living there. During this inspection we have found improvements in the homes care planning systems, risk assessments and staffs knowledge and understanding of peoples needs. The home does take steps through its own quality assurance systems to highlight areas for improvement and take action to address this. The manager continues to complete monthly audits of health and safety, the environment and care plans. We have recommended that a new audit be introduced for monitoring infection control. The home has also recently changed the supplier of peoples medication. They have done this to improve the service offered to people. In addition to the managers audits Care Homes for Older People Page 24 of 30 Evidence: the company also completes a Regulation 26 visit. This visit is unannounced and is a requirement of the Care Homes Regulations 2001. During these visits the person will spend time talking to people and staff and generally making sure that things are satisfactory for them. We have made a recommendation that the home keeps are record of the people who are spoken to during these visits for future reference should problems arise. The home has completed the Annual Quality Assurance Assessment (AQAA). All sections were completed and the information gives a reasonable picture of the current situation in the home. There are areas where more supporting evidence would have been useful to illustrate what the home has done in the last year or how it is planning to improve. The ways that they are planning to achieve this are briefly explained. We also spent time talking to the manager about her role and responsibility in understanding the principles and practise of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The manager, deputy manager and senior care assistants have received training in this area and understand their role in making applications to the appropriate authority should they feel that peoples liberty is being deprived. The manager also told us there are further plans to arrange training for all staff. The service takes charge of some personal monies on behalf of people who use the service. The monies are kept securely and written records are kept of all transactions. An audit takes place each day but the home does not record this has happened. We have recommended this be completed by the home. A random sample of the monies and accompanying records were seen during our inspection and there were no discrepancies. Staff training in ongoing, recent training has included moving and handling and fire safety. Training is completed at least yearly and this gives staff a chance to keep their knowledge up to date and make sure that peoples safety is promoted. There is a Fire Risk Assessment in place and a fire drill takes place at least every six months. The Fire Alarms must be tested each week. The Emergency Lights are tested on a monthly basis and records were seen to verify this. Records were seen to verify the regular servicing and maintenance of various systems, including the emergency lighting system, the gas system and boiler, the hoists, the lift, the electricity system and all electrical equipment. The water system is regularly tested for legionella and the tanks disinfected. The water temperatures are tested regularly and recorded. There are policies and risk assessments in place with regard to safe working practises. Care Homes for Older People Page 25 of 30 Evidence: Staff receive training in safe working practise topics during their induction. Care Homes for Older People Page 26 of 30 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 27 of 30 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 8 13 The home must make sure that peoples pressure area care is detailed and can be audited. This will demonstrate all of the care people have in relation to pressure area care. 30/03/2010 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 1 12 The home should consistently record the minutes of peoples meetings so there is an accurate record and a reference point for making sure that peoples requests have been actioned. The home needs to review the amount of stimulation/activity on offer for people all over the home but particularly on the ground floor. The home needs to repair the broken/loose hand rail in the bathroom on the first floor. The home should make sure that toilet roll holders are provided in each toilet so that people do not have to store 2 12 3 4 19 19 Care Homes for Older People Page 28 of 30 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 toilet rolls on the toilet tank. 5 26 The home needs to develop a cleaning schedule that includes the daily disinfection of mop heads. The home also needs to make sure that when mops are not in use they are stored inverted. The home needs to develop the infection control audit so that shortfalls in practise can be addressed and actioned. Staff need to understand their role in supporting people under the principles of the Mental Capacity Act 2005 and the deprivation of liberty safeguards. The home should make sure this happens. The person completing the Regulation 26 visits to the home should keep a record of the people they speak to during this visit so that it is possible to cross reference the information. The home should complete and record the audits it does for peoples money. It is also recommended that a safe audit be included in this process. 6 7 26 33 8 33 9 35 Care Homes for Older People Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!