Care Home: Hill Top Manor Care Home

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What the care home does well The assessment process is comprehensive and ensures that people are only offered a place at the home when it has been identified that their needs can be met. Individual care plans are person centered and personal, nursing and health care needs are addressed holistically. There is a robust staff recruitment and training programme which ensures that staff provided have the necessary skills and are safe. Staff feel very supported with their training needs. The service has made improvements to many of the outcome areas but most significant improvements are as identified below. What has improved since the last inspection? The monitoring of individual fluid intake has improved and people entering this home can be sure that their hydration and nutritional needs will be met by the service. There has been many improvements made in respect of cleanliness and infection control since we carried out the last Key Inspection of the service. All of the requirements we left have now been addressed and or are in the process of being addressed by the service. What the care home could do better: There is a programme of social and therapeutic activities in place at the home but not all of the people who live in the home benefit from what is on offer. The service will need to review the provision of activities and entertainment and listen to what people want in order to meet their individual needs. The provision of staff in some areas of the home could be improved. The service will need to review this in order to ensure that there are sufficient numbers of staff provided to meet peoples` needs and to offer appropriate supervision. Also staff moral is quite low at the service and not all staff feel that they are listened to. This is having a knock on effect in the delivery of care and we observed that some staff offer little interaction with the people who live in the home. The managers will now need to focus on listening more to staff suggestions and improving staff moral in order to present a workforce which is focused and working together. Key inspection report Care homes for older people Name: Address: Hill Top Manor Care Home High Lane Chell Stoke-on-Trent Staffordshire ST6 6JN     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: Yvonne Allen     Date: 0 6 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 27 Information about the care home Name of care home: Address: Hill Top Manor Care Home High Lane Chell Stoke-on-Trent Staffordshire ST6 6JN 01782828480 F/P01782828490 hilltop.manager@fshc.co.uk www.fshc.co.uk Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Kathleen Mary Barcroft Type of registration: Number of places registered: care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 80 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 80, Physical disability (PD) 10 Date of last inspection Brief description of the care home Hill Top Manor is a care home that can provide nursing care for people both male and female requiring long, short or respite care. The majority of people cared for by the Care Homes for Older People Page 4 of 27 Over 65 80 0 0 10 1 9 0 8 2 0 0 9 Brief description of the care home home are frail elderly people but the home can also accommodate people above the age of 18 who require intermediate care. The home has a separate dedicated intermediate care unit for up to 19 people with its own facilities. The home is a twostorey purpose built building situated in Chell, a small residential suburb within the Potteries conurbation. It is situated on a main road and provides easy access to local shops and amenities. It is within walking distance of bus routes and the home provides ample parking space. There are well-tended gardens that are accessible to people who live in the home. The home provides care for up to 80 people on two floors. There is lift access between floors. The majority of rooms at the home are single but there are four companion rooms available. Many of the rooms have en-suite facilities. There are a number of communal rooms, three dining rooms, an activity room and adapted bathing facilities. There is a central kitchen and laundry. The range of fees charged by the home can be obtained from the manager Mrs kath Barcroft. Additional charges are made for hairdressing, private chiropody, private dentistry, newspapers and magazines, private transport and special toiletries. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality Rating for this service is 2 STARS. This means that the people who use this service experience GOOD quality outcomes. We carried out this unannounced Key inspection of the service over two days. All of the Key Minimum Standards were assessed and for each outcome a judgment has been made based on the evidence gathered. These judgments tell us what it is like for the people who live in the home. Prior to the inspection visit the manager had completed a self assessment tool known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment which focuses on how well outcomes are met for people using the service. Information from the AQAA was used as part of our information gathering process. Care Homes for Older People Page 6 of 27 The ways in which we gathered our other evidence were as follows - We looked at any information we had received about the service since the last Key Inspection. We spoke with some of the people who live in the home and their visitors. We spoke with some of the staff who work in the home. Discussions were held with the manager of the service, the regional manager and operations director. We involved the Head of Infection, Prevention and Control nurse specialist from StokeOn-Trent Primary Care Trust in our inspection of the service. This nurse specialist had visited the service previously and carried out audits of infection control. She undertook this audit of the service in order to identify whether previous requirements and recommendations had been met. We examined relevant records and documentation. We walked around the home and visited all of the communal areas and a random selection of bedrooms. We observed staff interaction with people who live at the home. We are trying to improve the way in which we engage with people who use services so we can gain a real understanding of their views and experiences of social care services. We are using a method of working where experts by experience are an important part of the inspection team and help inspectors obtain a picture of what it is like to live in or use a social care service. An expert by experience is a person who, because of their shared experience of using services and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. During this inspection an Expert by Experience joined us from 10 am to 1pm. He spoke to some of the people who live in the home and made observations about the care they receive. He also looked around the home and spoke to some visitors and some staff members. These comments and observations have been included in the main body of this inspection report. At the end of the inspection visit we discussed our findings with the above managers of the service. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. No person is admitted to the home without having had his or her needs assessed and people can be assured that their assessed needs will be met. People assessed and referred solely for intermediate care are helped to maximize their independence and return home. Evidence: Before being offered a place in the home people undergo an assessment of their needs. This is usually carried out by the manager or the deputy manager of the home. People and their families are actively involved in this assessment process and their thoughts, preferences and suggestions are taken into account. Any questions they may have about the service are addressed at this stage. The process often includes assessments from other health care professionals and Care Homes for Older People Page 10 of 27 Evidence: purchasers of care, such as Social Services. The assessment of needs is recorded by the service as a Care And Health Assessment Profile (CHAPS) and is a thorough and comprehensive assessment of an individuals personal, nursing, physical, social and mental health needs. The service provides a unit which is dedicated to meeting the needs of people for intermediate care. This unit includes specialized facilities, equipment and staff to deliver short term intensive rehabilitation and enable people to return home. At the time of the inspection visit there was a meeting in progress to discuss the future of this unit. We were informed that the outcome of this meeting was that the service would, in the future, no longer be funded to provide intermediate care, so this facility will cease to be provided. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are person centered and designed to meet specific individual needs. People can be assured that their health care needs will be met by the service. Care will be delivered with dignity and respect. Evidence: We observed the care of people throughout the two days we were there. We looked at peoples individual care plans and how these plans meet their assessed needs. Plans are comprehensive and detailed and risk assessments and care plans are developed to ensure that each identified need is assessed, monitored and met. Plans are also individual, contain preferences and choices and are geared around meeting specific needs. People have a say and an input into their care plans and are encouraged to be involved in reviews of their care. This means that care plans are person centred in their approach. Care Homes for Older People Page 12 of 27 Evidence: Personal needs are set out so that people are assisted wherever required but also independence is promoted. One person told us Its very good here, they let me keep independent. Health care needs are assessed and planned so that people receive nursing and medical care based on current best practice. Access to health care professionals is facilitated and people receive advice and treatment from specialist services. This includes tissue viability nurse specialists, dietitians, chiropodists, physiotherapists and occupational therapists. People are able to self medicate following a suitable risk assessment. Most people are assisted to take their prescribed medication under the supervision of nurses. The service has improved in the way it monitors individual fluid intake and fluids are readily available throughout the day and night. Where people are at risk of becoming dehydrated, they are closely monitored. Almost all of the people spoken to said that they get regular hot drinks throughout the day, starting early in the morning into the evening. We get a cup of tea in the room, the cleaner brings it in They bring a cup of tea when I am in bed, it is very good I can ask for a drink anytime, I get it in ten minutes I get five drinks a day and Horlicks at night I dont ask for drinks, they just come Drinks are always available, they bring them round They bring tea about seven times a day I ask for a drink, they dont ask me A visitor advised, They will come in every two hours and offer a choice of drinks. I have seen this. If she wakes up at night she will get a drink. Recently she was in bed and at 3am, a carer came in with a drink and found that she was ill. She had to go to hospital People who live in the home feel that their needs are met and that staff treat them with dignity and respect. I am very well looked after and Yes the staff are all very good. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will be offered some activities in which they can participate but these may not always be geared to meeting their individual social and therapeutic needs. The activities of daily life are made flexible and varied and individual preferences are taken into account. Evidence: The service has a planned programme of therapeutic activities and entertainment in place. This is overseen by two people who work at the home as activity coordinators. The activity programme was as follows - Monday: Individual needs, Bingo Tuesday:Hairdresser, Movement to music, Dominoes. Wednesday: Hairdresser, Gardening/Potting, Mobility shop. Thursday:Communion, Movies. Friday:Picture Quiz, Bingo. We observed some activities taking place during the course of the inspection visits. Seven people were involved in potting plants and a number in watching videos. The activity calender indicated that occasional entertainers come in two or three times Care Homes for Older People Page 14 of 27 Evidence: per year. People told us that they would like more trips out. The service does have use of a minibus but this is shared with two other homes and the service does not currently have a driver for this. This restricts the use of this facility. Some of the comments we received were We plant bulbs and put them outside in the garden We have not been on any trips this year We do bingo and art every week I would like to do more We visited one person in their bedroom. This person has diverse needs and was sitting doing nothing. She told us - I dont take part in activities, so they dont ask me. They dont have entertainment, no one seems to want it. We never go on any trips mo one else is bothered I am too comfortable I rarely go out in the garden. A number of people commented that they prefer to stay in their room and not take part in activities. One visitor said They include my mum in activities but she does not want to take part. With the exception of the seven people doing gardening/potting we did not observe anyone pursuing any hobbies. One lady told us I do my knitting when I can. Some people go out to local venues or to do some shopping with friends or relatives. One lady told us that she is picked up and goes to Church every Sunday and also to Church events during the week. Regular Church services are held within the home and Clergy from different denominations visit their Church members. Peoples spiritual needs are assessed and individual beliefs are upheld. Individual rights are promoted by the service. We observed people being escorted to vote at the local polling station as it was election day at the time of our visit. We were informed that other people were given the opportunity of postal votes and that some people had participated in this with the help of their representatives. Individual choices in respect of the activities of daily life are discussed, documented and promoted wherever possible. Care Homes for Older People Page 15 of 27 Evidence: Individual nutritional needs are assessed, monitored and met. Menus are designed to offer variety and choice and special diets are catered for. People are assisted to eat their meals where necessary. One visitor told us that his mother, who had not been eating prior to admission, had now started to take an interest in her meals and was putting on weight. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home can be assured that any concerns they may have will be listened to, taken seriously and acted upon. People who live here are protected from abuse. Evidence: There is a simple, clear and accessible complaints procedure displayed in the home. This procedure includes the stages and timescales for the process, and identifies that complaints are dealt with promptly and effectively. This procedure is also contained within the Statement Of Purpose and Service User Guide. A record is maintained of all complaints received. On examination, however the service had not received any complaints since our last inspection. We, the commission had received one complaint about the service since we carried out the last inspection. This was in respect of a pre admission assessment. This was discussed with the managers at the time of the inspection visit where it was identified that these service acted appropriately in that they were unable to meet this persons needs and so refused admission. Care Homes for Older People Page 17 of 27 Evidence: The service has adopted systems which ensure that people who live at the home are safeguarded from abuse. Staff are carefully selected to work at the home and undergo relevant checks to ensure that they are safe to work with vulnerable people. There is a policy on Safeguarding and Whistle blowing and staff told us that they are aware of how to report poor practice. Staff also confirmed that they receive training in the Safeguarding of vulnerable people. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a clean, safe environment which has been adapted to meet the needs of the people who live there. Evidence: The infection control Nurse Specialist from Stoke On Trent Primary Care Trust accompanied us and carried out an audit of the service. The following improvements were noted The service has made improvements to the environment since we carried out the last inspection. Our requirements for improvements to infection control systems have been addressed as follows The Home were recruiting and specifically into the laundry staff and housekeeping team. The bed pan washers had been replaced with new machines. Personal Protective Equipment was in evidence in strategic places throughout the Home. All bins have been replaced with foot operated types in clinical areas. Care Homes for Older People Page 19 of 27 Evidence: Five hand hygiene sinks have been replaced in clinical areas and there is a planned programme to replace more. Some floor covering has been replaced and there are plans to replace more. A steam cleaner has been purchased Toilet brushes are still in use but are included in the cleaning schedule and there are replacements in the store so that they can be replaced as required. The manager Kath Barcroft told us that a refurbishment programme of the home is imminent. The nurse specialist said My detailed action plan was used as my guide to the visit today and the requirements had been completed or were on a planned programme for completion. The improvements clearly have to be sustained now. The Registered Manager Kath Barcroft and Regional Manager Steve Moore told us that a comprehensive refurbishment programme of the home is imminent. This is what people told us about their environment They come in every day to clean the room, very efficient They come in to clean the place every day from top to bottom They clean my bedroom daily. Its a very clean place Its cleaned every day while I am at breakfast I have seen the toilet cleaned twice a day Regarding the laundry service They come in with baskets, I get mine back, its all marked Laundry is very good, they come in every day, I get my clothes back In two years I have never lost anything, the staff are wonderful. They fetch it in the morning and its back the next day Once I got the wrong thing and my daughter took it back, I never got my missing item. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home are cared for by a staff team who have the skills required to meet their needs. Staff moral needs improving in order to create a team which is working together for the benefit of the people living in the home. Evidence: Staff are carefully selected to work for the service and there is a robust staff recruitment programme in place. This helps to ensure that people who live in the home are protected from harm and kept safe. There is a staff training and development programme in place. This helps to ensure that staff are equipped with the skills and training to meet the various needs of people who live in the home. Staff told us that they feel supported with their training needs and that the service is good at providing this. It was identified through examination of the off duty and workbook on the intermediate care unit that there had been a number of days when the unit had been left short staffed with 1 nurse and 3 carers instead of the required 4 carers. This Care Homes for Older People Page 21 of 27 Evidence: means that on these occassions peoples needs on this unit cannot be fully met. At the time of this unannounced inspection the service was adequately staffed on each unit throughout the home. Most of the people who live at the home and their visitors were very positive about the staff who work there. We received the following comments The staff are great, I am well looked after, sometimes I think they are too pushy in looking after me The carers are very good, I dont have any issues and if I did they would sort it out They are ever so nice, lovely girls However some of the people who live at the home and their visitors spoke of having to wait for long periods to have their call bell answered and for medication - one person told us I should have received my tablets at 9am but this person had still not received these at 10.30am. Also the service will need to be mindful of providing staff supervision to communal areas as these were often left unsupervised. Staff moral is quite low at the home and some staff feel that they are not listened to by the managers. This appears to be having a negative effect with some staff in the delivery of care. We observed that there was little or no interaction from some of the staff with the people they are caring for, yet others were fine. This was discussed with the managers during feedback. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and the home is run in the best interests of the people who live there. Evidence: The Registered Manager Kath Barcfoft was present throughout the two days and assisted us with our inspection. The Regional Manager was also present for both days and the Operations Director was present on the second day. The Manager has been responsible for making the necessary improvements in the home since the last inspection and has lead the Nursing and Care teams toward improving the outcomes for the people who live at the home. Kath has been the manager of this service for many years and she is supported by a deputy manager. Each unit has senior nurses with management responsibility. Care Homes for Older People Page 23 of 27 Evidence: We received mixed comments about the management style. From people who live at the home and some of the staff who work there they felt that the manager is approachable and that management is open and inclusive. However some staff felt that management is not open and inclusive and that their thoughts, concerns and suggestions are not listened to. Over the last few months the management of this service has needed to be strong and driven in order to achieve the necessary improvements for the people who live there. As a result of this some of the staff feel left by the wayside and somewhat forgotten. The managers will now need to focus on listening more to staff suggestions and improving staff moral in order to present a workforce which is focused and working together. This, in turn will help to continue with the improvements for the people who live at the home. The Quality Assurance programme has been further developed and action is taken to address areas of weakness identified during audits. This has helped to ensure that improvements continue to be made to the quality of the services provided. The service offers a secure facility for the safekeeping of monies and people who live at the home are able to use this facility if they wish. Relevant records, invoices and receipts are maintained in respect of pocket monies. This allows for an audit trail to be carried out easily if required. The manager is responsible for the overall health and safety of the people who live in the home and the staff who work there. Staff receive regular update training in areas of health and safety. People who live at the home are assessed as to their individual and collective health and safety needs. Risk assessments are carried out and reviewed monthly or more often as required. Environmental risk assessments are also undertaken to ensure that people live in a safe environment. The service complies with relevant health and safety legislation including those of the Environmental Health and Fire safety and where inspections have highlighted failings then these have been addressed by the manager. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 2 12 27 Social activities should be made more person centered and geared to meeting individual needs. The staffing arrangements should be reviewed on the intermediate Care Unit in order to ensure that there are enough staff at all times to meet the needs of people. The service should review the arrangements for staff supervision and monitoring of communal lounges to ensure that people are kept safe. The Registered Manager should improve the ethos of the home to ensure that there are strategies in place for enabling staff, people who live at the home and other stakeholders to affect the way in which the service is delivered. 3 27 4 32 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. 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