Care Home: Hornegarth House Nursing Home

What the care home does well Hornegarth House provides a safe and caring environment where staff offer support and assistance to our clients whilst promoting their individuality and independence. We take on board suggestions and feed back in order to provide continual improvement of our service provision. Provide the residents with more opportunities to go on outings, and have a varied programme of activities. The home is closely involved with the local community. What has improved since the last inspection? The home has continued the refurbishment program in the bedrooms and main lounge areas. The manager wishes to continue with the Dementia Strategy currently in place ans she would like to increase the emphasis on the YTT training and staff to be come more proficient in care provision in this area. Updated all staff personnel and training files What the care home could do better: The home could improve in the following areas - Monitor the quality of personal care through clinical supervision. - Include communication as a need in the care plans Obtain relatives signatures on care records. Key inspection report Care homes for older people Name: Address: Hornegarth House Nursing Home 204 Walsall Road Great Wyrley Walsall West Midlands WS6 6NQ     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: Joanna Wooller     Date: 2 3 0 9 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 25 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) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Hornegarth House Nursing Home 204 Walsall Road Great Wyrley Walsall West Midlands WS6 6NQ 01922701702 01922411115 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Ltd Name of registered manager (if applicable) Mrs Elizabeth Clewer Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 45. The registered person may provide personal care with nursing and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories:- mental disorder excluding learning disability or dementia, MD, 45; dementia, DE, 45. Date of last inspection Brief description of the care home Hornegarth House offers nursing care to 42 people with mental health problems and long-term mental illness. The home has 38 bedrooms with en-suite facilities. There are 34 single bedrooms and Care Homes for Older People Page 4 of 25 Over 65 0 0 45 45 Brief description of the care home 4 double bedrooms. The home promotes and encourages full community involvement. The home is situated within a thriving village on a bus route between Walsall and Cannock. It is within easy walking distance of the main Stafford to Birmingham railway line. This purpose built home has wide corridors and ramps for easy access by wheelchair users. The home is on two levels and has access via the stairs or a passenger lift. There are two lounges, a large dining room and a conservatory. A secure garden is planted out with bushes and plants and has seating. Many recreational and diversional activities are carried out daily and this is displayed on the notice boards and in the homes Newsletter. Care Homes for Older People Page 5 of 25 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 star. This means that that people who use this service experience good quality outcomes. This unannounced inspection took place on 23rd September 2009 by one inspector over one day. The inspector was joined by an Expert by Experience. The Manager was in the home and participated in the inspection process. The inspection included the following elements, a walk around the building, observation and inspection of records relating to provision of care, discussions with people, who use the service, case tracking whereby we select several people who use the service, chat to them and look at their care plans and lifestyle in the home. discussions with several of the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health and safety. Care Homes for Older People Page 6 of 25 We were made welcome in the home and all assistance was given to gain the evidence required for the report. We had dealt with one verbal complaints since the last inspection and this has now been resolved. People who use the service were very complimentary about the service and the care their relatives received. The home manager sent us their annual quality assurance assessment (AQAA) when we asked for it. This document was completed to a good standard and gave us all the information we asked for. A comment by the Expert by Experience Hornegarth in my opinion is lovely place for these ladies and gents to live. The accommodation is homely, spotlessly clean and has a welcoming feel to it. There is plenty to do and keep the ladies and gents stimulated and occupied if wanted. Equally, the staff are clearly supportive of residents who choose to or are not able to participate in all the activities that are on offer. All of the staff that I spent time with were committed, hardworking, friendly and respectful. They genuinely cared for and kept safe, the residents in their care. All staff were open and totally unguarded in their conversations with me. Great attention is given to individual needs and choices of the ladies and gents living there. I witnessed many, many, inclusive and genuine, caring behaviours. The relatives that I had the time to speak with all spoke highly of Hornegarth, its facilities and the staff that cared for their relatives. I would like to thank the staff at Hornegarth for their hospitality and generosity of spirit. The pleasure was genuinely all mine. The fee information available applied at the time of the inspection; persons may wish to obtain more up to date information from the service. Care Homes for Older People Page 7 of 25 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 25 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 25 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 moving into the home do so having had their needs fully assessed and assurances are given that they will be met. The home does not have any intermediate care places. Evidence: The Aqaa told us Southern Cross as a group hold a comprehensive range of information to assist in the delivery of care. We ensure at all times that a needs assessment has been completed by a trained member of staff on consultation with perspective residents and their advocate. Potential service users are able to visit the home prior to their admission if required, we fully support any trial visit in order to make the transition to our home a positive experience. We saw that people moving in to the home had received a full pre-admission assessment by the manager or deputy manager, this assured all those involved that the individuals needs can be met. We saw that the assessment covered all necessary Care Homes for Older People Page 10 of 25 Evidence: information, allowing the assessor to make an informed decision about the suitability of the placement. We spoke to several relatives that informed us about the assessment process and how they were involved. One man told us A full assessment was carried out by the manager prior to admission. Lots of personal details were discussed and recorded. Care Homes for Older People Page 11 of 25 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 who use the service each have an individual plan care which sets out their health, personal and social needs. The health care needs of the people are met and they are protected by the homes medication policies and procedures. Individuals living at the home are treated with respect and their right to privacy is upheld. Evidence: The Aqaa told us We provide residents, relatives and staff with the care and support needed to ensure each individual in our care maintains their independence, individuality and dignity. Respecting at all times the residents privacy and choices. We saw that the care plans were hand written and generally informative. They were person centered which evidenced their current individual needs, however the review process was less informative and in some cases repetitive which did not evidence their current state of health or any outcomes being met. Through case tracking we identified that not all needs were identified in the plan. Care Homes for Older People Page 12 of 25 Evidence: Communication is one need, which was overlooked, and this is an essential need for the people with mental illness. We saw that care plans were signed by the assessing nurse but not by the relatives or next of kin. These must be signed to ensure the care needs are being agreed. Care reviews with social workers were being held at regular intervals and these were signed by all those involved. The home has weekly visits from the local general practitioners, the practice nurse and other professionals. On the day of this inspection the practice nurse was administering flu vaccinations supported by the nurse and they were evidenced to have a good working relationship. We evidenced records of individuals that had received medical interventions and appointments with external health professionals. Hospital admissions and outpatient appointments were documented in the plan. We evidenced that medication was being stored correctly. The manager had recently had a medication audit by the dispensing pharmacy with excellent feedback. Staff that administer medicines in the home have their competencies monitored by the manager as part of the trained nurse supervision process and regular training and updates are carried out. People who use the service where witnessed to be treated with respect by the carers and other staff in the home. They were approached quietly and at their level. They were asked if they would like to move to the dining room at lunch time and which drinks they would prefer. Staff was seen knocking on bedroom doors prior to entering. One relative told us The staff treat my wife and myself with great respect, they are compassionate to my wife and very attentive. She has her health needs met and the staff inform me of any changes. One lady told us The staff are very professional, we can talk to the manager and senior staff when we need to, they make time for us. Care Homes for Older People Page 13 of 25 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 who use the service experience the lifestyle, which matches their individual expectations. They have contact with relatives and friends as they wish. People who use the service exercise choice and control over their lives and they receive a balance and wholesome diet. Evidence: The Aqaa told us Activities programme run by one staff member over 5 days a week. Fund raising for residents comfort fund. Visitations from relatives and friends, maintaining local community links for all in our care. We also maximise residents capacity to exercise their personal autonomy and choice. We also continue to provide a varied, appealing, wholesome and nutritious diet suited to the individual needs and requirements. Weekly outings to the local amenities such as local pub, restaurant and park for a variety of residents. Outings to entertainment such as Walsall Lights, Fire Station, Narrow Boat Cruise & Prince of Wales Theatre arranged. We saw that the staff interacted well with the people living in the service. They spoke to them at their level, usually sitting next to them and asking them to choose what they wanted to do. During the day visitors came to the home at varying times and Care Homes for Older People Page 14 of 25 Evidence: were seen to be welcomed by the staff and offered a drink. The Expert by Experience that accompanied us on the visit observed meal times and activities and she told us The dining room is spacious with a lovely bright conservatory area at that rear. The tables were well spaced, giving both dignified privacy between tables and ample access for wheelchairs without the risk of bumping anyone or making any unsafe manoeuvres when accessing the table. The tables were set with cutlery and in all it looked a pleasant environment in which to dine. Lunch smelled delicious. It was pleasing to see the unobtrusive assistance that was provided to the residents and the transfer to the dining room was a relatively quiet affair considering the registration category. I have to say that the care staff who were on duty were extremely busy but nothing appeared to be too much trouble for them. I particularly liked the fact that when offering a choice of lunch to each resident, the staff asked whether they would prefer chicken, vegetables, mash and maybe or maybe not gravy, or cauliflower and broccoli cheese bake and or chips or mash and then proceeded to show each person the choices plated up so that they had a visual choice. Clearly the staff at Hornegarth have undertaken training in dementia care and act on their training. She also told us I sat in the other lounge and observed the comings and goings, having been offered a further cup of tea. Two carers in particular circulated the room, chatting, sitting with or attending to each resident. One lady who was visiting her mum was keen to tell me the staff are so kind and work very hard to keep Mum happy. She is very well cared for here. In fact we are very well looked after here and my Mum loves it in her own way. Even visitors are treated as if we are part of an extended family. She said There is plenty to keep the residents occupied here if they want to but if they dont want they can do their own thing such as watch the TV. They do wonderful things such as summer fetes and trips out, even parties and there is always someone to talk to. She and another relative both said that they felt that the most important thing for relatives was that the staff always listened and took time to make sure the residents were safe and well. Photos depicting previous trips and event and an activity choice list were on another notice board as well as a Menu board in large legible text further along the corridor. It was a pleasure to notice immediately that there were 4 care staff assisting residents and chatting in the adjoining corridor area. A radio and singing could be heard emanating from a room further along (the dining room). It was a delight to hear, unguarded, friendly chat between staff and resident. Care Homes for Older People Page 15 of 25 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 use the service are confident that their complaints will be listened to and acted upon. People who use the service are protected from abuse. Evidence: The Aqaa told us Apart from having a robust complaints procedure that is on display in the homes reception area, all complaints are monitored at directorate level and answered within agreed timescales. The Home Manager engages in an open door policy encouraging residents, relatives and staff to utilise when ever the need arises. Also the manager holds regular staff meetings and family meetings. The manager is confident that people who use the service will complain if they wish to and she appreciates their input to improve the standards in the home. Two safeguarding issues had been raised and dealt with by social services with positive outcomes of the reviews. The staff spoken to was fully aware of the whistleblowing policy and the action to be taken. We saw that staff had received suitable abuse training and vulnerable adults updates. People who use the service told us that they could raise concerns or complain and that they were confident that the staff would deal with it correctly. One man spoken to said The staff are great but if I had a problem I would speak the manager and she would sort things out. Care Homes for Older People Page 16 of 25 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 who use the service live in a safe, well-maintained environment that is clean, pleasant and hygienic. Evidence: The Aqaa told us Our Dementia Unit provides our residents with an environment that is colourful, light & airy, touch and smell sensitive that stimulates residents senses. The outside space is also a focus that enhances the residents wellbeing. We saw that the home was very clean, tidy and free from any odour. The housekeeping team work with the care staff to ensure that any spills are dealt with quickly and rooms are kept looking nice. Some bedrooms were personalised with the individuals possessions which families had brought in to assist the person to settle in to the home. Bedroom doors were painted in a variety of bright colours to assist the individuals to recognise their own room. One corridor in the home is painted like a country lane to stimulate the individuals and make it more interesting. We saw that the soft furnishings in the home were of good standard. Some beds could have been dressed slightly better with the use of valances, but this was being arranged by the senior housekeeper. Other beds were finished with bed throws on them and cushions, which was nice to see. Ensuite toilets and sinks were clean and tidy. Communal lounge chairs are to be replaced in the near future to aid the peoples comfort and improve the overall appearance. Care Homes for Older People Page 17 of 25 Evidence: The home had recently had a outbreak of a skin condition which caused the home to be closed to visitors for a couple of days whilst treatments were given. This has now been fully cleared and the home have been praised by professionals in their management of the situation. No other infection control issues were noted or brought to our attention. Staff had sufficient protective clothing available to ensure good hygiene standards are maintained. One man told us One of the reasons I chose the home was due to the standard of cleanliness when I came to see it, the home is always clean and tidy when I visit. Obviously people have accidents with drinks and things but the staff are quick to clean up the individual and the environment. One lady told me The home is warm and inviting and I always feel that it is clean and tidy. The manager is always walking around making sure its tidy. The Expert by experience told us The home had a lovely stimulating environment. Painted scenic murals of birds in trees and of a variety of buildings, adorned the corridor walls. Further murals were situated on entry to each of them, for example Fireside Grove, Memory Lane and Sycamore Grove. I also noted with pleasure several tactile areas on the corridor wall such as a panel measuring about 3 ft by 4 ft covered in door knobs and handles of every age and description and a further panel with various fabrics, some textured or fluffy, others recognisably familiar in terms of design and historical appropriateness for example obvious 30s through to 60s and 70s fabrics. I witnessed these panels being used frequently by passing residents. These handles and knobs were polished twisted and pulled many times and were a great source of stimulation. The fabric panel was stroked and touched, or just stared at. There was even a live post box inserted into the wall. The post office does not actively empty the letterbox but the staff do, more importantly the post box acts as a stimulus and is a normalisation feature so rarely seen in other facilities. The manager was very proud of these features and the amount of attention they attract from the ladies and gents living here. Care Homes for Older People Page 18 of 25 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 are in safe hands and have their needs met by the numbers and skill mix of staff. People who use the service are supported and protected by the homes recruitment policy and procedure. The staff are now trained and competent to do their jobs. Evidence: The Aqaa told us Staff rotas are compiled by the Deputy Manager, ensuring the correct number and level of staff are on duty for the dependency levels of our residents. We provide all necessary equipment for staff to be competent in their delivery of care to the high standard and safe service. We ensure that all staff employed have the required checks such as CRB, references and POVA returned and cleared prior to their commencement of employment. We also deliver a robust induction strategy following Common Induction Standards framework. From our observations during the inspection and by speaking to people in the home we found that staff are provided in adequate numbers. We looked at three staff files to check recruitment processes and these we found to be in order which is good, as it means that people who use the service are not placed at risk by staff being employed without proper checks being carried out. We saw that all staff are POVA trained and the manager is proud of the fact that large Care Homes for Older People Page 19 of 25 Evidence: amounts of staff who are NVQ trained. The staff have regular supervisions which is documented on the supervisions list. We saw the training matrix plan. This was a computerised document that highlighted when individual training was due or out of date. This training is monitored by head office and targets have to be met by the managers. The staff told us about all the training they had completed and how it had improved the staff morale and working environment. We saw that nurse specialists for infection control, wound care and continence have all visited the home and updated the staff. One relative spoken to said Most of the staff she had dealt with were knowledgeable and professional. She went on to say that the staff were interested in the people who live at the home and showed compassion toward them. The expert by experience told us Hornegarth gives an instant feeling of warmth, homeliness and inclusivity. There was a lot of chatting and interactive banter with the ladies and gents that were being supported, in the corridor, dining room and two lounge areas further along. It was so refreshing to see that none of the residents were being talked over or ignored. Four staff approached me, within 15 minutes of arriving, introduced themselves, quite naturally, along with the person that they were assisting. They each asked me who I was and if I would like a drink. Care Homes for Older People Page 20 of 25 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. People who use the service live in a home, which is well managed by a responsible manager. The home is run in the best interests of the people who live in it.People who use the service have their finances safeguarded by the homes procedures. The health, safety and welfare of people who use the service and the staff are promoted and protected. Evidence: The Aqaa told us Our qualified team with many years experience in both management and administration are providing residents at Hornegarth House with an effective service to suit their individuality, thus meeting their needs. We saw that the home manager is professional and efficient. She holds a key position within the home and is the focal point for all enquiries. All the teams employed at the home are now committed to their work and are working together to create a good home for the benefit of the people living in it. Care Homes for Older People Page 21 of 25 Evidence: The managers management approach is firm but fair and she knows where she wants the home to progress to. She expects the people who use the service to receive good care and attention and she is planning to develop the monitoring of the staff through clinical supervision. Through issues that were raised when dealing with one complaint, the manager plans to check the quality of personal care being given in the home. Quality Assurance issues have been reassessed at the home and relative feedback is used rather than formal questionnaires at present. We received positive feedback from people who use the service, relatives and staff. The manager ensures that she is available for people who use the service and their relatives and she has open door management policy. She plans meetings for staff, people who use the service and relatives. Health and safety checks were made and recorded appropriately. The maintenance person monitors all the checks, and reports to the manager with faults or repairs. We saw that the staff training given ensured that the staff were competent in manual handling, first aid, fire safety, food hygiene and infection control. The accident book was seen and the care manager reviews this and it is audited by head office. We saw that risk Assessments were in place in the care records and formed the basis of daily living and choices. Care Homes for Older People Page 22 of 25 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 23 of 25 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 7 15 The care plans should be agreed and signed by the individual or their representative. This process reviews that the care being delivered is suitable and effective for the individual. 28/10/2009 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 8 Communication care plans should be introduced for all individuals in the home to demonstrate that their needs are being met holistically. Clinical supervision is to be given and monitored to ensure that staff carry out personal care as per the policy and procedures set down by the company. 2 36 Care Homes for Older People Page 24 of 25 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. 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