Care Home: Kingfishers Nursing Home

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What the care home does well Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. Detailed care plans have been produced for all people who use the service, and these inform the care staff what they must do to meet the needs of the individual. There is a motivated and established staff team that consists of nursing and care staff who respond to service users in a respectful and appropriate manner. The home provides a pleasant and comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. Communication between people who use the service and staff was observed to be positive and open. The provision of meals and mealtimes are of a high standard. There is a robust recruitment procedure in place that ensures service users are protected from harm. There is a good range of policies and procedures, providing staff with relevant information about all aspects of care and the home/organisation. Health and Safety procedures are thorough and records are well maintained. The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its What has improved since the last inspection? Daily notes are more detailed and show that the care given by staff is the same as noted in care plans, to ensure residents receive consistent, good quality care. Staff now receive regular formal supervision sessions and these are recorded, to ensure that staff are looking after residents in the best way possible. What the care home could do better: Staff`s practice in the recording, handling, safekeeping, safe administration and disposal of medicines in the home must be consistent. This is to ensure that the health and welfare of people using the service is not compromised. Key inspection report Care homes for older people Name: Address: Kingfishers Nursing Home Fieldhead Gardens Bourne End Buckinghamshire SL8 5RA     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: Barbara Mulligan     Date: 1 1 0 6 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 28 Information about the care home Name of care home: Address: Kingfishers Nursing Home Fieldhead Gardens Bourne End Buckinghamshire SL8 5RA 01628520020 01628524973 kingfisherscare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kingfisher Carehome Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 2. The maximum number of service users to be accommodated is 46. The registered person may provide the following category of service only: Care home with Nursing (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) Date of last inspection Brief description of the care home Kingfishers is a privately owned care home providing personal and nursing care to 43 older people. The home is situated in Bourne End, close to the shops and amenities of a small town. Marlow and the river Thames are a short drive away. The building dates back to 1904 and has been sympathetically restored and adapted for its current use. There are 25 single rooms and nine shared rooms. Many of the rooms have ensuite facilities. Access to the upper floors is via a passenger lift. The gardens are well maintained, attractive and easily accessible to older people. Care Homes for Older People Page 4 of 28 Over 65 46 0 Brief description of the care home Fees range from £650 to £850 per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 unannounced key inspection was conducted over the course of a day and covered all the key National Minimum Standards for older people. Prior to the visit, a detailed self-assessment questionnaire was sent to the registered manager for completion. Information received by the Commission since the last inspection was also taken into account. The inspector was Barbara Mulligan. The inspection consisted of discussion with the management of the home, discussion with other staff, opportunities to meet with some people who use the service, examination of some of the homes required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Twenty-eight of the National Minimum Standards for Older people were assessed Care Homes for Older People Page 6 of 28 during this visit. Standard 9 was assessed as almost met and standard 6 was assessed as not applicable. The remaining standards were assessed as fully met. As a result of the inspection the home has received one statutory requirement. Feedback on the inspection findings and areas needing improvement was given to the management of the home at the end of the inspection. The management of the home, the staff and service users are thanked for their cooperation and hospitality during this unannounced visit. Care Homes for Older People Page 7 of 28 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. Care Homes for Older People Page 8 of 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessment process works well and potential residents and their families have information about the home to help them decide whether their needs can be met, before they decide to move permanently. Evidence: Four completed needs assessments were examined, including those for people newly admitted to the home. Each file had a completed needs assessment and showed that all areas and conditions of people using the service were assessed prior to offering them a place in the home. Each assessment contains further information about the persons family and friends, likes, dislikes and preferences. We spoke with some people who were receiving a service at Kingfishers Nursing Home and/or their relative and they told us that they were given good information before they moved into the service. People told us that the information they received was sufficient, and that staff of Kingfishers Nursing Home and health and social care Care Homes for Older People Page 11 of 28 Evidence: professionals had explained to them the service that Kingfishers Nursing Home provides. One person said they had been able to bring their relative to visit the home and the staff had been very welcoming and answered all their questions. The assessment demonstrates that prospective service users, family members or representatives are included in the assessment process if this is appropriate. The home does not provide intermediate care, so this standard is not applicable. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the health, personal and social care needs of the residents, by developing good quality care plans and responding to their changing needs, as appropriate. Medication Staffs practice in the administration and recording of medication is not consistent and could pose a risk to peoples health and welfare. Evidence: The care of four residents; including those new to the service; were looked at and their care plans were examined. Care plans were up to date and contained sufficient detail for staff to learn about residents they support. Specific needs have been identified within the care plans and there is a detailed action plan in place to provide staff with the details of how these needs are to be managed and fully met. Individual preferences, likes and dislikes and reference to end of life care are recorded in care plans and describes how these will be met. Care Homes for Older People Page 13 of 28 Evidence: Visual observations of people using this service showed that people were smartly dressed including jewelery, make up and nail varnish, people were seen to be wearing the aids needed, for example hearing aids and clean glasses. The care plans show that that service users, family members or representatives are included in the care planning process. One comment received from a visiting relative was, Oh, yes I know what is in the care plan. I like to take part and be involved. Another visiting relative confirmed that the care plan had been explained to them. Daily notes are detailed and informative but some entries were difficult to read and this should be addressed. There is evidence that care plans are reviewed monthly. Comments received in the surveys about the care provided include, the carers and nurses are great and will help me with anything I need extra help with and staff always ask me if there is anything else they can do for me. Three comments were made about accessing toilets in the home. Comments made were everyone wants to go to the toilet at the same time and it is always a rush and the home needs more toilets and sometimes I have to wait to go to the toilet. This should be addressed by the home. Risk assessments are in place covering areas such as falls, moving and handling, wound assessment and pressure area care. These are up to date, signed and dated by the person completing the assessment. The inspector was told that all service users are registered with two local GP practice. Tissue viability assessments are in place for service users and these were seen to be reviewed on a monthly basis and pressure relieving equipment was seen in place for individuals who need it. The registered manager said a domiciliary optical service visits the home and service users receive an annual eye test and referrals for a hearing test go through the service users G.P. Two comments received by people using this service were made about hearing aids. Under the heading of what the home could do better comments made were the home could ensure my relatives hearing aid is always working and check the hearing aids more often. The home should address these concerns. Weight monitoring is undertaken on a monthly basis and recorded. This was evident in the four files examined. Chiropody services visit the home every six weeks. Records of health screening was noted in multi disciplinary notes and feedback received in the surveys was positive about how people access medical treatment and healthcare services. The procedures for the administration of medicines were examined during this inspection. At this visit we looked at the medication administration record (MAR) charts, medication supplies and care plans for the four people whose care was being Care Homes for Older People Page 14 of 28 Evidence: looked at as part of this inspection, and at the MAR charts for half of the people using this service. The home works closely with the local surgery and pharmacy to ensure an effective and safe medication administration system is operational. The pharmacist visits the home to look at medication administration procedures. The home uses controlled drugs, mainly for pain relief and these are properly stored and administered. The MAR charts show several hand written entries on them. One of these was difficult to read. When it is necessary to handwrite on a medication administration record chart in the home, the member of staff writing the chart should sign and date the chart and a second carer should check the entry for accuracy and then initial the chart. In addition the entry should include a reference to where this information was sourced, such as the prescribers name. All handwritten entires must be legible. There are some written guidelines for as required (PRN) homely remedies medicines. This needs to be in place for all as required (PRN) medicines and the home must implement a system to be put in place that ensures service users plans include guidelines for the administration of all when required/when needed medicines. These guidelines must include when the medicine is to be given and when it is not and include a strategy for when variable doses can be given. A requirement is issued for improvement in this area. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a range of activities available to residents who are encouraged and supported to remain in contact with their families and friends and to use local community facilities ensuring people do not become socially isolated. The presentation and standard of food is good and meets the nutritional needs of people who use the service. Evidence: Care plans show individual routines of daily living and include bathing, rising and retiring times. As part of the admission process, the home complete a section called knowing the person which is a life history of the individual which gives staff information about previous leisure pursuits, hobbies and other interests. The home employs an activities organiser and there is a range of activities which is displayed in the home. The activities include quizzes, book readings, exercise sessions, hand-care, bingo, movie days and one - to -one room visits for people who do not wish to join in the arranged activities or for people who are being nursed in bed. One comment received about the activities in the home was, the activities are very Care Homes for Older People Page 16 of 28 Evidence: good, especially Pat the Dog and a further comment made was I can do anything and I go out on outings to lunch, church, coffee mornings and the garden centre. The homes self-assessment tells us that special events held in the home have included a Summer garden party, celebrations of special birthday events, valentines day, mothers day, Christmas gatherings and other religious or traditional gatherings. There are photograph albums in the reception area of the home which shows photographs of special events held in the home. Involvement by local community groups includes the local church, the brownies, scouts and cubs, the local school and regular visits by the hairdressers and various visiting entertainers. There is a residents forum which is held every three months and service users relatives are now attending these. Minutes of these meetings are maintained and copies are available to see. One resident had requested a raised garden bed and this has been planted with flowers on the day of the visit. Two people who responded to the surveys said, When the weather is warm it would be nice if we could use the garden more and a relative said, I would like to see staff take people out to use the garden when it is warm. Service users are able to receive visitors in the privacy of their own rooms and are able to choose whom they see and do not see. One visiting relative said,the staff always make me feel welcome when I visit. Im even asked if I would like to eat and tea and biscuits are always on offer. Family and friends are invited to participate in some of the social events organised. On the day of the visit several relatives were visiting and supporting their relatives with lunch. Service users are offered three meals a day. The menu is rotated on a four weekly cycle. The inspector had the opportunity to observe a lunchtime meal in the main lounge where eight people were having their lunch. Three individuals were being supported by relatives with their meals. The meal was relaxed, unrushed and well organised. People were well supported by staff and the food was attractively presented. Some people chose to take their meals in their rooms on the day of the visit. Comments made about the food include, the food is lovely and I always have a choice and the food is good and the cakes are especially nice. A further comment received was, I would like to see more variety in the the vegetarian menu. One person siad, I would like to sit in my own chair and not be moved at dinner time. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are policies and procedures in place to protect people who use the service from harm and the home has an effective complaints procedure to ensure that people who use the service or their representatives are listened to. Evidence: The inspector examined the homes complaints procedure which illustrates timescales for responding to complaints. This is clear and accessible to service users and is available in large print. A summary of the complaints procedure is included in the Statement of Purpose and Service Users Guide. The registered manager said she welcomes any complaints or concerns and actively encourages residents and relatives to raise any issues they have at the earliest opportunity. The AQAA tells us that the home has not received any complaints. However one complaint has been received by the home between the return of the AQAA and the site visit. This has been responded to within the stated timescales, has been well recorded and resulted in a satisfactory outcome. A summary of the complaints procedure is included in the Statement of Purpose and Service Users Guide. People who responded to the surveys all said they knew how to make a complaint and who to complain to. Procedures are in place for safeguarding vulnerable adults (SOVA) and staff have access to a whistle blowing policy. The home has a copy of the local authority SOVA policy. Training records demonstrate that staff have completed Safeguarding training and this is regularly updated. The Annual Quality Assurance Assessment tells us that Care Homes for Older People Page 18 of 28 Evidence: there has not been any safe guarding referrals in the previous twelve months. The home has continued to keep the Commission informed of any safeguarding incidents. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is good, providing people who use the service with an attractive and homely place to live. Evidence: The home has a programme of refurbishment and redecoration. There is a system in place to address day-to-day maintenance issues, so that the safety of service users and staff is safeguarded. The fixtures and fittings are of a high quality, well maintained and adapted to meet the diverse needs of individuals. The internal decoration of the home is in good repair and well maintained. There are many personal touches around the home such as flowers, pictures, books and mirrors. A new wide screen television is now in place in the library with extra speakers on the other side of the room in order to make it easier for everybody to hear without the volume being too excessive. Service users are able to personalise their rooms and can use their own furniture if they wish. Fitted carpets have been laid in bedrooms that have recently been refurbished. One comment received in a survey, under the heading, what they could do better was improve the decor to my relatives bedroom and repair the damage to Care Homes for Older People Page 20 of 28 Evidence: bedroom furniture and carpets. Further comments made are the home is always kept clean and fresh and I love the fresh flowers on the table and I love having my own room. The kitchen is small but well ordered and clean, the bottom kitchen where the washing up and equipment is stored has recently been refurbished. The gardens are well maintained and accessible to people in wheelchairs. Several comments have been made about the garden; they could make more use of the garden on fine days and the home should provide more opportunities to sit in the garden with company. This should be addressed by the home. There are accessible toilets available for service users throughout the home and several are close to the lounges and dining area. However, several comments have been received about the length of time people wait to go to the toilet. One comment made in a survey was we need more toilets. This should be addressed by the home. Laundry facilities are sited so that soiled articles,clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on service users. The laundry floor finishes are impermeable and these and the wall finishes are readily cleanable. The home has recently received an independent audit on infection control and the outcome of this was positive. Planning permission for building works has been received to start later in the year to include a new laundry, hairdressing, staff room and a bigger training room. The shifting of the managers office to inside the main building and a walk-in shower room is part of the refurbishment plans. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers and skill mix is satisfactory and staff training is sufficient and up to date to ensure that people who use the service benefit from staff who are competent to do their job. Recruitment procedures are undertaken to ensure staff have the right skills and competencies to support the people who live there. Evidence: The homes staff rota demonstrates that there are adequate numbers and skill mix of staff on duty at all times. The manager confirmed that there were additional staff on duty at busy times of the day. The manager is supernumerary on the roster, allowing for flexibility during peak and holiday periods. The home employs bank staff to cover additional shifts so that the homes staff ratio is maintained. The care team are also supported by full time housekeeping laundry and catering teams. Service users spoken to on the day of the visit said that staff are very kind and always helpful and the staff are lovely. They will always do that bit more then they need to and I like having my own carer in my section to get me up. The home continues to support care staff on NVQ training and at the time of this inspection the percentage of care staff who have achieved a national vocational qualification in care has exceeded the 50 target as set out in the national minimum Care Homes for Older People Page 22 of 28 Evidence: standards. Other staff including housekeepers, catering and maintenance staff have also undertaken training to achieve national vocational qualifications. The recruitment files for four staff were examined, including those new to the service. These contain the necessary documentation as detailed in schedule 2. Staff files are kept in lockable filing cabinets in the managers office. All staff complete an induction programme that covers the common induction standards for social care and this was seen in the four files examined.During the initial induction to the home, which is a two week period, new staff are extra to the numbers on the staff rota and work alongside more experienced staff. Training records show that staff are up to date with their mandatory training. This includes moving and handling, fire, basic food hygiene and infection controltraining. There is specialist training available for staff, and an example of this is nutritional care, oral health, managing challenging behavior and dementia care. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed by a stable experienced management team and service users are protected by safe working practices ensuring the health and safety of people using the service. Evidence: The registered manager is Mrs. Orcilla Van Ec and she is a qualified general nurse with midwifery, psychiatry, primary health care, including pharmacology and a Bachelors degree in nursing administration. She has been in post since November 2007. The registered manager has completed the Registered Managers Award. The organisation & home has a clear and accountable management structure and the registered manager is supported by the organisation. The inspector noted good teamwork in progress and all the staff spoken to had a good working knowledge of the individual residents and their care needs. The organisations management system includes a quality assurance module which includes a satisfaction survey. These have been sent out and a summary of the results Care Homes for Older People Page 24 of 28 Evidence: have been collated and an action plan is to be drawn up to address any improvements needed. Regular residents forums are held three monthly. Senior managers from the organisation also undertake regular monitoring visits. Reports of these visits are kept at the home and are open to scrutiny. Service users are encouraged to look after their own financial affairs where at all possible. If this is not practicable then families will undertake this role. There are secure facilities available for the safe-keeping of money and valuables and record and receipts are kept of possessions left for safe keeping. There is a comprehensive health and safety policy in place and health and safety training is completed and up to date for all staff. Records were seen for fire safety. These cover the homes fire procedures, practice fire drills, fire prevention, fire alarm testing and emergency lighting testing. Testing of the homes fire alarm system is undertaken on a weekly basis and evidence was seen of this. There is a fire based risk assessment that is reviewed annually. Service reports are in place for PAT testing, gas appliances and electrical installation. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Staff practice in the recording, handling, safekeeping, safe administration and disposal of medicines in the home must be consistent. This is to ensure that people using the service health and welfare is not compromised. 30/06/2009 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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