Care Home: Kingsbury House

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What the care home does well The provider and new acting manager worked well with the Inspector, and `Expert by Experience`, and provided every assistance throughout the inspection. The home has a pleasant domestic atmosphere. Staff are polite, courteous and respectful. The `Expert by Experience` said that Kingsbury House is a friendly home and has an open atmosphere. They also said that a real effort is being made to improve the home and provide people and their relatives with a good experience. The `Expert by Experience` said that the quality of care provided at Kingsbury House is good. People and their representatives are encouraged to visit Kingsbury House before making a decision to accept a place at the home. This helps them to reach a decision about whether Kingsbury House will be able to meet their needs. A range of care plans have been devised for each person. These address people`s needs in a variety of areas such as mobility, nutrition and personal care. Monthly reviews are carried out. These arrangements help staff to be clear about how they should meet people`s needs. A range of preventative healthcare risk assessments have been completed. These help to ensure that people receive the healthcare support they require. The home is clean, hygienic and tidy. Staff are provided with a staff handbook and a Code of Practice. The provider employs an independent company to provide them with personnel and employment law advice. Staff receive regular work practice supervision. This helps to ensure that people are being cared for by staff who are properly supported and supervised. What has improved since the last inspection? A new acting manager has been appointed. Mrs Gallon provides strong leadership and has clear plans for improving the home. Some areas of the home have been refurbished in line with the home`s improvement plan. Improved cleaning routines and better quality care practices have eliminated unpleasant odours. The organisation and layout of the main office has improved. This helps to ensure that people are able to benefit from living in a clean and well maintained home that meets their needs. Improvements have been made to the way in which staff handle medicines. A new system for carrying out medication audits has been introduced and the process for assessing staff`s competency to administer medication is more robust. This helps to promotes people`s health and well-being. Mrs Gallon makes sure that any concerns arising within the home are reported to the Commission within 24 hours, and that where appropriate, relevant professionals are notified. This helps to ensure that people using the service are properly protected.Robust pre-employment checks are being carried out. This helps to ensure that only suitable staff are working at the home. A Welcome Pack has been introduced and the home`s Service User Guide has been reviewed and updated. This helps to provide new people with information about what they can expect once they move into the home A more in-depth induction training programme has been introduced. This helps to provide staff with the skills and knowledge they need to provide safe care. Regular staff and resident/relative meetings now take place. This will help staff and people using the service to become more involved in the day to day running of the home. What the care home could do better: Continue to make improvements to people`s care plans and make sure that Mental Capacity and Deprivation of Liberty assessments are carried out. This will help people to feel confident that staff will know how to meet their needs. Continue to make improvements to the premises in line with the provider`s improvement plan. This will help people to benefit from living in a well-maintained home that meets their needs. Make sure that fire prevention checks are carried out on a regular basis and written records kept. Make sure that workplace risk assessments are reviewed and updated on a regular basis. This will help to promote people`s health and well being. Continue to improve the home`s quality assurance systems. This will help to make sure that the home is being run in the best interests of the people using the service. Key inspection report Care homes for older people Name: Address: Kingsbury House 61-62 Percy Park Tynemouth North Shields Tyne & Wear NE30 4JX     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: Elizabeth Gaffney     Date: 2 2 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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 26 Information about the care home Name of care home: Address: Kingsbury House 61-62 Percy Park Tynemouth North Shields Tyne & Wear NE30 4JX 01912575121 01912575121 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Pamela Craig Dawson Name of registered manager (if applicable) Mrs Elizabeth Linda Gallon Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Kingsbury House consists of three converted terraced houses which have been adapted to provide care and support for 30 older people, some of whom may have dementia care needs. Nursing care is not provided. The home is close to the Tynemouth seafront and sea views can be enjoyed from some bedrooms. The home has a large lounge, a smaller quiet lounge and a spacious dining room. The home is located close to local transport links and street parking is available. Bedrooms are situated on the ground, first and second floor levels. Single room accommodation is offered throughout. Ensuite facilities are available in two bedrooms. Access to all floors is by way of a passenger lift. The weekly fee charged ranges from 379 to 410 pounds per week. A Care Homes for Older People Page 4 of 26 Over 65 9 21 0 0 Brief description of the care home service user guide and copies of Care Quality Commission inspection reports are available to help people decide whether the home can meet their needs. Care Homes for Older People Page 5 of 26 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 the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit we looked at: * Information we have received since the last key inspection visit on the 04 August 2009; Care Homes for Older People Page 6 of 26 * How the service dealt with any complaints and concerns since the last visit; * Any changes to how the home is run; * The acting managers view of how well they care for people. The views of people using the service and staff. An unannounced visit was made on the 20 April 2010. An Expert by Experience attended the inspection and consulted people about the quality of care they receive. The Expert by Experience spoke with most service users and three visiting relatives. Feedback from the Expert by Experience has been included throughout this report. During the inspection we: * Talked with the provider and acting manager; * Looked at information about the people who use the service and how well their needs are met; * Looked at other records which must be kept; * Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; * Looked around the building to make sure it was clean, safe and comfortable; * Checked what improvements have been made since the last visit. We told the provider and manager what we found. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? A new acting manager has been appointed. Mrs Gallon provides strong leadership and has clear plans for improving the home. Some areas of the home have been refurbished in line with the homes improvement plan. Improved cleaning routines and better quality care practices have eliminated unpleasant odours. The organisation and layout of the main office has improved. This helps to ensure that people are able to benefit from living in a clean and well maintained home that meets their needs. Improvements have been made to the way in which staff handle medicines. A new system for carrying out medication audits has been introduced and the process for assessing staffs competency to administer medication is more robust. This helps to promotes peoples health and well-being. Mrs Gallon makes sure that any concerns arising within the home are reported to the Commission within 24 hours, and that where appropriate, relevant professionals are notified. This helps to ensure that people using the service are properly protected. Care Homes for Older People Page 8 of 26 Robust pre-employment checks are being carried out. This helps to ensure that only suitable staff are working at the home. A Welcome Pack has been introduced and the homes Service User Guide has been reviewed and updated. This helps to provide new people with information about what they can expect once they move into the home A more in-depth induction training programme has been introduced. This helps to provide staff with the skills and knowledge they need to provide safe care. Regular staff and resident/relative meetings now take place. This will help staff and people using the service to become more involved in the day to day running of the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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. There are good arrangements for making sure that before people move into the home their needs are assessed by a relevant professional and they receive a written contract setting out what the home provides. This means that people know what to expect before they move into the home and can be confident that staff will know how to meet their needs. Evidence: The acting manager reported that peoples needs are assessed before a placement is offered at Kingsbury House. Copies of social services assessments are obtained so that an informed decision can be reached about whether a suitable placement can be provided. The acting manager has taken steps to make sure that each person has an up to date contract with the provider. Copies of local authority contracts have been obtained for each person where relevant. This helps to make sure that people have information Care Homes for Older People Page 11 of 26 Evidence: about what they can expect once they move into Kingsbury House. Care Homes for Older People Page 12 of 26 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. Good progress has been made with improving the quality of peoples care plans and the arrangements for handling peoples medication are good. This will help people to feel confident that staff will know how to meet their needs and keep them safe. Evidence: As part of the arrangements for improving the care and facilities provided at Kingsbury House, the provider has invested in a tailor made assessment and care plan package. This includes formats for carrying out preventative health care, Mental Capacity Act and Deprivation of Liberty assessments. At the time of the inspection, the new acting manager had completed one persons assessment and care plans using the new system. Whilst the new system is being introduced, the home will continue to make use of the current system in which every person has a range of care plans covering areas such as mobility, nutrition and personal care. The provider said that Mrs Gallon is in the process of reviewing all end of life information currently held for each person. A suitable format to record this information is available in the homes new assessment and care plan package. Peoples in-house care plans are generally Care Homes for Older People Page 13 of 26 Evidence: reviewed monthly. Mrs Gallon is in the process of arranging for each person to have a social services placement review. Staff are clear about how to meet peoples health care needs. Peoples records show that arrangements are made for them to receive regular dental, chiropody and optical healthcare. GP intervention is arranged when necessary. Staff have completed preventative health care risk assessments covering nutrition, skin care and falls management, for each person. Improvements have been made to the arrangements for handling peoples medication. The home has a controlled drugs cupboard to which only designated staff have access. Medicines requiring cold storage are stored in a dedicated lockable fridge. A predispensed monitored dosage system is used and staff said that the system works well. Peoples medication administration records are generally well completed. The medication trolley is kept secure, clean and hygienic. There has been one incident involving the mis-administration of medication since the last inspection. Mrs Gallon took appropriate action to prevent a further re-occurrence. Staff were observed administering medication in a safe and professional manner. People are supported to participate in day-to-day decision making about issues affecting their daily lives. For example, staff consult people about their meal choices on a daily basis. Resident and relative meetings are being held regularly and these help keep people up to date with what is happening within the home. Peoples care records contain information about their personal preferences regarding how they want to be cared for. Mrs Gallon is in the process of completing an assessment of each persons capacity to make key decisions about matters affecting their daily lives. Carrying out these assessments will help staff to be clear about the decisions that each person can make for themselves and in what areas they might need help and support. The majority of staff have completed training in implementing the Mental Capacity Act and Deprivation of Liberty Regulations. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements for providing people with access to social activities within the home have improved and peoples contact with their relatives is positively supported by staff. Although people generally receive a good diet, the organisation of meal times and the choices available could be improved. Evidence: Information about peoples social interests and hobbies is obtained before their admission into Kingsbury House. Peoples care records contain a social history which helps staff to understand their life experiences before they moved into the home. A social needs care plan has been devised for each person and these are reviewed each month. The new acting manager is in the process of developing person centred activity plans for people with dementia care needs. The Expert by Experience praised the effort made by staff to provide people with opportunities to engage in social activities. The Expert by Experience said that two group activities took place during their visit. The morning activity involved a musical bingo session and armchair exercises took place in the afternoon. The new acting manager reported that people are asked whether they would like to join in a particular Care Homes for Older People Page 15 of 26 Evidence: activity before it begins. A social activity programme is available and provides details of what is on offer and on what day. People told the Expert by Experience that they had watched a film the day before which they had enjoyed. People also spoke about the chef who provides opportunities to take part in flower arranging and cookery sessions. The Expert by Experience also reported that staff support one resident to attend a club which they frequented before they moved into the home. Mrs Gallon reported that another service user is taken to a local jazz club and that people go out with staff support in line with their personal interests. The home has a rotating four-week menu which details what food will be provided at main meal times. However, the menu does not include adequate details of meals served. Although the menu does not confirm that a hot choice is available at the evening meal, Mrs Gallon confirmed that a hot choice alternative can be provided on request. The inspector joined people for their lunchtime meal. There was a friendly and unhurried atmosphere in the dining area. Staff provided sensitive and caring support. The meal served was tasty, nutritious and of a good standard. It was nicely presented with good portion sizes. Mrs Gallon is in the process of reviewing what steps need to be taken to improve peoples dining experience. The Expert by Experience reported that the dining room is light and airy, and the tables have tablecloths and fresh flowers. They confirmed that people are asked midmorning to make a choice about which of the two main courses they would prefer at lunchtime. Feedback from in-house quality satisfaction surveys showed that people are generally happy with the quality of food provided at the home. However, one person told the Expert by Experience that ...although the food is very good there is not much variety. Care Homes for Older People Page 16 of 26 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 appropriate arrangements for managing complaints and protecting peoples welfare. This means that people can be confident that they are being cared for by staff who will take appropriate action to keep them safe and listen to their concerns. Evidence: The providers complaints procedure is displayed in each bedroom so that people using the service, and their families, know who to complain to and how to make a complaint. The procedure is also included in the homes service user guide. Three complaints have been received since the new acting manager took over. Mrs Gallon has handled these concerns appropriately. There has been one safeguarding concern since the last inspection. The concerns raised have been handled under the local authoritys safeguarding procedures. The provider reviewed the concerns that led to the safeguarding referral being made and took appropriate action to address these matters. All staff have completed safeguarding training and are clear about how any safeguarding concerns will be handled. The homes safeguarding policy has been updated to take account of recent legislative changes. Mrs Gallon works with the local council to help support the delivery of basic safeguarding awareness training. Care Homes for Older People Page 17 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are being made to the home which demonstrate that the provider is committed to improving the premises. This will help to make sure that people are able to benefit from living in a home which is well-maintained. Evidence: The home provides a physical environment that generally meets the needs of the people who live there. The home is comfortable, warm, well lit and clean. However, the decor in some areas of the home is in an unsatisfactory condition and some fittings and furniture are in need of replacement. The provider has prepared an improvement plan which sets what improvements will be made and within what timescales. Some areas of the home have already been refurbished to a high standard and further refurbishment work is currently underway. Six bedrooms have been completely stripped out and re-decoration commenced. As part of the refurbishment works, consideration has been given to how the premises can be made dementia friendly. Each person has their own bedroom but only two have private en-suite facilities. People can personalise their bedrooms if they wish. Toilets are appropriately located within the home, they are easily accessible and available in sufficient numbers. People have access to a range of aids and adaptations such as hoisting equipment and assisted bathing facilities. Additional aids and adaptations are being provided in all toilets and bathrooms as part of the refurbishment. Care Homes for Older People Page 18 of 26 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. Appropriate pre-employment checks are carried out and staff receive the supervision and training they need to do their job. This means that people can be confident that they will be cared for by safe staff who are appropriately supervised, supported and trained. Evidence: There is a rota that shows which staff are on duty and at what times. The rotas show that there are always a minimum of three staff on duty between 8am and 10pm to care for up to 30 people. A senior member of staff is available on each shift. The level of staffing provided means that staff are able to make sure that peoples needs are met. Carers said that the homes staffing levels are satisfactory. The new acting managers hours are supernumerary, providing time for management duties to be carried out. Although the hours worked by Mrs Gallon are not recorded on the homes rota, discussions held with the provider indicated that she works a minimum of 45 hours per week Monday through to Sunday. Mrs Gallon said that she works whatever hours are needed to make sure that the home runs well. Two staff cover the night-time period. Domestic and catering staffing levels are satisfactory. A check of the rota showed that one member of had worked 73 hours in one week. Mrs Gallon said that this was not the homes normal practice and the Care Homes for Older People Page 19 of 26 Evidence: situation had been addressed. The Expert by Experience said that staff are pleasant, capable and treat people with respect. They reported that after coming on duty, a member of staff took time to speak with each individual resident. The Expert by Experience described how staff supported a person to transfer in a dignified and sensitive manner whilst using the hoist. A relative told the Expert by Experience that ...the care here is exceptional. Another relative said ...Im impressed with the care here. The Expert by Experience commented that staff are happy working at the home and the atmosphere is friendly and open. A range of pre-employment checks are carried out before staff can start working at the home. For example, personnel files contain confirmation that staffs identities have been checked. Criminal Record Certificates have been obtained for each worker and staff have been asked to supply a statement confirming whether they have any convictions or cautions. Staff are required to complete an application form and undergo a selection interview. Staff receive regular supervision which they said they value. All staff have received at least one supervision session since Mrs Gallon started at the home. Appropriate written records are being kept of these sessions. Over 69 per cent of the care team have obtained a relevant qualification in social care. Staff have completed their mandatory training which covers first aid, health and safety, food hygiene, moving and handling, infection control and fire safety. Staff said that they are provided with the training they need to do their job. A new member of staff said that she had been provided with an induction and arrangements had been made for them to complete their mandatory training. They also said they had had the opportunity to shadow more experienced staff as part of their induction training. However, this person described how she had been shown how to move people using a lift which is no longer in use. Mrs Gallon said that this matter would be addressed immediately. Arrangements have been made for three new staff to complete training in the Common Induction Standards. Care Homes for Older People Page 20 of 26 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. Peoples health and safety is protected and the arrangements for monitoring the quality of care and services they receive have improved. This means that people can feel confident that the home is being run in their best interests and staff will know how to keep them safe. Evidence: The new acting manager holds the Registered Managers Award, has substantial experience of meeting the needs of older people within a residential setting and has previously achieved registration with the Care Quality Commission (CQC). Mrs Gallon regularly updates her mandatory training to ensure that her practice is up to date. Although the home does not presently have a registered manager, Mrs Gallon is in the process of submitting an application to register with the CQC. Mrs Gallon said that she feels well supported by the provider who visits the home on a regular basis. The arrangements for handling peoples money have improved under Mrs Gallon. A record is kept of any money received into the home and of all transactions carried out Care Homes for Older People Page 21 of 26 Evidence: on peoples behalf. Good financial records are kept and regular audits take place. Two staff signatures are obtained for all relevant financial transactions involving peoples money. Receipts are obtained for all purchases. Following the last inspection, the provider has improved the information held about the management of peoples money. However, individualised care plans addressing the support that each persons needs with the day to day management of their money have not been completed. The building is maintained in a safe condition. The home has current gas and electrical safety certificates. Moving and handling equipment is regularly checked. Health and safety audits are carried out to make sure that the building is safe for people to live in. There is an up to date fire risk assessment. However, there are some gaps in the homes fire prevention safety records. Immediate action was taken to address this concern and the homes records were updated. Although a range of workplace risk assessments have been carried out these have not been updated for over 12 months. Mrs Gallon has already identified this an issue and has plans in place to review and update the homes work place risk assessments. The arrangements for monitoring the quality of care provided at the home have improved. The provider carries out regular monitoring visits and produces a written report. Service users, relatives and staff have completed satisfaction surveys and the outcomes have been analysed to make them easier to understand and act upon. Regular resident and relative meetings now take place and attendees are encouraged to make suggestions about how the home could be improved. Audit tools have been introduced to enable health and safety and medication checks to be carried out. Mrs Gallon and the provider have devised a detailed action plan which sets out what improvements need to be made, who will make them and within what timescales. Care Homes for Older People Page 22 of 26 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 26 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 10 15 Carry out assessments of peoples capacity to make key decisions affecting their daily lives. Make sure that: * Menus include specific details of the food served at each meal time; * Condiments are available for peoples use at meal times. 3 4 27 33 Make sure that the hours worked by the acting manager are detailed on the homes rotas. Make sure that the in-house quality assurance systems enable the provider and acting manager to assess the homes performance against the National Minimum Standards and Care Home Regulations. Make sure that each person has a support plan and/or financial profile in place that covers the following: * What the person needs to pay for; * How their money and valuables will be made secure; 5 36 Care Homes for Older People Page 24 of 26 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 * Whether they have been assessed as competent to manage their own money and financial affairs; * Whether advocacy input is needed. A risk assessment of their money management skills should also be completed. 6 7 38 38 Review and update the homes work place risk assessments at least every 12 months. Make sure that the required fire safety checks are carried out at the frequency specified by the local fire service. Care Homes for Older People Page 25 of 26 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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