Care Home: Langdale Nursing Home

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What the care home does well This is a newly registered service. Mr Tariq Majeed has re registered as a limited company. However we have previous knowledge of the home when owned by Mr Majeed as sole owner and when the last Key Inspection was completed on the 5th August 2009 the overall rating was adequate. People`s care needs are properly assessed and they are given the opportunity to stay at the home before they move in permanently. This helps them make an informed decision about whether Langdale Nursing home is the right place for them to live. People living in the home, their relatives and visitors, told us they were happy with the care in the home, comments included. "I feel the care here is good and the staff caring and conscientious" " Nothing is too much trouble here, if I ask for something to be done I don`t have to think of it again" "Langdale is a small concern and it benefits from this. There is an intimacy and friendliness between the very good staff team (under the excellent leadership of Mr Majeed) and the care of the patients is both professional and loving" "I think the size of the home makes it more like a family home and the staff are well known to us and always make us feel welcome" The owner has put into place an acting manager Mr Umar Majeed and has proceeded with an application to register this manager with the Care Quality Commission. What has improved since the last inspection? People`s care plans have improved to reflect people`s care needs and the nursing staff have followed the recommendations to use a more detailed critical care plan for people with high dependency needs. People living in the home and their relatives told us that the home cares for them well, they told us, "The staff are very special and are the sort that can`t do enough for the people they care for" "This is a lovely family home I have been coming here for many years and always found the staff to be dependable and caring" In response to the previous inspection the home has made sure that the staff have received the right training to make sure they work safely in the home and this includes further training in safeguarding to make sure that people are kept safe from harm. There is a clear record of complaints held in the home. This details any concerns raised and what action has been taken There is also a "comments book", that is kept near the front door to encourage suggestions from people who live at the home, their relatives and visitors. Staff working at the home are safely recruited and the proper checks are completed to make sure that people are kept safe from harm. Staff told us that they had the right training and that they are supported to do their jobs well. They told us, "I have had my induction, safeguarding training and the other staff have been really helpful helping me get to know how people liked to be cared for." Staff tell us that they have regular supervision and that staff meetings are held. This makes sure that staff work consistently in meeting people`s needs. What the care home could do better: Activities at the home do need to be planned and organised better to give people enough opportunities and choices to lead a fulfilling life. People must be given more activities and choices through leisure and recreation in and outside the home which suit their needs, preferences and capacities. Health and safety must be closely monitored to make sure that the home is always safe. The practice of wedging open doors including the kitchen and the medication room must cease. This compromises the safety and well being of people living at the home, staff and visitors. The registration of the manager with the Care Quality Commission has been an area of concern for some time. The acting manager informs us that he has submitted an application. It is hoped that this will be completed in the near future and will provide continuity and stability to the home. Key inspection report Care homes for older people Name: Address: Langdale Nursing Home 233 Keighley Road Cowling near Keighley North Yorkshire BD22 0AA     The quality rating for this care home is:   one star adequate 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: Linda Trenouth     Date: 1 6 0 6 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Langdale Nursing Home 233 Keighley Road Cowling near Keighley North Yorkshire BD22 0AA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Caring Partners Limited Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 18. The registered person may provide the following category of service only: Care home with nursing:Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories:Old age, not falling within any other category: Code OP. Date of last inspection Brief description of the care home Langdale care home provides nursing care and accommodation for up to eighteen people who are over the age of 65 years. This is a newly registered service. Mr Tariq Majeed has re registered as a limited company. However we have previous knowledge of the home when owned by Mr Majeed as sole owner. The last key inspection was completed on the 5th August 2009 and the overall rating was adequate. Care Homes for Older People Page 4 of 30 Over 65 18 0 Brief description of the care home The property is a converted bungalow, which is situated in a small village on the border of Keighley. It has open views of countryside from the rear of the building. There is a small garden area to the front of the house and private parking for staff and visitors. People who live at the home would need transport to take advantage of the facilities and amenities of the village or the local towns of Colne, Skipton and Keighley. On the 16th June 2010 the fees were between £475.00 (residential) to £525.00 (nursing) , this amount is dependent upon income and savings. The Care Quality Commission reports are available in the home for anyone to read. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 one star adequate service. This means that people who use the service experience adequate quality outcomes. The Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This is how we gathered information to write this report. We looked at information we have received about the home since it was registered. We looked at information which is requested prior to an inspection, this is called an annual quality assurance assessment (AQAA). We also sent surveys to people who live at the home and people living at the home and to the staff. Care Homes for Older People Page 6 of 30 One inspector visited the home unannounced. This visit lasted six hours and included talking to the acting manager Mr Umar Majeed and the staff about their work and checking some of the records and procedures. We also spent time talking with people who live at the home and their relatives. We looked at three peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people who use the service. The site visit took place on the 16th June 2010. The acting manager was available to assist throughout the visit and available for feedback at the end of the day. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? Peoples care plans have improved to reflect peoples care needs and the nursing staff have followed the recommendations to use a more detailed critical care plan for people with high dependency needs. People living in the home and their relatives told us that the home cares for them well, they told us, The staff are very special and are the sort that cant do enough for the people they care for This is a lovely family home I have been coming here for many years and always found the staff to be dependable and caring In response to the previous inspection the home has made sure that the staff have received the right training to make sure they work safely in the home and this includes further training in safeguarding to make sure that people are kept safe from harm. There is a clear record of complaints held in the home. This details any concerns raised and what action has been taken There is also a comments book, that is kept near the front door to encourage suggestions from people who live at the home, their relatives Care Homes for Older People Page 8 of 30 and visitors. Staff working at the home are safely recruited and the proper checks are completed to make sure that people are kept safe from harm. Staff told us that they had the right training and that they are supported to do their jobs well. They told us, I have had my induction, safeguarding training and the other staff have been really helpful helping me get to know how people liked to be cared for. Staff tell us that they have regular supervision and that staff meetings are held. This makes sure that staff work consistently in meeting peoples needs. 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 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are properly assessed prior to admission this makes sure that Langdale Nursing Home is the right place for them to live. Evidence: The senior nurse on duty and the acting manager were both present during the site visit and they confirmed that information is made available to anyone interested in moving into the home in the form of a brochure. There had been two new admissions recently into the home and their relatives confirmed that they were encouraged to look around the home before they moved in. They also confirmed that they were given good information about the services the home can provide. This is important so that they have all the information to decide if the home is right for them. Three peoples care records were reviewed. Of these, two individuals had recently Care Homes for Older People Page 11 of 30 Evidence: been admitted to the home. These care records were looked at in detail and it was evident that good procedures were in place. Thorough assessments were carried out before people moved into the home and these contained details of peoples daily life and health needs. The information included health and risk assessments with good information detailing personal histories. This information was regularly updated and developed depending on peoples individual needs. Peoples files held copies of terms and conditions or contracts. All of the files seen held contracts in them that had been agreed and signed by people living at the home or their representative. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met. Evidence: Three peoples care records were looked at to make sure that a care plan had been formulated. The care plans help staff provide support to people according to their needs and wishes. It was evident that peoples health care needs were recorded in their individual care plans. Care plans included good detail and descriptions about how a person wished to be supported with their personal care. The care plans also included details such as risk assessments, health checks, weight and moving and handling assessments. Risk assessments help identify potential risks to people, this helps the staff to put into place arrangements which may minimise risk. One individual told me that she was aware of her care plan but did not necessarily want to be involved with it, she felt very happy that she was being cared for in the way she chose. Care Homes for Older People Page 13 of 30 Evidence: During the visit a relative said, We are always kept informed and if there are any changes or concerns the staff tell us when we come in or contact us if it is urgent. People are registered with a local General Practitioner (GP). Other health care professionals are involved with peoples health care needs such as the Chiropodist, Optician and District Nurses. The home works well with the local health care professionals and seeks advice in areas such as continence and pressure care. Where advice is given this is then included into the care plan to ensure a consistent approach to meet peoples needs. Peoples health care needs were promoted and maintained. The care plans reflected any changes to health care needs and how these needs would be met. The home operates a monitored dosage system. There is a policy in place for the storage and administration of medication for all staff working in the home to follow. The Medication Administration Records show that everyone receives their medication as prescribed. Records were up to date and well maintained. Medication seen in the home was securely stored in a locked drugs cabinet. Controlled drugs held were stored appropriately and records were maintained as required. All staff that administer medication in the home have been provided with medication training. Discussions were held with the senior nurse about medication not being held securely. Concerns were raised about the medication door being held open throughout the visit. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a comfortable life at the home but more work needs to be done to ensure they have stimulating activities that suit their individual needs. Evidence: The AQAA told us, We have held two major events and an open day and a charity event for Haiti which had an excellent turnout and raised a lot of money for the charity And We have created a dedicated Activities room and have got staff more Involved in co-ordinating these. Utilised the second lounge more as a dining area to get service users to come out of their rooms more. We were told that people who live at Langdale have the opportunity to participate in some activities such as playing board games, floor exercises, walking and reading. The senior nurse also said that a lot of time was spent sitting talking to people reminiscing about the past, people also had a lot of one to one with activities such as manicures. There did not appear to be a set programme although the manager said that peoples individual activities were displayed in their rooms. There were also photos displayed in Care Homes for Older People Page 15 of 30 Evidence: the activities room of floor games being enjoyed. The manager said that they do not tend to do group activities but look at the individual and what they would like to do. We did not however find evidence of this in individual care plans. People must be given more activities and opportunities through leisure and recreational in and outside the home which suit their needs, preferences and capacities. There were many visitors who came to the home including two volunteers who visited weekly and talked to everyone during their visit. The local church held communion at the home regularly and the hairdresser held her, salon, every fortnight. Although on the day of the visit, there were no activities taking place. The senior nurse said there had been an open day at Christmas and they hoped to plan more events where everyone can be involved. During the visit we talked to and observed people who live at the home, it was evident that the home was relaxed and informal. People did not feel that routines impeded their day, I can do what I want whenever I wish, I can get up early or lie in One relative said The place is always friendly and relaxed, the staff couldnt be more helpful, they bring you a drink and have a chat. Mealtimes were discussed with the acting manager and cook. Menus seen were rotational. Menus seen were varied, and nutritionally balanced. The chef told us that the home caters for people with special diets such as those with soft diets and diabetes. People are given a choice of nutritious drinks and meals when they request them. The menu was displayed in the entrance area of the home, but staff said they talked to people about the menus choice individually as some people prefer to spend time in their rooms People have choices at breakfast, cereal toast or hot food, and at teatime they are offered a cooked meal or sandwiches or a salad at teatime. The main cooked meal is at lunchtime. Care Homes for Older People Page 16 of 30 Evidence: One relative told us, My aunt never ate properly when she was at home, now she may not have a big appetite but she eats regularly and looks very well on it The food choices are good nothing is too much trouble Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to an effective complaints procedure and are well protected from harm by staff safeguarding training. Evidence: The homes complaints procedure is followed and is made available to people as it is on display in the entrance of the home. The AQAA says, We handle and address complaints in an efficient and sensitive manner. All points are addressed individually and in detail. We protect the Service Users rights and take every complaint seriously no matter how small it maybe. The home records any complaints they receive. The complaints log was seen which recorded complaints received by the home and the action taken. One complaint has been sent to the CQC since the last visit and has been investigated by the owner of the home. Some of the areas were founded, all the areas have now been addressed. We spoke to people who live at the home and their relatives who were clear as to whom they would speak if they had any concerns or worries. People told us they knew how to make a complaint. Care Homes for Older People Page 18 of 30 Evidence: There is a policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse, the staff demonstrated a good awareness of this. All staff have received training in adult protection and safeguarding issues during induction training and all but the new staff have completed further training in safeguarding since the last inspection. There has been one allegation regarding safeguarding which is being reviewed by the care management team. The acting manager said that they hold in safe keeping monies on behalf of one individual in the home. The records were reviewed and a recommendation was made that this format be further developed. The document needs to clearly show the incoming and outgoing monies and the required signatures, to make sure that the information is transparent and clear. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable home and areas have been improved with some redecoration and re-refurbishment. This has enhanced the quality of life for people living at the home. Evidence: The home provides accommodation for people that is based on two floors. The building is a bungalow and has been extended over the years and now provides accommodation on the ground floor and lower ground floors. The accommodation includes a choice of two sitting areas with a dining area. At the last visit the inspector recommended that the office moved to a different location. This was to give people a more relaxed and comfortable lounge area. This has now been completed successfully and has improved the quality of the environment for everyone. Peoples bedrooms were seen. They had been personalized with all their possessions. People living at the home told us in their surveys that the home is always fresh and clean the home is continually refurbishing areas and has redecorated two bathrooms in the home. There are sufficient toilets and bathrooms to meet the needs of people living at the home. The home was clean in all of the communal areas, the kitchen was also clean Care Homes for Older People Page 20 of 30 Evidence: and everywhere was free from odours. The owner said that the lounge on the ground floor had been re decorated. The carpets throughout the home in the communal areas have been replaced which has improved those areas in the home. The AQQA said As well as the new sluice room. We have created a new activities room which is an extension Of the upper lounge room. New office has been created for the manager which is central to the home. This was as a result of feedback from the inspector in the last visit. Medicine room has been decorated and new flooring installed. Laundry room has been redecorated. Common areas and some of the individual bedrooms redecorated. New furnishing in the upper lounge as well as new dining tables. Upper bathroom has been refurbished and a new bathroom suite added. Less clutter around the home. Removed and replaced some of the old and tired furniture A sluice disinfector has now been installed and was in good working order at the time of the visit. One new washing machine had been purchased for the laundry, the home now has three washers. Staff confirmed that all the equipment was in good working order. It was observed that some doors were being wedged open, this included the kitchen and medication room doors. The kitchen door had a broken magnet catch, but it was clearly practice that the doors were being habitually held back. The medication room door was also held back by a chair. The staff must ensure that doors are closed when they are fire doors or areas of high risk. Staff are provided with protective clothing, which helps to reduce the risk from cross infection. Disposal aprons and gloves seen in the home. There was anti bacterial hand wash around the home for staff and visitors to use. There is a small garden with table and chairs with a small car park to the front of the home. There is a seated area with bench at the side of the home for people to sit in the better weather. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are safely recruited, well supported and in sufficient numbers to ensure that peoples needs are safely met. Evidence: Staffing levels were sufficient for meeting the needs of people. The duty rota showed that there are usually three members of staff on duty both in a morning and afternoon. There is one trained staff and two carers on duty throughout the day. The home also employs ancillary staff which includes a domestic and Chef. New staff have been recruited including a new RGN and two carers. The home has also appointed a handyman. The files were reviewed of two new members of staff. Appropriate recruitment procedures are followed, with references and Criminal Records Bureau (CRB) checks made to reduce the risk of unsuitable people working in the home. The staff files included application forms, references, proof of identity and confirmation of employment. The home has a training matrix in place for all the staff working at the home which Care Homes for Older People Page 22 of 30 Evidence: confirms when staff had undertaken training. Records of staff supervision were seen for one staff member which showed that they had regular individual supervision. Staff meetings are held more regularly and the last meeting was in May 2010. The National Vocation Qualification Level 2 (NVQ) training has been completed by eight staff at the home, with NVQ Level 3 completed by two staff. There are two further staff registered on NVQ Level 2. Staff tell us , I like working here, everyone has been very welcoming and extremely helpful I think the home has improved, I feel a lot happier because things are being done now The most important thing is the care of the people here and we are proud of the way we care, we feel well supported and have meetings with the manager to look at our work Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home would be better served by a registered manager who provides consistent and continuous support to the home. Evidence: The home does not currently have a registered manager. The acting manager said that he has now put forward an application to be a Registered Manager to the Care Quality Commission (CQC). The acting manager has a degree in Business Management and is registered on the Leadership and Management course which replaces the old Registered Managers Award (RMA). This course commences in September 2010. It has been a concern that there has not been a registered manager at the home for sometime, it is positive to note that the owner has taken steps towards the registration. The staff tell us, the manager is always around and it is easier to get things sorted out, he is open to suggestions Care Homes for Older People Page 24 of 30 Evidence: and the relatives say, The manager is very approachable he gets things done A range of Health and Safety records were looked at. All were up to date with the exception of the fire training. The acting manager stated that the fire training has now been organised with an independent company who service their fire systems. The acting manager informed us that the fire officer has recently visited and raised some concerns about areas of fire safety and fire training in the home. These are currently being addressed. This also addressed staff fire safety training and awareness of evacuation in a fire. There is also a habitual practice of doors being held open by wedges or other implements. This practice must cease, negotiation with the fire officer must be made with suitable door holders to ensure that the safety of the home is not compromised. The atmosphere in the home was relaxed and informal, the management of the home is open and positive. People spoken to who use the service, relatives and staff all commented positively about the home. A range of other records were seen from care plan, health and safety records to medication records were also up to date. Improvements have been made since the last inspection to the care records, staff support and the environment. Peoples finances were reviewed and a recommendation was made to re look at the way in which the transactions are recorded and verified. Quality Assurance systems are in place. The owner of the home visits the home regularly and provides a monthly report a copy of which is sent to the CQC. Relatives said, This is such a good home, I have been coming here for many years and cannot fault the care and wonderful staff The manager is very approachable he gets things done My Dad has the best care, he is so well looked after by a dedicated and conscientious team of people Care Homes for Older People Page 25 of 30 Evidence: Very happy with care received, all staff friendly and welcoming. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The medication must be safely stored. To make sure that peoples health needs are met safely. 30/07/2010 2 31 9 There must be a registered manager to provide consistent support and management of the home. This is to make sure that the home is run in the best interests of people living at the home. 30/09/2010 3 38 23 There must be satisfactory arrangements in plave to make sure staff have the right fire training and fire doors must not be held open. This is to make sure people are always kept safe. 26/06/2010 Care Homes for Older People Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 The home needs to develop and plan activities for individuals to ensure they have choices and opportunities to live a fulfilling life. The financial transactions forms should be developed to give clear and accurate information of each transaction, including signatures to confirm receipt of monies. 2 18 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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