Care Home: Lyttleton House

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What the care home does well This home provides a comfortable, clean and very well maintained environment which is homely. One person who lives in the home told us, `It is a home from home, I am very comfortable here`. People are consulted so that their needs and preferences are known and care plans provide staff with relevant information so that they can provide the right support to each person. People are supported to receive appropriate health care and to follow a healthy lifestyle. People are protected by the home`s arrangements for the storage and administration of medication. People choose how they spend their days. There is a wide range of suitable activities. Visitors are welcomed to the home. There is a good variety of food and menus suit the people in the home. One relative told us, `The food is excellent, nutritional and varied`. There are good arrangements for handling complaints and comments and for protecting people who live in the home. There is a staff team made up of people who receive ongoing training so that they are competent. The manager is committed to maintaining high standards and making improvements where possible.One relative told us, `The staff are brilliant...They treat everyone as an individual, respecting their humour, needs and personality as well as ability`. The system for assuring the quality of the care takes account of people`s comments about the service they receive. What has improved since the last inspection? Since the last inspection there have been some improvements to the building including large screen televisions and new flooring in bedrooms. Some of the bedrooms have been decorated. A wall has been knocked down to create a larger lounge in one of the units. This has helped people to have a more pleasant and spacious environment. There have been recent improvements in the systems for the administration and recording of medication. There have been improvements in the arrangements for checking the medication and making sure that the right doses have been given. This helps to provide people with better protection. Staff have received further training in several areas relevant to their job, including the administration of medication. There have also been improvements in the arrangements for supervising staff and planning their training, so that they are better able to meet people`s needs. There is a greater range of activities for people and these are displayed on the notice board in the entrance area. There have been monthly meetings of the entertainments committee so that people are fully involved in planning the activities which suit their needs. The records of people`s individual needs are better organised and more detailed, so that staff are better informed about how to provide care which meets people`s needs and preferences. There are better arrangements for monitoring the quality of the service. The key indicators are displayed so that people can see what the home is aiming for in terms of performance. What the care home could do better: The manager has identified a need to continue to improve the standard of recording in people`s individual daily records and is planning to provide more training for staff in this area. This should help to make sure that there is improved monitoring of people`s progress. The manager is planning to develop further the system for monitoring and planning staff`s professional development so that they continue to be well supported to meet people`s needs. Key inspection report Care homes for older people Name: Address: Lyttleton House 1 Ormond Road Frankley Birmingham B45 0JD     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: Christine Lancashire     Date: 2 5 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 27 Information about the care home Name of care home: Address: Lyttleton House 1 Ormond Road Frankley Birmingham B45 0JD 01214601150 01214577302 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Notknown Birmingham City Council (S) care home 30 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: 30 The registered person may provide the following category of service only: Care Home Only (Code PC); 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) 30 Date of last inspection Brief description of the care home Lyttleton House is owned and managed by Birmingham City Council and is registered to provide care for 30 older adults who may have mild dementia. The building is a bungalow construction and divided into three separate units, each with their own dining area, kitchen and lounge. Facilities briefly include 30 single bedrooms, the majority of which are less than 10 square metres and therefore cannot contain all the items of furniture specified in the standards. Each bedroom has a call system. Care Homes for Older People Page 4 of 27 Over 65 30 0 Brief description of the care home There are a number of communal areas equipped with televisions, videos and music systems where people living at the home can socialise. The home is situated on a corner plot in a cul-de-sac. It has an open plan frontage with lawn, shrubs and flowers. There is level access to the front door and parking to the front and side of the property. Lyttleton House is located close to local shops and facilities, including public transport. Fees at the home are based on the financial assessment carried out by the social worker. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited this home on a weekday without telling anyone that we would be arriving. The purpose of the visit was to see how the home is meeting key National Minimum Standards and to make sure that the requirements made in previous reports have been addressed. We returned to complete the inspection two weeks later as we wanted to see if the new arrangements for recording medication were working and it was too early for us to tell at the first visit. Before the visit we had received a completed Annual Quality Assurance (AQAA) from the manager that gave details about the running of the home and the plans for development. This information arrived when we asked for it and it contained good detail. At the inspection we spoke to the manager, several members of the staff team and several people who live at the home. We also spoke with four relatives of people in the home. We sent questionnaire to ten people who live in the home, ten relatives, six members of staff and three professional visitors. We received the majority of these Care Homes for Older People Page 6 of 27 completed so that we were able to take the answers into account. We looked round the building and into several bedrooms. we chose three people who live in the home and looked at all the records which relate to them. This included looking at their assessments, care plans, daiy records and medication. We looked at the other records which the home is required to keep and these include records about safety, menus, staff rotas, medication, staff recruitment and training, complaints and minutes of meetings. We looked at the systems which the home has for monitoring its performance and at the results of questionnaires completed by people who live there. We used this information to write this report. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? Since the last inspection there have been some improvements to the building including large screen televisions and new flooring in bedrooms. Some of the bedrooms have been decorated. A wall has been knocked down to create a larger lounge in one of the units. This has helped people to have a more pleasant and spacious environment. There have been recent improvements in the systems for the administration and recording of medication. There have been improvements in the arrangements for checking the medication and making sure that the right doses have been given. This helps to provide people with better protection. Staff have received further training in several areas relevant to their job, including the administration of medication. There have also been improvements in the arrangements for supervising staff and planning their training, so that they are better able to meet peoples needs. There is a greater range of activities for people and these are displayed on the notice board in the entrance area. There have been monthly meetings of the entertainments Care Homes for Older People Page 8 of 27 committee so that people are fully involved in planning the activities which suit their needs. The records of peoples individual needs are better organised and more detailed, so that staff are better informed about how to provide care which meets peoples needs and preferences. There are better arrangements for monitoring the quality of the service. The key indicators are displayed so that people can see what the home is aiming for in terms of performance. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into this home are provided with the necessary information to make an informed choice. Assessments and visits to the home ensure that people know, before they move in, that their needs can be met by the home. Evidence: The home has a Statement of Purpose which contains relevant information describing the home and the services provided. We looked at this and saw that it has been updated during the past year and provides up to date information about the staff qualifications. There is also a service user guide which is given to all people moving in so that they can refer to it for information about how the home runs. We spoke to several people in the home and relatives. They confirmed that they had been provided with good information to enable them to make a choice about moving in. They had been provided with opportunities to visit the home and sample the atmosphere before Care Homes for Older People Page 11 of 27 Evidence: moving in. We sampled three files for people in the home. We saw that assessments of their needs had been carried out prior to them moving into the home, to make sure that the home could meet their needs. These assessments had been used to form the basis of the care plans which help the staff to know how to care for each person. This home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are set out in a care plan so that they can be met by staff. People are treated with respect and their privacy and dignity are maintained. They are protected by the homes practices in relation to the storage and administration of medication. Evidence: We sampled three peoples records and found that all contained plans for staff to follow giving details of how each person needs and prefers to be supported. We saw signatures to indicate that people had been involved in the preparation of these plans and had provided information about their preferences. This shows that people are consulted about how their care is provided. We saw risk assessments which cover relevant areas and the measures which staff need to take to make sure that each person is kept safe. Staff keep daily notes to show the progress which people are making. The manager has identified that some of these these could be improved and plans to provide additional training for staff in this area. The files which we examined contained details of peoples health and the support Care Homes for Older People Page 13 of 27 Evidence: needed from staff in this area. They also show contact details and records of visits to and from a range of health professionals such as nurses, chiropodists, dentists, opticians and physiotherapists. The medication currently prescribed is also listed. Changes made by the GP are recorded, For example, we saw that one person had recently been discharged from hospital and had a temporary change in medication which was clearly recorded. Each person has a health action plan, showing the measures which are taken to ensure that people maintain good health through healthy eating and exercise and the ways in which they are kept safe in the home. A pharmacy inspector carried out an inspection of the home in June 2009. This showed some areas in which improvement was needed to make sure that people would be fully protected by the practices in the home. At this inspection we checked to make sure that suitable action had been taken to make sure that the requirements and recommendations made in the pharmacists report had been met. We looked at the storage facilities for medication in the home, the records of medication which had been administered by staff and the records of medication which had been received into the home and returned to the pharmacy. We found that all of the shortfalls identified by the pharmacy inspector had been addressed and the home now has improved arrangements for making sure that all medication is administered in the right way at the right time. There are now daily and weekly checks on the medication and this helps to make sure that people are better protected by the homes practices. We saw that people in this home are helped to maintain a dignified appearance. People confirmed that staff take good care of their clothes. One relative told us, My mother is kept clean, they dress her nicely and put her jewels on her as they know she likes to dress up. There is a hairdressing salon in the home and a hairdresser visits at the weekends. There are plans to extend this service in the near future. The bathing facilities and WCs are large enough for staff to support people whilst maintaining their privacy. People told us that staff ask them how they like to be supported and take notice of what they say. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples lifestyles in the home match their preferences and suitable activities are arranged. They are encouraged to maintain significant relationships with people in the community and they receive a choice of nutritious meals which meet their needs and take account of their preferences. Evidence: We saw that the large notice board in the day room had details of a variety of activities on offer. These included card making, coffee mornings and visiting entertainers. The manager told us about outings to places of interest such as the Safari Park. People told us that they had recently enjoyed wearing hats to celebrate ladies day at Ascot. They had made decorated hats at Easter. On the day of the inspection, people were sitting out in the garden, singing. Staff had made sure that people were shaded from the hot sun. The garden is accessible from the living rooms and has raised beds, where people in the home are having a sunflower growing competition. Some people were enjoying a walk down a path around the garden. One person who lives in the home told us, There is always something to do, so you dont get bored. Staff told us that they are encouraged to bring ideas and skills to the home to vary the activities. Several people in the home showed us their knitting, which staff Care Homes for Older People Page 15 of 27 Evidence: had encouraged them to do. Another person was completing word puzzles. A professional visitor to the home told us that the staff are, very dedicated to stimulating people by offering various activities and days out. Staff told us that visitors may arrive at any time. We met several visitors on the day of the inspection and they all said that the staff made them welcome. One said, They keep me informed about things which happen to my mother and how she has been. Another told us, They take her to the shops and buy her clothes. We saw peoples signatures on their files, indicating that they had been consulted about a variety of aspects of their care, such as whether they want to be checked in the night. There are residents meetings and people are involved in reviews of their care. We saw staff encouraging people to chat in the small living rooms, by starting group discussion and making sure that people all had a chance to contribute. We looked at the menus and they show a choice at each meal. The meals are varied. Staff told us that the meals are prepared in the main kitchen and moved to the smaller serving kitchens in heated trolleys. Several people told us that they like the food. The records show that people are able to make choices and if they do not want the choices offered, they are provided with an alternative meal. We saw that peoples needs and preferences in terms of food are recorded in their plans. The choices which they have made are also recorded. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements to ensure that people are protected, including the arrangements for handling complaints. Evidence: The home has policies and procedures for handling complaints. The details of how to make a complaint are in the Statement of Purpose and service user guide to the home and are displayed around the home on notice boards. We spoke to several people who live in the home and to four relatives, who all confirmed that they would know how to make a complaint should the need arise. All expressed confidence that the manager would put things right should they bring anything to her attention. The manager informed us that there have been no formal complaints about the home since the last inspection. The home has investigated 6 complaints and responded to people within 28 days. Only one of these was upheld and action was taken to make sure that the problem was put right and could not happen again. We saw that the home has received many letters complimenting the staff team on the standard of care provided. There have been no issues regarding Adult Protection at the home, and the Manager stated they would refer to the Birmingham Multi Agency Guidelines for the Protection of Vulnerable Adults should an issue arise to ensure all the relevant authorities are notified. The training records show that staff have been trained in the protection of vulnerable adults. Care Homes for Older People Page 17 of 27 Evidence: There are standard procedures for the recruitment and selection of staff. These are robust and the appropriate checks are carried out prior to the person commencing employment. Criminal Records Bureau checks are renewed for staff every three years, in line with good practice. This provides protection for the people living at the home. We saw that people living at the home have access to their personal money and there is a system to monitor and record financial transactions for each resident, ensuring an accurate account is kept and enabling an audit trail to be maintained. These arrangements mean that people living in this home are well protected. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean and safe environment which meets their needs. Evidence: We toured the building and found that all areas looked clean and were free from unpleasant odours. Several people told us that they are pleased with the conditions and they liked their bedrooms. We looked at several bedrooms and found that they contained personal items and were individual in style to reflect the personalities and preferences of the people using them. There are no en-suite facilities available but wash hand basins are present in each bedroom, and bathroom and toilet facilities are close to the bedrooms. The home is on one level floor, with one large communal lounge where gatherings and shared activities take place. There are also small lounges and dining areas close to peoples bedrooms. These are very homely, with patterned wallpaper and fireplaces. People told us that they feel very comfortable in these areas. The garden is accessible and has furniture. There are paths, raised flower beds and seating areas in addition to the grass. Some people were sitting out singing on the day of the inspection and others were having a walk round the paths. Care Homes for Older People Page 19 of 27 Evidence: We saw procedures for making sure that infection is controlled. Staff are trained in this area and they confirmed that they have easy access to gloves and aprons when necessary. We saw that hand washing areas have liquid soap and paper towels. There are also instructions about how to reduce infection. The kitchen has received four stars from the Environmental Services, which indicates that there are good standards of hygiene. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home are cared for by sufficient numbers of staff who are well trained and competent to do their jobs. They are protected by the homes recruitment practices. Evidence: Staffing levels at the home are adequately maintained to meet the needs of the people living at the home. The rota was seen for the the month of the visit and this shows that there are four care staff plus a member of the management team on duty during the day. The manager told us that there have been no newly recruited staff recently because any vacancies have been filled by people from other homes which have been closed. Some of the people who responded to the survey told us that they were not sure if there were always enough staff. Others suggested that more staff would provide additional opportunities for people to go out with staff on an individual basis. The manager told us that each member of the senior management team has designated roles, senior carers are in charge of the units and the staff on those units. The Manager has overall responsibility for Lyttleton House, plus financial management, supervision of senior staff, staffing rotas and annual leave planning, health & safety, quality audits, and coordination of staff training. This means that the well being of the people living at the home is safeguarded by the clear lines of staff Care Homes for Older People Page 21 of 27 Evidence: accountability. When staff are recruited, there is a standard procedure which includes relevant checks including taking up references and checks through the Criminal Records Bureau. We sampled three staff files and saw that the relevant checks had been carried out prior to the staff member starting work at the home. New staff undergo an induction programme and work with a more experienced staff member until they feel confident to work on their own. The culture and gender mix of the staff team reflected the culture and gender mix of the people living at the home so that care is provided in an understanding way. From talking to staff and observing them during the day it was evident that staff are enthusiastic about their role. They told us that they are encouraged to have ideas about how the home can be improved and to use their skills to interact with and support the people living there. People who live in the home told us that the staff are good at meeting their needs. One told us, Nothing is too much trouble. A professional visitor to the home told us that staff are caring and attentive to needs. There are regular staff meetings so that staff are involved in and informed about plans and developments in the home. Staff told us that they feel that their ideas and opinions are valued by the managers. We looked at the staff training matrix and saw that all staff are provided with suitable training. Over 50 per cent of staff are trained to at least level 2 NVQ and others are completing this training. The manager told us that training is accessible. The matrix shows that staff receive refresher training in basic areas such as food hygiene. They also receive training in areas which help them to meet the specific needs of people living in the home. This means that staff can meet peoples needs. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home which is run in their best interests and where there are good systems for maintaining the quality of care. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. Evidence: The Manager has been in post for over a year and has made a number of improvements to the home. She has many years experience in health and social care and substantial management experience. The Manager is ably supported by the senior carers, and it was evident from talking to the manager and staff at all levels that they know the people living at the home very well, and have good knowledge of the individual care needs for each person, ensuring that a good standard of care is delivered. Staff told us that they feel well supported and supervised. Some acknowledged that there is uncertainty associated with the possibility of the impending closure of the home, but they stressed that they make great efforts to make sure that the people in Care Homes for Older People Page 23 of 27 Evidence: the home continue to feel safe and content. There are various methods of making sure that the standards at the home are maintained and areas of shortfall are identified and addressed. These include meetings of people in the home and staff, satisfaction surveys and visits from senior managers to report on the conduct of the home. The quality management system is based on the required standards. Auditors from outside the home annually complete various audits within the home and identify any issues that need improvement. People living at the home have access to their personal money, and there is a system to monitor and record financial transactions for each resident. This means that accurate accounts can be kept and enables an audit trail to be maintained. This provides protection for people living in the home. There is an annual plan for each staff member, and sessions take place monthly. The manager and staff told us that staff have the chance to discuss care issues, air any concerns they may have, gain feedback from their mentor and residents, and identify any training needs they may have. This further safeguards the people living at the home by ensuring that staff have the skills, knowledge and support they need to meet peoples needs. General arrangements for health and safety are good. Maintenance checks are carried out on schedule to ensure equipment is safe to use. Weekly tests of the fire alarm take place, and staff undertake fire drills. The manager provided us with the dates of the maintenance and servicing of equipment in the home. We checked a sample of these and found that they were accurate. We saw that staff complete reports of accidents involving residents and take appropriate action to ensure good outcomes for the person concerned. A falls report and accident audit are undertaken each month in order to reduce the risk of similar accidents occurring again. These measures mean that there are good arrangements to make sure that people who use the building are kept safe. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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