Care Home: Manor House Residential Home

What the care home does well The staff at the home were friendly and welcoming. Some comments received from visitors include, " The staff are always friendly and willing to help", and "All levels of staff seem caring towards the residents". Most people that were able to told us they had received enough information about the home before moving in. People can visit before they make a decision. The home`s Statement of Purpose gives people information about what to expect of the service. The person most recently admitted had had a pre-admission assessment completed and there are good admission procedures in place to allow the person to feel at home. Visitors to the home are made welcome, offered refreshments and kept up to date with developments Complaints are generally handled well. People`s concerns are listened to and people told us that the home responds appropriately when concerns are raised. The home has good systems in place with regard to staff recruitment, this ensures people are looked after by suitable people. What has improved since the last inspection? At the last inspection six requirements were made. Five of these have been addressed and improvements made. Namely they were issues regarding risk assessments, medication, and several aspects of health & safety. The call bell system throughout the home has been renewed and updated which will ensure that people will be able to call when help is required. Many areas of the home have been redecorated and new carpets fitted. A bathroom has also been updated and a new hoist fitted. What the care home could do better: There is concern about the detail of information in plans of care. Assessments are not always being updated where changes have taken place and the detail in care plans and risk assessments do not describe how individual needs are to be met. Without good quality information that is reviewed and changed to take into account peoples changing needs, the quality and consistency of care could be compromised. Some aspects of the management of medicines must be addressed so that practices are safe and people`s wellbeing is assured. Improvements are needed to ensure that peoples` social and leisure needs are met and recorded, especially those with limited capacity or specialist needs. People could be better enabled to take control over their daily lives and make decisions about where and how they spend their day. The food provided needs to be improved to ensure that people get a good quality meal suited to their individual needs. All staff must be appropriately trained so that they can properly meet the needs of the people they are caring for, including traing in the proctection of vulnerable adults. The re decoration and refurbishment of the home must continue to ensure the home is kept safe and comfortable for the people living there. Several untoward incidents have occurred at the home and have not been reported to the Commission nor recorded properly. The home looks after the personal monies for two people; these must be kept up to date and accurate. Several areas in respect of Health & Safety ( Fire) have been identified and pose a risk to people living in the home. Key inspection report Care homes for older people Name: Address: Manor House Residential Home 21 Manor Road Torquay Devon TQ1 3JX     The quality rating for this care home is:   zero star poor 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: Caroline Rowland-Lapwood     Date: 2 9 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 31 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 31 Information about the care home Name of care home: Address: Manor House Residential Home 21 Manor Road Torquay Devon TQ1 3JX 01803312759 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Manor.house@hotmail.co.uk Mr Richard Conway Name of registered manager (if applicable) Mr Richard Conway Type of registration: Number of places registered: care home 14 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 14 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Manor House offers accommodation with personal care to older people 65 both male and female. The home is registered to provide a service for up to 14 residents. Manor House has 14 single bedrooms 9 of which have en suite facilities. In terms of communal space, the home offers a T.V. lounge, quiet lounge and a dining room. It also has communal assisted bathrooms and toilets. To the rear of the building there is an accessible courtyard style garden with seating provided. A gate is available from the Care Homes for Older People Page 4 of 31 Over 65 14 0 Brief description of the care home garden into the local park from the rear of the home. It is located in the St. Marychurch area of Torquay and offers level access to the local shopping precinct and has good public transport links to Torquay and Newton Abbot. The weekly cost of care at Manor House ranges between £330 and £350 per week. To find out the current costs the home should be contacted. Care Homes for Older People Page 5 of 31 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: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place as part of the normal programme of inspection. It was undertaken by one inspector and an Expert by Experience over two days, ( the Expert for only one of those). During the visit to the home we (the Commission) spoke with or observed the majority of people living here. We looked closely at the care, services and accommodation offered to 3 people living here. This is called case tracking and helps us to make a judgment about the standard of care overall. It also helps us to understand the experiences of people living here. We looked at the care and attention given by staff to these people and we looked at their assessments and at their care planning records. We looked at the environment in relation to their needs and how their health and personal care needs are met. We also spoke with visitors to the home, with staff and with the owners. We visited the Care Homes for Older People Page 6 of 31 majority of bedrooms and saw all service and communal areas of the home. We looked at records relating to accidents and incidents, staff training, staff recruitment, medication and some policies. Prior to the inspection the owners sent us their Annual Quality Assurance Assessment (AQAA) which gave us information about the home and its management and about the needs of the people living here. This document asks for evidence in relation to what the home does well and what they think they can improve upon. We sent surveys to people living here, asking for feedback and comments 3 were returned. We also sent surveys to staff and 1 was returned, and to health and social care professionals who visit the home and none were returned. Feedback and comments are included in the report. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: There is concern about the detail of information in plans of care. Assessments are not always being updated where changes have taken place and the detail in care plans and risk assessments do not describe how individual needs are to be met. Without good quality information that is reviewed and changed to take into account peoples changing needs, the quality and consistency of care could be compromised. Some aspects of the management of medicines must be addressed so that practices are safe and peoples wellbeing is assured. Improvements are needed to ensure that peoples social and leisure needs are met and recorded, especially those with limited capacity or specialist needs. People could be better enabled to take control over their daily lives and make decisions about where and how they spend their day. The food provided needs to be improved to ensure that people get a good quality meal suited to their individual needs. All staff must be appropriately trained so that they can properly meet the needs of the Care Homes for Older People Page 8 of 31 people they are caring for, including traing in the proctection of vulnerable adults. The re decoration and refurbishment of the home must continue to ensure the home is kept safe and comfortable for the people living there. Several untoward incidents have occurred at the home and have not been reported to the Commission nor recorded properly. The home looks after the personal monies for two people; these must be kept up to date and accurate. Several areas in respect of Health & Safety ( Fire) have been identified and pose a risk to people living in the home. 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 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure is good and means that staff has enough information to decide whether they are able to meet the needs of the person. Evidence: There is a guide to the home, the Statement of Purpose, which gives people an idea of what to expect of the home. People returning CQC surveys told us they had received enough information about this home before they moved in, helping to ensure it was the right place for them. Surveys from relatives show that the home always or usually give people the support expected and agreed. Peoples comments were mixed some people were happy at the home two others said they were not, for example, some comments made to the expert by experience include, Its alright here, On the whole I am very satisfied here, Its much better with the new owners now and Its fine here,but I am easy to please. Care Homes for Older People Page 11 of 31 Evidence: The home uses an assessment as a way of getting information about peoples needs and preferences before they move to the home. This helps to ensure that individual needs can be met. We looked at two assessments, both gave good information about peoples abilities, needs, usual routines and preferences to enable staff to plan and deliver care appropriately. The home does not provide intermediate care. Care Homes for Older People Page 12 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care people receive is provided in a respectful and helpful way. The care planning systems at the home are inadequate, they do not reflect how health and personal care needs are to be met in a safe way, improvements are needed to ensure people get the care they need. The management of medicines is satisfactory, however one aspect identified must be improved to ensure peoples safety. Evidence: One person responding to CQC surveys told us they usually received the care and support they need. People spoke with were generally happy with the care provided, one said, I am happy here, another told us, Its alright here. Several people were unable to tell us about the care they received. One relative responding to our survey felt that their relative always received the support they needed, another relative spoken with said they were happy with care. We looked at the care planned for three people with complex and changing needs. Care Homes for Older People Page 13 of 31 Evidence: One persons care plan indicated that they were sometimes aggressive and abusive which staff confirmed saying that they sometimes kicked off. No advice has been recorded as to how to manage this behaviour. Another care plan we looked at recorded that the person had diabetes and required a sugar free diet, however there was no other guidance for staff to follow with regard to this condition nor were there any care planned for risks associated with diabetes such as good feet and nail care. When asked one member of staff said they looked after this person and they had no special care and that they Ate normally, just not pudding. We asked the cook about a special diet she confirmed that they had sugar free jelly or a normal pudding Just without the cream. This is not meeting the needs of a person requiring a sugar free diet.The same person had also recently had a bout of diarrhoea, there was a note in the daily care notes but no care plan was in place with regard to this and no infection control measures were in place. Care plans had not always been reviewed to reflect changing needs for example one persons daily notes showed that they were had been visited by the GP and had been given antibiotics, no mention was made about this in the care plan other than a record of the doctors visit. Basic manual handling plans are in place but lacked detail about things, which might affect moving people safely, for example where they may be confused. Care plans need further development, which includes consultation, regular reviews and updating and staff must be aware of their content. We saw evidence that outside professionals, such as GP, nurse specialists, chiropodist and optician are involved in peoples care. We looked at how the home manages medication. We found that the Controlled Drug book was well documented, accurate and up to date. Staff told us how they carry out the medication round. The medication was kept securely in a cupboard. We were told that no one self medicates but when we found tablets for pain relief and migraine not labeled in the cupboard, we were told that a person living at the home had bought them and they were for them to use. If a person is unable to self medicate and a risk assessment has been completed to confirm this, any other condition for which medication is needed must be supplied via the GP. A homely remedies policy should show what medication is acceptable other than this. Care plans do not state how peoples dignity is maintained through their appearance, although one member of staff said they tried to involve people in choosing their daily Care Homes for Older People Page 14 of 31 Evidence: clothes. On the day of the inspection, generally peoples clothes looked clean and appropriate. Many bathrooms or toilets do have not have paper towels and instead have domestic hand towels this is poor practice in the prevention of infection control. Care Homes for Older People Page 15 of 31 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. Whilst there are some activities, and good contact with family and friends, social and leisure needs are not well organised and do not provide regular stimulation for people to ensure that their individual needs are met. People could be better enabled to exercise a full range of choices or take control over their daily lives. The food provided is adequate but needs improvement to ensure it meets the needs of all the people living at the home. Evidence: We looked at three care plans and the activities log for each person. We saw some personal stories detailing peoples lives and what interests and hobbies however this did not match what activities were provided individually for them. Two people told us they would like to get out more but there was no evidence to suggest this had taken place. One persons care plan stated he liked to go out 3-4 times a week but when we spoke to them it seemed they had not been out at all recently. The Manager and the Senior Carer along with their other duties undertake the task of organising the activities. There is a diary showing past activities and whilst in some weeks several events took place there were spells (including nearly a whole month) when nothing was recorded. The plan is said to be for twice monthly trips using a people carrier to take a maximum of 4 people to local viewpoints or nearby resorts. There are also Ad Care Homes for Older People Page 16 of 31 Evidence: Hoc opportunities for trips to local shops and supermarkets. The diary shows that a professional activity person visited earlier in the year with small animals and last year there was a visit from a donkey. Quizzes, seasonal craftwork, drawing, painting and exercises etc. takes place from time to time. Some activities are undertaken on a one to one basis. The intention for the future is to publish a set timetable of activities. The Vicar of a nearly Church visits most Thursdays and people are invited to partake of Holy Communion this was witnessed during the inspection. Several people receive regular visitors who are made welcome by the staff. Some people are able to walk or ride in wheelchairs to the nearby shops and the beautiful, secluded and peaceful Tessier Gardens at the rear of the Home where only adults are permitted to enter. The sheltered south facing patio at the rear of the premises is used by smokers and has potential for improvement to provide a pleasant seating area for all people. A carer has taken a resident to a local Public House and for a fish and chip meal in the recent past. Others have been taken to shops to buy new clothing of their choice. The lunch on the day of the visit was sausage casserole with fried potatoes, cauliflower cheese and butter beans followed by apple and mincemeat pie with either custard or ice cream. Most diners cleared their plate and there was very little waste. No one was seen to require assistance or pureed meals. The teatime meal was usually of sandwiches, a variety of items on toast or hot light snacks. Home made buns and cakes are produced for mid morning and afternoon snacks. Overall people were not exactly enthusiastic about the food commenting, Food not too bad, Food not that good, Not too bad, We seem to have an awful lot of sausages, although one person said, I enjoy the food always nice, I am easy to please, I like most things. Another person said that her favourite meal was sausages. People were satisfied with the quantity of food available. There is a three weekly menu, which is said to be under review at present. The menu is on display in the dining room and some residents had a copy in their bedrooms. An ample supply of fresh fruit for people to help themselves was available in the lounge. The kitchen is small but on the day was clean and tidy. We spoke with the cook about pureed and special diets, she said they were provided although through discussion it was evident that she was not providing a special diet to the person with diabetes. Pureed food is served up as one dish, this is unappetising and not good practice it should be served separately so the person can identify the different tastes of what they are eating. Care Homes for Older People Page 17 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their complaints will be listened to and that staff understand the principles of adult protection, which helps to protect people from abuse. However additional supervision, guidance and care planning will protect people further. Evidence: The CQC has received no complaints about this service in the past twelve months. A relatives confirmed they knew how to complain if they had any problems. People spoken with said they felt safe and knew who to speak to if they had any problems. The complaints procedure is contained within the statement of purpose and everyone living at the home has a copy. Some people were reported as can be aggressive. There was no consistent information to guide staff about whether this was a consenting behaviour or how to reduce any risk to people. There was no evidence that the home had consulted with other professionals about how to deal with this situation. Staff spoken with were aware of the situation and described some actions taken to deal with it. One member of staff was clear about their duty to report poor practice, and was clear who she would inform within the home but was less clear about agencies external to the home i.e. CQC or the Police. Some staff has had training in the Protection of Care Homes for Older People Page 18 of 31 Evidence: Vulverable Adults whilst others have not; we were told that this training is booked for all within the next two months. Care Homes for Older People Page 19 of 31 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. Manor House provides a pleasant and homely environment for people living there. However some areas need immediate attention to ensure the safety of the people living there. Evidence: A tour of the home was completed with the owner and some peoples rooms were looked at. Several of the rooms have been redecorated and had new carpets, a programme of refurbishment is ongoing. The ground floor communal areas were homely and tidy without being austere and with a reasonable standard of cleanliness, decoration and repair. The furnishings were of good quality, comfortable and clean. The bedrooms visited were clean and homely with items of personal memorabilia on display. Whilst a certain amount of maintenance work has already been undertaken there is clearly much more yet to be done to bring the premises up to an acceptable standard. The owner said that he had drawn up a prioritised work plan. The redecorated rooms are fresh and pleasant. Several people living there and a visitor said that during the cold weather the heating had been inadequate and that the staff had said, The heating goes off for a couple of hours in the afternoon. The Senior Carer advised that supplementary heaters had been placed in a couple of bedrooms at this time, although no risk assessments were seen in respect of these. Some areas were seen to need immediate attention; The Yale type lock had been removed from a door and the resultant hole (covered by a thin plastic notice) degraded the integrity of Care Homes for Older People Page 20 of 31 Evidence: this Fire Door. In a WC a communal towel was the only means of drying hands. A bedroom door ( Fire Door) to the rear of the building had a substantial gap underneath it. Some areas had carpet that had not been finished off and had uncut edges. The communal stairway carpets were worn and tired. No unpleasant odours were present. Antiseptic gel was available at the front door. All people were well dressed in freshly laundered attire and appeared to be comfortable in their surroundings. They all commented positively about the speed and efficiency of the laundry service. Care Homes for Older People Page 21 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs staff in sufficient numbers to meet the needs of the people living there. However further training would ensure that people are cared for properly. The recruitment procedure must be more robust to ensure people living at the home are safe and cared for by people appropriate to do so. Evidence: One person described the care staff as kind and patient but commented that they did not have enough to really talk to people living at the home. Another said At times they have been short staffed, another said staff dont have time to take me out, a visitor refereed to the dedication and kindness of the Manager adding, Mum really loves him. We spent time in the communal areas of the home observing practice. We saw staff showing affection towards people and people living at the home being relaxed in their presence. On other occasions we saw people living at the home enjoying a joke with staff. We looked at the recruitment files of three members of staff. We found that the checks carried out on them to determine their suitability were robust. We spoke to three staff members . Two carers told us that they were both up to date with moving and handling, and one was currently in the process of completing their NVQ 4 in care. Both said that their first aid training had expired, but both confirmed Care Homes for Older People Page 22 of 31 Evidence: they had were going to do it again in the near future. Mandatory training for most staff was not up to date Not all staff had up to date training in Moving & Handling or the Protection of Vulnerable Adults, Infection control or First Aid. Care Homes for Older People Page 23 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owner has an open and friendly style but he is unable to fully discharge his duties to ensure peoples needs are met safely and consistently. Some aspects of health & safety within the home are putting people at risk. Evidence: The owner has worked in the care home industry for several years. He has achieved the Registered Managers Award and NVQ Level 4 in Care. One staff member told us that there was a positive atmosphere at the home and this was a reason why they stayed working at the home. Another staff member said that the owner was approachable, and said that they could ask for help when needed. There is a Quality Assurance system at the home, and questionnaires are sent out to people living at the home and their representatives,the last one was sent in January but to date nothing has been done with this information. The home manages the personal allowances for two people. When these amounts Care Homes for Older People Page 24 of 31 Evidence: were counted and checked against the totals both were found to be incorrect. A serious incidents has occurred at the home, involving a service user being admitted to hospital as an emergency this has not been reported by the owner to the Commission. Fire records showed that fire training was due, we were told this was booked in for the end of May. Some areas around the home were of concern with regard to the risk of fire prevention, these being two issues regarding a bedroom door with the locked removed and having a hole in it and another bedroom door being wedged open. Devon & Somerset Fire & Rescue Service will be informed of this. Care Homes for Older People Page 25 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 (b) The registered person shall(b) keep the service users plan under review. Plans of care had not been reviewed monthly or sooner to reflect changes in peoples individual care needs. This means staff will not have the information they need to ensure people receive the care they need. 31/05/2009 Care Homes for Older People Page 26 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be kept under review to refect the changing needs of the individual. This will ensure that people are cared for properly. 30/06/2010 2 7 15 Care plans must provide 30/06/2010 guidance on how peoples needs are met to ensure that physical well-being is maintained. For example, monitoring and recording peoples diet and the control of diabetes. This will ensure that people are cared for properly. 3 9 13 You must ensure the safe 31/05/2010 management of medicines in the home by All medicines in the home must be prescribed by the GP unless identified as a homely remedy under the policy in house. Care Homes for Older People Page 27 of 31 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 This means people will be kept safe by taking the correct medicine at all times. 4 12 16 You must consult with 30/06/2010 people about their social interests and make arrangements to enable them to engage in a range of activities inside and outside of the home. Particular consideration must be given to people less able and those spending considerable time in their bedrooms. This will ensure people lead fulfilling lives. 5 15 16 The home must ensure that 31/05/2010 it provides suitable, wholesome food which is properly served for the peole living at the home. This will ensure that people are given the correct diet to suit their needs, keeping them well. 6 18 13 All staff must have up to date training in the Protection of Vulverable Adults. This will keep people safe. 30/06/2010 Care Homes for Older People Page 28 of 31 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 7 19 23 All parts of the home must be kept in a safe state of repair. This will keep people safe. 31/05/2010 8 30 18 All satff must have up to 30/07/2010 date training in mandatory areas such as Moving & Handling, First Aid, Infection Control and the Protection of Vulnerable ADults. This will ensure people are cared for by competent well trained staff. 9 35 13 People must be safeguarded against abuse by the safe keeping and recording of personal monies. This will ensure peoples monies are kept safe and accurate. 31/05/2010 10 37 37 You must notify the Commission of all untoward incidents that occur in the home This means the safety of people at the home can be monitored. 31/05/2010 Care Homes for Older People Page 29 of 31 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 30 of 31 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 31 of 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!