Care Home: Mayfield Care Home

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What the care home does well A suitable procedure was in place for assessing the needs of people before they moved into Mayfield. The assessments gathered good evidence for identifying each person`s needs and any risks associated with the delivery of care and support. Information from the assessments had been developed into plans of care to inform staff what support they must provide to meet each person`s specific needs. We asked several people about the quality of care they received. People told us that they received the right amount of support to meet their needs. They described staff as kind and caring. We observed staff interacting well with the people they cared for and support was provided in a dignified and respectful manner. A visitor told us that she couldn`t fault the care her mother received. She got on well with staff and said they always contacted her if they were concerned about her mother`s wellbeing. The home has benefited from extensive refurbishment in the previous twelve months. The people we spoke to were pleased with the improvements to their living environment. People living in Mayfield, and their representatives, told us that their views are listened to and taken seriously. A visitor spoke about the efficient and timely manner in which her complaint had been resolved. Records also provided us with evidence that complaints were being managed well. Regular meetings had been held to consult people about the service they received and these outcomes had been written down. Staff receive appropriate training to ensure that they have the skills required to meet the needs of the people admitted to the home. What has improved since the last inspection? Three of the four requirements made at our last inspection had been addressed. We looked at personnel records belonging to three staff appointed since our last visit in 2009. Improvements to the system for recruiting new staff had been made. Staff files now contained all the required copies of pre-recruitment checks. This ensured that staff appointed would be suitable to work with older people. Improvements had also been made in relation to fire safety in the home. Records detailed the regular checks that had been made to comply with fire safety legislation. The previous practice of wedging open fire doors had ceased. Door guards, linked to the fire alarm system had been fitted to a number of bedroom doors. This meant that people choosing to have their bedroom doors open would not be at risk of smoke inhalation in the event of a fire in the home. What the care home could do better: A requirement made during our last visit for the manager to submit an application for registration with the Commission had not been met. The provider explained that it had been decided to recruit a new manager. At the time of writing this report the provider was pursuing an application. References and a Criminal Record Bureau check had been applied for and the person was to attend an interview. Suitable management arrangements were in place until a new manager was appointed. The provider gave us an assurance that once the appointment was made, an application for registration would be submitted. Improvements were needed in the area of care planning. Care plans must detail each person`s preferences for their daily routines, including the activities they would like to participate in and the manner in which they prefer their care to be provided. We were concerned to find that staff were not consistently recording the care and support that had been provided each day. This meant that there was no audit trail to track the wellbeing of people using the service. Medication records were not being securely stored. These had been left on top of the medication trolley, which was stored in a alcove adjacent to the dining room. In order to maintain confidentiality of information, the medication records must be securely stored to deny unauthorised access. Key inspection report Care homes for older people Name: Address: Mayfield Care Home Mayfield Care Home Beaufort Road Sale Manchester M33 3WR     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: Val Bell     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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 28 Information about the care home Name of care home: Address: Mayfield Care Home Mayfield Care Home Beaufort Road Sale Manchester M33 3WR 01619732371 01619732371 gilmours@runbox.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Stephen Reid Gilmour Name of registered manager (if applicable) Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, to people 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 The maximum number of people who can be accommodated is: 24 Date of last inspection Brief description of the care home Mayfield is registered to provide care and accommodation for 24 older people. The home was purchased by Stephen and Julia Gilmour in 2008. Both owners are actively involved in the home and are always available for consultation with people living in the home and their representatives. Mayfield is situated in Sale and is a large Victorian detached property with easy access Care Homes for Older People Page 4 of 28 Over 65 24 0 0 5 0 8 2 0 0 9 Brief description of the care home to shops and public transport. The original building has been extended to provide accommodation on three floors. Four bedrooms have en-suite facilities. The home occupies a quiet position at the end of a long driveway. There is parking for 10 cars and disabled access is provided to the front door. The well maintained grounds include a large front lawn, where people using the service can sit out during the summer months. The home has undergone substantial refurbishment since 2008, with a new passenger lift installed and several bedrooms and communal areas benefitting from redecoration and the provision of new furniture. New bathing and toilet facilities have also been installed. Fees currently charged range from £380 to £500 per week. Additional charges are made for hairdressing, newspapers and toiletries. A charge may also be made for certain types of continence products that cannot be provided by the Primary Care Trust. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection, which means that the manager was not told we were coming to visit. Our visit was just one part of the inspection. We also looked at other information we had about the home, including events that the home had told us about since our last visit. We spoke to staff, visitors, the providers, management and people living in the home to ask their views on the quality of the service being provided. We received comments from six staff and six people using the service in completed satisfaction surveys that were returned to us. We also looked at samples of the homes policies, procedures and care records belonging to people using the service. We also looked around the home to assess the quality of the environment provided for the people accommodated. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: A requirement made during our last visit for the manager to submit an application for registration with the Commission had not been met. The provider explained that it had been decided to recruit a new manager. At the time of writing this report the provider was pursuing an application. References and a Criminal Record Bureau check had been Care Homes for Older People Page 7 of 28 applied for and the person was to attend an interview. Suitable management arrangements were in place until a new manager was appointed. The provider gave us an assurance that once the appointment was made, an application for registration would be submitted. Improvements were needed in the area of care planning. Care plans must detail each persons preferences for their daily routines, including the activities they would like to participate in and the manner in which they prefer their care to be provided. We were concerned to find that staff were not consistently recording the care and support that had been provided each day. This meant that there was no audit trail to track the wellbeing of people using the service. Medication records were not being securely stored. These had been left on top of the medication trolley, which was stored in a alcove adjacent to the dining room. In order to maintain confidentiality of information, the medication records must be securely stored to deny unauthorised access. 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into the home receive sufficient information to help them make a decision and staff receive enough information to understand the persons needs. Evidence: We examined the written information that was given to people enquiring about using this service. This contained good information to enable people to decide if the service would be able to meet their needs and whether the home would be a good place to live. Of particular value was the inclusion of peoples views and comments about the home, which had been taken from satisfaction surveys conducted during the previous year. This told the reader that the service listened to the views of people living in the home in order to make continual improvements in their best interests. Some of the information, such as the fees charged for the service was in need of updating. The provider told us that this would be addressed. Care Homes for Older People Page 10 of 28 Evidence: We examined the process for assessing the needs of people before they moved into the home. We looked at two assessments of needs; one for a person who had lived in the home for four years and the second for a person who had moved in during April 2010. The in-house assessment procedure had been designed to gather information in line with current good practice. Attention had been paid to the identification of risks relating to moving and handling needs, falls, nutrition and pressure area care. This was a thorough process that ensured the home would not admit a person whose needs were not able to be met. Mayfield Care Home does not offer an intermediate care service. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service receive the support needed to meet their personal and health care needs, although this is not always written down. Evidence: We looked at the care records belonging to the two people whose assessments we had examined under Choice of Home. Care plans had been provided in booklet form, which included sections for recording needs assessments, plans of care, risk assessments, monthly reviews, visits from health care professionals and daily records. In principle this provided a good system for ensuring that care records were secure and organised. In practice, however, the booklets soon became full, particularly for those people with more complex needs. Additionally, some of the boxes did not provide enough space for staff to record complex information. The staff we spoke to agreed that this was an issue. To overcome this they had photocopied and stapled sheets of paper into the care records. This resulted in the booklets becoming unwieldy and time consuming in finding relevant information. The providers told us that this had already been recognised as an issue and work was currently underway to add more pages and amend the way information was presented. We were shown a copy of Care Homes for Older People Page 12 of 28 Evidence: the amended care plan booklet. The two care records we examined had been drawn up from information contained in assessments of need. Care plans were in place for each identified area of need and risks had been assessed. More detailed information was needed to describe the action that staff were expected to take in meeting each persons needs and manage identified risks. This should be written with more focus on how individuals prefer their care and support to be provided. This is known as a person-centred approach to providing care. For example, in relation to bathing, care plans should include the persons preferred frequency, time of day and the manner in which they are to be supported. Care records must also include a daily account of the specific care and support provided to each individual. This had not been done consistently in the two care plans we examined. On occasion there were gaps of up to four days when nothing had been recorded. In discussion with staff we were told that they had been instructed not to write anything if there had been no significant events that day. A senior member of staff explained that this was done to prevent entries such as no change being made. Consequently, written records did not provide evidence that people were receiving the support as detailed in their plans of care. We asked the views of three people accommodated, about the quality of the service they received. Each person said that they received the right amount of support to meet their needs. They confirmed that staff responded well to their requests for assistance and they said they were able to make choices in how their care was provided. One person commented, I get on well with staff. They work hard and they are kind and caring. They do a difficult job well. A relative we spoke to said she couldnt fault the care her mother received. She had a good relationship with staff and they always let her know if they had any concerns about her mothers welfare. Another relative completed a survey and remarked, Staff attend to comfort and needs. We looked at the system in place for administering medication to the two people whose care records we had assessed. A suitable medication trolley was used to store medicines held in the home. This had been anchored securely to the wall in an alcove of the dining room. Medication records were stored on top of this trolley. An alternative and more secure place should be identified for the storage of medication records to maintain confidentiality, as the dining room is accessed by all service users and visitors to the home. Care Homes for Older People Page 13 of 28 Evidence: All medication received into the home had been checked as accurate and records were held for unused medicines returned to the pharmacy. The recording of medicines administered to one person was accurate and up to date. Records belonging to the second person contained a gap several days previously with no staff signature recorded. One of the staff told us that she had administered the medication, but had forgotten to sign the record. There was no evidence to show that this had been brought to the attention of the member of staff concerned. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Mayfield are afforded choice at mealtimes. Although people are asked about the type of activities to be provided this is not always managed in a way that reflects their personal interests and preferences. Evidence: We looked at what was provided in the home to stimulate and interest the people accommodated. There was evidence of some structured activities, such as weekly bingo sessions, fortnightly armchair aerobics and a visiting entertainer every three weeks. Staff told us that some of the people accommodated participate and enjoy these sessions. One of the staff said activities were not provided every day. They said the planned activity on the day of our visit was an afternoon sing along, although we saw no evidence that this took place. The self-assessment completed by the provider told us that improvements had been made in this area and it identified further improvements that needed to take place. One issue was that staff sometimes needed reminding to record the activities that people had participated in and the outcomes that they had experienced. This was confirmed by a lack of detail recorded in the daily records. We asked three people living in the home and a visitor about the activities that take Care Homes for Older People Page 15 of 28 Evidence: place. They told us that there seemed to be very little going on. The care plans we examined did not contain detailed information on the types of things people liked to do on a daily basis. However, it was pleasing to be told that some staff come in on their days off to take people out for a walk to the park, shops and to have a cup of coffee Additionally, the provider told us that they planned to offer organised outings once the weather became warmer. We looked at the quality of the meals provided in the home. A new cook had been employed and each person we spoke to remarked on how the quality of the catering had improved recently. The cook had been trained in safe food handling. A relative completing a survey commented that, The food is good quality. We joined four people for lunch. There were two choices of hot meal and the cook told us that alternatives to the set menu were always available. The roast chicken dinner that we ordered was attractively presented, well cooked and tasty. We saw staff providing support to some people that needed assistance and encouragement to eat. One person told us that she had lost her appetite and she only managed to eat a small part of her meal. A member of staff offered encouragement and a choice of alternatives. Good records were maintained to monitor the quantity of food eaten by people at mealtimes. Weights had been regularly recorded and it was pleasing to see several examples of people gaining weight. Sufficient stocks of food were stored to provide choice and variety to people living in the home. This included a supply of fresh fruit and vegetables. Food stored in fridges and freezers had been labelled appropriately. The minutes of meetings held to consult people about the service provided, contained evidence that meals and activities had been discussed. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to ensure that people are safeguarded from harm and the people accommodated can be confident that any concerns they have will be managed well. Evidence: We examined the procedures in place to safeguard people living in the home from harm. Staff had access to the local authority safeguarding policy and procedures. The homes policy on safeguarding was also available. The wording of this procedure was misleading, as it might have led the reader to believe the home would take the lead in investigating safeguarding issues. The provider told us that this would be amended to reflect that the local authority would take this decision. The staff we spoke to confirmed that they had received training in recognising abuse and what action action they must take if abuse was alleged or suspected. We found confirmation of this training in staff files. Staff were confident in talking about the action they would take if a person in their care was at risk of harm. During the previous twelve months one referral had been made to the local authority for investigation under the Safeguarding Adults Procedures. The allegation was found to be unsubstantiated. The self-assessment completed by the provider told us that four complaints had been received in the previous year. We examined the complaints records and found Care Homes for Older People Page 17 of 28 Evidence: evidence of good management in this area. Each complaint had been thoroughly investigated and written responses had been provided to the complainants. We spoke to the relative of a person living in the home, who had made a complaint. She told us that her concerns had been dealt with in a very professional manner and resolved to her satisfaction. The people we spoke to during our visit knew who to approach if they had any concerns or complaints and they were confident that these would be dealt with appropriately. Six people completing surveys also said that there was always someone they could speak to if they were not happy. A relative completing a survey commented that, Staff are very helpful. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean, comfortable and pleasant surroundings. Evidence: We toured the home to assess cleanliness, hygiene and health and safety. All areas were found to be clean and no malodours were present. Staff had been trained in infection control procedures and a number of staff confirmed that they had sufficient supplies of personal protective equipment. We had been informed of an incident of Clostridium Difficile in the home three weeks before our visit. Infection control procedures had been followed and there were no further reported incidences of this infection. Considerable attention had been paid to the refurbishment of the home since our last visit. Two people completing surveys made positive references to this as follows, New passenger lift installed and The home has been refurbished to a high standard. The work programme was ongoing. For example, one of the vacant bedrooms had water damage to the ceiling. The provider told us that this would be rectified before anyone was accommodated in the room. A number of new windows had been installed above ground floor level. These did not have their opening widths restricted to minimise the risk of falls. The provider arranged for restrictors to be fitted to these windows within 24 hours of our visit. Care Homes for Older People Page 19 of 28 Evidence: We found combustible materials stored in the room containing the gas boiler. These were removed to a safe place the same day at our request. All external areas of the home had been maintained in good condition and pleasant and private gardens were accessible to people living in the home. Suitable laundry facilities had been provided and this area was found to be in good order on the day of our visit. The home did not employ dedicated laundry staff. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People accommodated in Mayfield have their personal care needs met by a trained staff team. Evidence: At the time of our visit sufficient staff had been deployed to meet the assessed personal care needs of people living in the home. The staff we spoke to said that staffing levels had improved since the rotas had been reorgansied. However, we noted that the person on the rota with designated domestic duties had been providing personal care during our visit. Although we found no issues with the cleanliness of the home, we were informed that the infection control team had visited the home five days later and found several shortfalls in cleanliness and infection control practice. Rotas must accurately reflect the number and designation of staff on duty at all times, to ensure that sufficient staff are being deployed for the efficient running of the home. We saw evidence in personnel files of training undertaken by staff since we last visited Mayfield. Examples included infection control, safeguarding adults and fire safety training. Additionally, in excess of 50 of staff had achieved a National Vocational Qualification in care at or above level 2. We examined three personnel files belonging to staff who had recently been appointed to work in the home. The three files contained copies of the required pre-employment Care Homes for Older People Page 21 of 28 Evidence: checks. This robust recruitment process ensured that staff employed would be suitable to work with older people. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are listened to and their views contribute to the development of the home. Evidence: At our last inspection we made a requirement for a manager to be appointed and for them to submit an application to register with the Commission. A manager had been appointed, although it had been decided that they would work at the home in a different capacity. At the time of our visit, recruitment for a manager was ongoing and we were informed that the provider was pursuing an application and intended to interview the candidate. Mayfield was being managed by the provider and his partner, with support from the registered manager of another home owned by the provider. Staff told us that the provider was approachable and supportive. Additionally, the provider took positive action in dealing with issues that we raised during our visit, such as making upstairs windows safe and removing combustible materials from the boiler room. Care Homes for Older People Page 23 of 28 Evidence: People living in the home and their representatives had regular meetings to discuss the service provided. At these forums their views and suggestions for improvement had been listened to and action had been taken to make improvements where necessary. Satisfaction surveys had been issued to people on a 12-monthly basis. The outcome of these surveys were available in a report reviewing the quality of care provided in the home. Mayfield encourages people using its services to control their own personal finances wherever possible. For people who lack the capacity to manage their own money, support was being provided by relatives or the local authority. Improvements had been made since our last visit to ensure that fire safety checks were being done regularly. Further improvements had been made by installing a number of door guards linked to the fire alarm system. This enabled people to have their bedroom doors open without being at risk of harm in the event of a fire in the home. We looked at a sample of health and safety and equipment maintenance records and found these to be accurate and up to date. Care Homes for Older People Page 24 of 28 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 31 8 The manager must make an application for consideration to be registered with the CQC In line with regulations and to ensure the acting manager has the skills and qualifications and is a fit person to be registered. 31/12/2009 Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 12 Care records must provide evidence that people are receiving the support as detailed in their plans of care. To ensure that people are receiving appropriate support to meet their assessed needs. 29/05/2010 2 27 18 Rotas must accurately reflect the number and designation of staff being deployed in the home at all times. To ensure that there are sufficient staff of all designations for the efficient running of the home. 29/05/2010 Care Homes for Older People Page 26 of 28 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 1 Written information provided to people enquiring about using the service should be reviewed and updated to ensure that it contains accurate and up to date details about the home and the services provided. Care plan documents should provide evidence that the health, personal and social care needs of people are being met in accordance with their preferences. Medication records should be held securely to ensure that confidentiality is maintained for each person living in the home. Care plans should detail the preferred activities of daily living for each person accommodated in the home. To provide evidence that people are supported to lead their chosen lifestyles. 2 7 3 9 4 12 5 12 Care records should provide evidence that people can choose to participate in a regular and structured programme of activities. To ensure that people have sufficient opportunities for stimulation that meets their needs, preferences and capacities. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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