Care Home: McAuley Mount

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What the care home does well This inspection showed the home was being well run in the best interests of the residents. People living at McAuley Mount were mostly happy with the care and attention they received. We received the following comments on what they considered the home did well -"Provides a home from home environment, pleasant staff, adequate dietary requirements, pleasant surroundings and facilities" - " I think they do very well as a care home" - "Myself and relatives have been quite impressed by the care and surroundings" There were some good ways of finding out about peoples` individual needs and wishes before they moved in to the home, this helped make sure the home could meet their needs and plan for their care and support. Prospective residents and their families were being encouraged to visit the home, to see the accommodation available and meet current residents and staff. People were getting attention for their health care needs, they were being treated with dignity and respect. "We get looked after very well" was one comment made. A `key worker` system was in place, which linked residents to a specific staff member to provide a more personal service. People spoken with during the inspection were generally very satisfied and content living at McAuley Mount, comments made were, "It`s wonderful" and "It`s a 5 star standard" Routines at the home were very flexible and people were being supported to be as independent as possible. A four course meal was being provided at lunch time, with food being served on individual salvers, which helped to promote choice and independence. Arrangements for visiting were good and the home had strong links with the local community. The residents were aware of how to make a complaint, which meant they knew what to do if they weren`t happy at the home. To help make sure staff provide effective care, good arrangements were in place for staff recruitment, training and development. Staff working at McAuley Mount were described as, "Pleasant" - "Friendly and considerate" - "Very good" - "Respectful" - "Helpful" and Exceptionally kind" The home was well equipped and furnished to a very good standard, further improvements were ongoing and being planned for.The residents and other relevant people, were being regularly consulted about their opinions of the service being provided at the home. What has improved since the last inspection? Progress had been made with the care planning process, care plans were being used more effectively to promote good care practice. Some improvements had been made with medication practices and storage. Several parts of the home had been redecorated and new carpets fitted. Two new staff offices had been created. What the care home could do better: Care plans needed to include full details of peoples` individual needs and preferences, so that staff know exactly what to do for each person. To make sure people are properly and safely supported with their medication, some practices and instructions needed improvement. Catering arrangements should continue to be reviewed with the residents, at least two main courses options should be routinely offered at lunchtime. Inspecting for better lives Key inspection report Care homes for older people Name: Address: McAuley Mount Padiham Road Burnley Lancashire BB12 6TG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jeffrey Pearson     Date: 0 3 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 28 Information about the care home Name of care home: Address: McAuley Mount Padiham Road Burnley Lancashire BB12 6TG 01282438071 01282431502 tlevertonmanager@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Institute Of Our Lady Of Mercy Name of registered manager (if applicable) Miss Tracey Leverton Type of registration: Number of places registered: 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 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 - Code OP. The maximum number of people who can be accommodated is: 24. Date of last inspection Brief description of the care home McAuley Mount is a two-story purpose built care home situated in its own grounds. The home is owned and run by the Roman Catholic Order of the Institute of Our Lady of Mercy. The grounds and gardens are attractive, well maintained and accessible to the residents. The home is furnished and decorated to a high standard. The accommodation includes flats, which consist of a single en-suite bedroom, living room Care Homes for Older People Page 4 of 28 care home 24 Over 65 24 0 Brief description of the care home and kitchenette; single en-suite bedrooms and there are 2 single rooms without ensuite facilities. A passenger lift and stairs, provide access between the two floors. The philosophy of care is underpinned by the Roman Catholic faith, Mass is held on a daily basis in the homes Chapel. The main aim of the home is to provide high quality care for older people, both male and female, who feel comfortable and supported in an environment where the Christian values and lifestyle are paramount. Residents do not have to follow the Catholic faith and are free to choose their own lifestyle; everyone is welcome in the Chapel. Staff are available, to provide assistance with personal care and support, in response to individual needs and wishes. At the time of the Inspection visit, the weekly fees were £366.00 to £442.00 based on the assessed care needs of the individual. Services not covered by the fees included, hairdressing, individual newspapers and magazines. Information about the home, which should help people make a choice about using the service was available in the entrance hallway. 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: An unannounced inspection which included a visit to the service was conducted at McAuley Mount on the 2nd July 2009. The visit took 12 hours over two days and was carried out by one inspector. The last inspection was carried out on the 22 June 2007 and an Annual Service Review undertaken on 29 April 2008. People using the service were invited to complete surveys, to tell the Commission what they think about the support and care provided by the home, several were returned to us. Before the visit the manager was asked to complete and return to us an annual Quality Assurance Assessment (AQAA). This was to enable the service to show how they were Care Homes for Older People Page 6 of 28 performing and provided details about arrangements, practices and procedures at the home. The files and records of 2 people were examined as part of case tracking, this being a method of focusing upon a representative group of people using the service. We spoke with residents, the acting manager, area manager and staff. Various documents, including policies, procedures and records were looked at. Parts of the home were viewed. What the care home does well: This inspection showed the home was being well run in the best interests of the residents. People living at McAuley Mount were mostly happy with the care and attention they received. We received the following comments on what they considered the home did well -Provides a home from home environment, pleasant staff, adequate dietary requirements, pleasant surroundings and facilities - I think they do very well as a care home - Myself and relatives have been quite impressed by the care and surroundings There were some good ways of finding out about peoples individual needs and wishes before they moved in to the home, this helped make sure the home could meet their needs and plan for their care and support. Prospective residents and their families were being encouraged to visit the home, to see the accommodation available and meet current residents and staff. People were getting attention for their health care needs, they were being treated with dignity and respect. We get looked after very well was one comment made. A key worker system was in place, which linked residents to a specific staff member to provide a more personal service. People spoken with during the inspection were generally very satisfied and content living at McAuley Mount, comments made were, Its wonderful and Its a 5 star standard Routines at the home were very flexible and people were being supported to be as independent as possible. A four course meal was being provided at lunch time, with food being served on individual salvers, which helped to promote choice and independence. Arrangements for visiting were good and the home had strong links with the local community. The residents were aware of how to make a complaint, which meant they knew what to do if they werent happy at the home. To help make sure staff provide effective care, good arrangements were in place for staff recruitment, training and development. Staff working at McAuley Mount were described as, Pleasant - Friendly and considerate - Very good - Respectful - Helpful and Exceptionally kind The home was well equipped and furnished to a very good standard, further improvements were ongoing and being planned for. Care Homes for Older People Page 8 of 28 The residents and other relevant people, were being regularly consulted about their opinions of the service being provided at the home. What has improved since the last inspection? 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 set out 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 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 10 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. The admission process ensured peoples needs, abilities and preferences were known and planned for before they moved into the home. Evidence: Previous inspections have shown the home has a good track record of ensuing people are properly assessed before moving into McAuley Mount. There was a clear indication in the AQAA (Annual Quality Assurance Assessment) that good systems were in place to support an effective admission process, for example, mention was made of involving prospective residents their family and friends with a pre-admission assessment. The AQAA also indicated that the homes assessment paperwork was due to be updated to ensure a more in-depth and person centered approach. The admission process was discussed with the manager, who said that no-one was Care Homes for Older People Page 11 of 28 Evidence: being admitted to the home without a full needs assessment. The manager said people were always visited in their current environment, be it hospital or their own home. Prospective residents and their families were being encouraged to visit the home, to see the accommodation available and meet with current residents and staff on duty. We looked at assessment information of two people who were due to move into the home and found detailed assessments had been completed, with information being obtained as appropriate, from Social Services. Peoples personal and social care needs and wishes had been considered along with their preferences about daily routines such as bed times and meals and mealtimes. Written information about the home had been recently been updated, a copy of the homes guide was seen to be available in the homes entrance hallway. People completing surveys indicated they had received enough information about the home prior to moving in. At the time of this inspection visit, McCauley Mount did not provide intermediate care. Care Homes for Older People Page 12 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. Most health and personal care practices were effective in ensuring peoples needs are sensitively met. Evidence: Seven residents completing surveys, said they always get the care support they need, five said they usually did, one comment made was the staff are very attentive. People spoken with during the inspection visit made positive comments about the care and support provided at McAuley Mount, they said, I am very happy here - We get looked after very well. Since the last inspection progress had been made with the care planning process, carers were being more actively involved in devising care plans with the residents and the plans were being more appropriately used as working documents. One resident said,There is more attention being given to peoples needs, a general sense of more care. The care plans seen provided much better information, however, they did not give clear directions for staff to follow to ensure peoples needs were responded to, in Care Homes for Older People Page 13 of 28 Evidence: the way the person preferred. For example, one care plan action stated, assistance with personal hygiene which was not specific in describing exactly what staff needed to do meet the persons needs. Regular reviews of care needs were being carried out and it was apparent residents were being consulted about the content of their care plans. Most residents completing surveys indicated they always get the medical care and attention they need. Records and discussion showed people were getting attention as necessary from health care professionals such as GPs and District Nurses. The AQAA (Annual Quality Assurance Assessment) indicted that a key worker system was in place, which linked residents to a specific staff member to provide a more personal service and promoted the monitoring of peoples health and well being. Various health care assessments had been carried out, for example in relation to continence, pressure area care and risk of falls. The AQAA showed nutritional assessments were to be further developed, along with interventions to reduce the risk of falls and accidents in the home. Staff responsible for medication administration had received training. Medication administration policies and procedures were available, it was advised copies be kept with the medication, to ensure staff have access to this information. Medication storage was seen to be clean and secure. Records showed the temperatures in the storage area had been too hot on several occasions, the manager agreed to take action to rectify this matter. Most medication administration records seen were clear and up to date. However, there were some discrepancies, for example there were gaps in relation to one prescribed item which meant it was not clear if the person had had there medication or not, also, an inappropriate entry had been made in relation to this item. The same item had a variable dose, however, there were no clear instructions explaining how much to offer. One person had a none prescribed item of topical cream which had not been entered onto the medication record. There were some discontinued items entered on the printed medication records, there were no written instructions to indicate they were no longer in use which may be confusing. The manager agreed to pursue these matters. The residents spoken with did not express any concerns about how they were treated, one comment made was, The people here are very helpful, the staff are exceptionally kind. Observations of care practices, showed peoples privacy needs were respected, personal care was carried out in the privacy of the persons own bedroom, or bathrooms. Staff were seen to provide support and interact with people in a very friendly and courteous manner. The AQQA showed that training was to be arranged for staff on recognising and promoting equality and diversity. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 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 at McAuley Mount had opportunities to make choices, join in activities and had lifestyles which generally matched their expectations. Evidence: People spoken with during the inspection were generally very satisfied and content living at McAuley Mount, comments made were, Its wonderful and Its a 5 star standard Most residents completing surveys indicated there were always or usually suitable activities on offer at the home. A number of people living at the home were very independent and were able to organize and arrange their own activities and lifestyles. Some people spoken with said they thought more activities should be arranged by the home, others explained the previous programme of activities had been too much. Residents meetings were being held on a regular basis and people were being given opportunities to voice their opinions and make suggestions about activities and entertainment at the home. The AQAA (Annual Quality Assurance Assessment) showed social activities were to be further improved, consideration was being given to further reviewing activities with the residents, arranging outings and various celebrations. Care Homes for Older People Page 16 of 28 Evidence: Routines at the home seemed very flexible, it was apparent people could spend time in their bedrooms and flats as and when they wished. People spoken with said they could get up and go to bed whenever they wanted, a number of people had their own kitchenettes and were therefore able to make drinks and snacks for themselves. Consideration was being given to landscaping the gardens to help make them more accessible to the residents, a trolley shop had been introduced but the home was aiming to encourage use of local facilities also. Residents spoken with mentioned the contact they had with relatives and friends. Visiting arrangements were outlined in the homes guide, people could visit at any reasonable time. The home had developed strong links with the local community, including the nearby school and convent. Services were held in the homes chapel each day, members of the local community were welcome to attend. Some residents were taking an active part in the services. There were some mixed comments about the meals provided at the home, some people said they were not always of the same standard, others said the food provide was good. Various options were routinely offered offered at breakfast and teatime. A four course meal was being provided at lunch time, food being served on individual salvers, which helped to promote choice and independence. The cook on duty explained new menus were just being devised, the residents had been consulted. One person confirmed they had put forwarded suggestions which had been included on the menu. Various diets were being catered for. A set main course was provided at lunch time, alternatives were available on request, however, it was advised further options be routinely offered to further promote choices. The menu was available but needed to be produced in large print to make it easier to read, the manager agreed to address this matter. The catering arrangements were discussed with the manager, it was apparent action was being taken to make improvements. The dining room provided a pleasant environment for people to eat and socialise, tables were attractively set. People could eat in their rooms if they preferred. The manager explained the kitchen and dining room were soon to be refurbished. Care Homes for Older People Page 17 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. Polices, procedures and practices supported the complaints and provided safeguards for people living at McAuley Mount. Evidence: The residents spoken with and most of those completing surveys indicated they were aware of the homes complaints procedure and how to raise concerns. The manager said a copy of the homes complaints procedure had been placed in each persons bedroom, the procedure was also displayed in the entrance hallway. The procedure explained how complaints could be made and how they would be dealt with. As there were no contact details of external management within the Institute, the area manager agreed to pursue this matter. It was also suggested the contact details for Social Services be included in the procedure. Regular quality assurance surveys provided opportunity for issues and concerns to be raised and there was a suggestion box available, should anyone wish to raise issues anonymously. Information about advocacy agencies was readily available in the home. Records and discussion showed all staff had received abuse prevention and protection of vulnerable adults training, the manager said this was to be arranged annually. Policies and procedures were available which included definitions and indicators of Care Homes for Older People Page 18 of 28 Evidence: abuse and clearly explained the procedure for making a safeguarding alert. The local authorities safeguarding information was also available. The manager and staff spoken with expressed a good awareness of safeguarding and protection issues. The whistle blowing procedure provided directions for staff on reporting bad practice and included the contact details of the area manager and other agencies, including the Commission, it was suggested Social Services details also be included. Care Homes for Older People Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. McAuley Mount provided people with a comfortable, clean and pleasant place to live. Evidence: All of the residents spoken with expressed an appreciation of the accommodation and facilities at the home, I like my bedroom, its just perfect, was one comment made. The home provided a very good standard of accommodation and furnishings and was well maintained. Since the last inspection a number of areas had been redecorated and improved for example, the Chapel had been painted and a new carpet fitteded in the conservatory. A number of the flats had been refurbished and this work was continuing throughout the home. Arrangements were also being made to refit the kitchen and up-grade the dining room. The laundry provided suitable facilities, new washing machines had recently been obtained. The home was found to be clean and free from unpleasant odours. A cleanliness audit had recently been carried out and cleaning schedules revised. Domestic staff were to undertake NVQ level 2 training in cleaning and support services. Infection control policies and procedures were available. One relative commented in a survey, McAuley Mount is an excellent well kept clean home Care Homes for Older People Page 20 of 28 Evidence: The AQAA (Annual Quality Assurance Assessment) provided a clear indication that improvements to the home were to continue. Care Homes for Older People Page 21 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. Staffing arrangements at McAuley Mount aimed to ensure people receive effective care and support. Evidence: We received some positive comments about the current staff team. Comments made in surveys were, Pleasant staff - Friendly, considerate staff night and day - Staff are very friendly. Residents spoken with described the staff as, Very good Respectful - Helpful and Exceptionally kind Staffing levels seemed to be satisfactory, records and discussion showed there were usually three carers and a senior carer on duty throughout the day. People completing surveys indicated there were usually, or always staff available when they were needed. There were sufficient arrangements for catering, administrative and ancillary staff. Staffing levels were discussed with the manager, who considered there were sufficient staff on duty. Staffing arrangements were being reviewed and adjusted accordingly, to ensure people were effectively and safely supported. Staff training and development was being given high priority at McAuley Mount. Records and discussion showed there was a rolling programme of ongoing training. The majority of the care staff have NVQ (National Vocational Qualifications) level 2 or Care Homes for Older People Page 22 of 28 Evidence: 3 in care. Training courses in safe working practices, such as, moving and handling, food hygiene and first aid, had been completed or arranged, as well as more specialised training in topics such as dementia and person centered care. Appropriate policies and procedures were available to support the staff recruitment process. The staff recruitment records seen indicated all the required checks had been effectively carried out with records kept. It was suggested, the application form could provide some guidance on the suitability of referees. The possibility of involving the residents more fully in the staff selection process was discussed with the manager, who agreed to pursue this matter. New staff were being given initial training, records showed an induction programme was been completed which included, client care, health and safety and administration. Some staff had also completed a more in depth, accredited induction training programme. Staff spoken with confirmed training and development was on going at the home. The AQAA (Annual Quality Assurance Assessment) provided a clear indication that staff training and development was to continue at McAuley Mount. Care Homes for Older People Page 23 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. Management and administration practices were effective in ensuring the home is run for the benefit of people using the service. Evidence: This inspection showed several improvements had been made at the home, including addressing the previous requirements and recommendations. The manager had been in post for over 12 months and had quite recently registered with the Commission. She had several years experience in care management, had obtained relevant qualifications and was continuing to up date her knowledge skills and ability, by attending appropriate training courses and seminars. The manager considered she was well supported by the Institute and lines of accountability were clear. The atmosphere in the home was again found be tranquil and supportive. The residents spoken with, made positive comments about the management team at McAuley mount, one person said, The manager is very nice, the area manager is very Care Homes for Older People Page 24 of 28 Evidence: approachable and nice, I would tell them if anything was wrong at the home The AQAA Annual (Quality Assurance Assessment) contained some relevant information and included an number of plans for further development, including spending more time with the residents and involving them as much as possible with the running of the home. Satisfaction surveys had been given to the residents and relatives and other professionals had also been consulted, results had been collated and published in the homes News Letter. Quality assurance was discussed with the manager, including appropriately using the AQAA as part of the process and ensuring the results of surveys are included. The area manager was making regular visits to the home, reports were available of her findings. As previously indicated, training in safe working practices was ongoing or being arranged. Information in the AQQA showed the servicing and checking of equipment and installations. Arrangements were in place to check fire safety equipment. Any maintenance issues, or matters relating to health and safety, were bing identified and promptly dealt with. Care Homes for Older People Page 25 of 28 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 26 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 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 7 Care plans should be more person centered and sufficient in detail to provide clear instructions to staff, of the actions to be taken to meet the residents, personal, health and social care needs. To ensure medication is appropriately and safely managed for the well being of the residents, action should be taken to ensure the auditing system effectively identifies and resolves inappropriate practices. Clear individual protocols should be defined and introduced in relation to all variable dose and when required items of medication. This will ensure people are properly supported with their medication. 2 9 3 9 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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