Care Home: Merok Park Nursing Home

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What the care home does well People who are considering moving into the home can be confident their needs will be assessed by a qualified person. People who live in the home have their physical care needs met, staff are respectful, gentle and patient. People are protected through the safe handling of medication. People can be confident staff will care for them with respect and kindness People enjoy good home cooked food and are protected from abuse. They benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of care and nursing staff on duty to meet their needs. What has improved since the last inspection? The availability of information about peoples` backgrounds, social needs and preferences has improved and is being recorded in the care plan to improve the staffs` ability to provide a personalised service. People have more opportunity to exercise choice and control over their own lives. Improvements in the planning and delivery of meals is ensuring they are more enjoyable and offer choice in a way people can understand. An external activities organiser comes to the home twice a week to provide activities for people who live in the home. People are being offered more opportunity to engage in activities that are meaningful to them. The home is providing adequate stimulation to promote the wellbeing of people who have dementia or other mental health difficulties. A requirement was made following the last Key Inspection that the home must uphold the privacy and dignity of the service users by having locks installed on all service users` toilet doors. Compliance has been achieved with this requirement. Standards of maintenance and cleanliness have been improved and the management have made some adaptations which take account of the specific environmental needs of people who have dementia. Recruitment practice have been tightened up to ensure people are fully protected. There are sufficient cleaning and maintenance staff to maintain a clean environment for people who live in the home. Management systems have improved and now ensure the effective monitoring of staff qualifications and competencies. Staff are suitably qualified and competent to meet the specific needs of people who live in the home including dementia and other mental health needs. The provider is working on improving quality assurance systems to ensure that improvements in the home are sustained and built on to ensure people who live there receive a good service. Customer satisfaction surveys are now being evaluated to demonstrate that the management listen to the views of relatives and representatives of people who live in the home. The registered provider is in the process of applying to register as manager for the home. Monthly provider reports on the service are available in line with the Care Homes Regulations. What the care home could do better: Improvement is continuing in Care planning and risk management. It is strongly recommended that further work is done to ensure there is sufficient guidance for staff to enable them to provide a consistent, personalised service whilst recognising and taking appropriate action to minimise all risks to people`s health and welfare. It is strongly recommended that systems for evaluating the quality of the services provided at the care home are further developed to ensure improvements already achieved are sustained and built on, taking account of the views and expectations of people who live in the home. Particularly in the areas of individualised care planning and risk management. Key inspection report Care homes for older people Name: Address: Merok Park Nursing Home Merok Park Nursing Home Park Road Banstead Surrey SM7 3EF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ruth Burnham     Date: 0 9 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 27 Information about the care home Name of care home: Address: Merok Park Nursing Home Merok Park Nursing Home Park Road Banstead Surrey SM7 3EF 01737352858 02086527702 cooppencare@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Maleenee Coopen,Mr Soondressen Cooppen Name of registered manager (if applicable) Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 29 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Merok Park is a large detached property located within a five-minute drive or fifteen minute walk of Banstead town centre and its amenities. The home currently provides accommodation and nursing care to twenty nine service users who are elderly and Care Homes for Older People Page 4 of 27 Over 65 0 29 29 0 0 8 1 2 2 0 0 9 Brief description of the care home some of whom suffer from dementia. The home has twenty-five single and two double bedrooms. Fourteen of the single rooms have an en-suite toilet and washing facility and all other rooms have a hand wash basin. The rooms are arranged over two floors and the first floor can be reached by staircase or passenger lift. There are three toilets, a bath and a shower on the ground floor and three toilets, a bath and a shower on the first floor. The toilets and bathrooms are located in such a way that all bedrooms have a toilet and bathing facilities nearby. There are two lounges and two dining rooms on the ground floor and a large kitchen. The home stands in its own large gardens and has parking spaces to the front of the building. Fees at this home are in the region of £550 to £750 per week and do not cover hairdressing and chiropody costs. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The site visit, which forms part of the homes key inspection was undertaken on 9 June 2010. One compliance inspector was in the home for three and a half hours. from 09:00 to 13:30. The actual date of the site visit is unannounced. The purpose of the visit was to check compliance with the requirements made following our visit on 8 December 2010 when it was our judgement that people who live in the home experienced poor quality outcomes. We undertook an additional random inspection on 15 March 2010 to check compliance with the statutory notices issued in February 2010 when We found that improvements had been made and the home was working towards compliance with all the requirements. There were 22 residents in the home. We spoke to a number of people who live there, staff and the provider. We looked at communal areas of the home and 4 bedrooms. We examined a number of records including staff employment and training records, Care Homes for Older People Page 6 of 27 medication records, pre admission assessments, care plans, risk assessments and quality assurance tools. There is still no registered manager for the service, feedback was given to the provider who is currently applying to register as manager of the service. There are no outstanding requirements from our last inspection, the majority of which have been fully met. Three requirements have been made where further development work is needed to ensure improvement is sustained and built on. People who are considering moving into the home can be confident their needs will be assessed by a qualified person. People who live in the home have their physical care needs met, staff are respectful, gentle and patient. People are protected through the safe handling of medication. People can be confident staff will care for them with respect and kindness People enjoy good home cooked food and are protected from abuse. They benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of care and nursing staff on duty to meet their needs. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The availability of information about peoples backgrounds, social needs and preferences has improved and is being recorded in the care plan to improve the staffs ability to provide a personalised service. People have more opportunity to exercise choice and control over their own lives. Improvements in the planning and delivery of meals is ensuring they are more enjoyable and offer choice in a way people can understand. An external activities organiser comes to the home twice a week to provide activities for people who live in the home. People are being offered more opportunity to engage in activities that are meaningful to them. The home is providing adequate stimulation to promote the wellbeing of people who have dementia or other mental health difficulties. A requirement was made following the last Key Inspection that the home must uphold the privacy and dignity of the service users by having locks installed on all service users toilet doors. Compliance has been achieved with this requirement. Standards of maintenance and cleanliness have been improved and the management have made some adaptations which take account of the specific environmental needs of people who have dementia. Recruitment practice have been tightened up to ensure people are fully protected. There are sufficient cleaning and maintenance staff to maintain a clean environment for people who live in the home. Management systems have improved and now ensure the effective monitoring of staff qualifications and competencies. Staff are suitably qualified and competent to meet the specific needs of people who live in the home including dementia and other mental health needs. The provider is working on improving quality assurance systems to ensure that improvements in the home are sustained and built on to ensure people who live there receive a good service. Customer satisfaction surveys are now being evaluated to demonstrate that the management listen to the views of relatives and representatives of people who live in the home. Care Homes for Older People Page 8 of 27 The registered provider is in the process of applying to register as manager for the home. Monthly provider reports on the service are available in line with the Care Homes Regulations. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home can be confident their care and nursing will be fully assessed through the homes admission and assessment processes to ensure these needs are understood and can be met. Evidence: People have their needs assessed by a qualified person before they move into the home to ensure their needs are understood and can be met. The home has a policy and procedure on admission to and discharge from the home. The person in charge is trained in the principles of assessment of peoples needs. Either the person in charge or the owner carry out all pre admission assessments. We reviewed the file of a person who has recently moved into the home. This showed that a pre admission assessments was carried out which identified all the persons care and nursing needs. Assessments have improved in that they now include some information about peoples background and social histories where this is available. The majority of people who live in the home are experiencing significant levels of dementia or mental health Care Homes for Older People Page 11 of 27 Evidence: difficulties. Staff have received training to ensure they understand these specialist needs and know how to provide support in a way that promotes the wellbeing and enhances the quality of life for people who live in the home. Improvements are being made in the environment to reflect relevant specialist guidance and promote the wellbeing of people with dementia or mental health difficulties. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident their care and nursing needs are understood and met. Staff are respectful, gentle and patient. Care plans and risk assessments have improved. Further development of individual care planning and risk management will ensure staff have sufficient guidance to provide a consistent, personalised service to each person in a way that promotes their health and welfare. People can be confident staff will care for them with respect and kindness in a way that promotes their privacy and dignity. Evidence: The majority of people who responded to our last survey in May 2009 were satisfied with the care and support their relatives receive. They were unanimous in their praise for the helpful, gentle and caring staff. Staff were observed providing care in a respectful way and with gentleness and patience. People who live in the home have an individual plan of care. These have been improved since our last visit to ensure staff understand peoples care and nursing needs and some information about peoples background, social histories and former Care Homes for Older People Page 13 of 27 Evidence: interests. We discussed the need to further develop these to ensure there is clear, personalised guidance for staff to make sure there is a consistent, individualised approach to meeting each persons needs in line with their individual preferences, wishes and expectations. Records of individual reviews of care have been improved. A short monthly report is now recorded where any changes are noted. The provider confirmed that people who live in the home are involved in the care planning and review process via their relatives or representatives. Daily records are maintained of the care and nursing support provided to each person. People who live in the home are protected from risk of physical harm. Observations during this and other visits show that staff are attentive and vigilant. Risk assessments were seen for two people who live in the home, these focused on physical risks. Further development of individual risk assessment is needed to ensure all risks are identified including those associated with cognitive, psychological and sensory impairments to ensure staff have clear guidance on the actions they need to maintain and improve the wellbeing of the people they care for. This was discussed with the provider who agreed to seek additional advice and guidance about how to further improve risk management processes in the home. There have been improvements to the environment to promote the wellbeing of people who live there in that appropriate signage is being used to assist people to find their way around the home and locate toilets and bathrooms. Lighting has been improved and some doors which people who live there would not or should not access have now been painted to blend in with the surrounding walls. People who live in the home can be confident there are sufficient qualified nursing staff in the home to meet their health care needs and people are supported to access a variety of health care services such as dentists, opticians, chiropody and the local GP. Improvements have been made in the way the service operates to ensure people are able to make choices about their daily lives and activities. People are protected through the safe handling of medication. Medication is stored securely and administered by trained staff in line with current good practice guidance. Records seen were in good order. Additional information is now available to staff about the purpose of each medicine prescribed for use in the home. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle experience of people who live in the home has improved in that more choices of social and recreational activities are available. People now have increased opportunity to exercise choice and control over their own lives. Meals are provided in pleasant surroundings and people enjoy good home cooked food. They are offered a choice of food and drinks in a way they can understand. Evidence: The lifestyle experience of people who live in the home has greatly improved with a variety of activities on offer to meet their social and recreational interests and needs. The provider told us that he intends to employ a full time activities coordinator this year. There is a large fish tank in the lounge to provide a point of interest. During our visit One person had a newspaper, another person had a book. Objects were placed on tables for people to look at or interact with. Staff were engaging people in a variety of activities,including skittles, building blocks and table games. Some people were watching the large television. Suitable small tables have been provided for people to use for drinks or games and activities. These are also used for people who prefer to eat their meals in the lounge. Care Homes for Older People Page 15 of 27 Evidence: There is an activities programme for the home. We discussed the advantage of including information about individual interests and appropriate activities in peoples care plans to ensure staff have guidance about peoples preferences and abilities. The home has an outside contract for activities, an activities organiser visits the home on one morning and one afternoon each week. One person also told us how much they enjoy the entertainer who makes monthly visits to the home. Staff provide activities at other times, as they can, between carrying out their other duties. Staff were seen to be very gentle and patient with people and were able to spend time engaging people in conversation or activities during our visit. Records are now being maintained of activities for each person. There are monthly religious church services. Religious needs are recorded in care plans seen. There are no restrictions on visitors to the home and people are encouraged to maintain contact with family and friends. People who live in the home enjoy good home cooked food. There are two dining rooms in the home. The dining room at the front of the home is a pleasant room and has been rearranged to provide more space for the people who use it, either for activities or dining. The internal dining room has been converted into a small quiet lounge and the former lounge which looks out onto the garden is now the main dining room. This provides a pleasant place for people to sit and enjoy their meals. Dining chairs have been renewed since our last visit. Meals are now served at the table from a hot trolley to increase opportunity for choice at mealtimes. A photographic menu has been introduced from which people can choose their main meal which is served at lunchtime. The menu is also written on a white board in the small lounge. A choice of hot and cold drinks is offered throughout the day. People told us the food is good and they enjoy their meals. They can choose where to eat their meals. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home know who to speak to if they are unhappy. They are protected from abuse. Evidence: People who live in the home can be confident staff will listen to them and, those who are able, know who to talk to if they are unhappy. There is a written complaints procedure and a log is kept of all formal complaints. We have not received any information relating to concerns about the service in the last 12 months. People are protected from abuse. Staff are trained in safeguarding vulnerable adults. All new staff are checked through the Criminal Records Bureau before they begin working in the home. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Better standards of maintenance and cleanliness, reorganisation of rooms and adaptations to the environment have improved the quality of life for people who live in the home. The provider is aware of the improvements still needed to ensure the home provides a pleasant, safe and suitable environment for all the people who live there. Evidence: The quality of life of people who live in the home has been enhanced through the Improvements made to the environment in the last year.The home now provides a much homelier and pleasant environment. Bathrooms and shower rooms have been refurbished. Appropriate signs now indicate where some bathrooms and toilets are. The carpet in the main lounge has been replaced and the inner room, formerly used as a dining room has also been carpeted and furnished as a quiet lounge. There is a large garden where there is a shelter for the use of residents who smoke. A new table and chairs have been purchased for the garden. A new dining room has been created in the former lounge overlooking the garden. Suitable tables have now been provided in the lounge. Hygiene in the home has improved and there were no unpleasant odours at the time of our visit. Areas of the home are now more easily identified by people who live in the home through the use of different wall colours. Some improvement is still needed. Redecoration is ongoing and some radiator covers have still not been painted. The provider told us he plans to replace existing hospital Care Homes for Older People Page 18 of 27 Evidence: style beds with more suitable ones in the future. There is still some bed linen that needs replacing where it is worn. The provider is aware of these issues and told us of plans to address them. A shared bedroom, which is currently occupied by one person,is located next to the lift shaft which is noisy when in use. In the last report from the Environmental Health Department following their inspection of the kitchen they noted that food safety management systems need detailed attention to ensure compliance and gave a list of items requiring attention. The report also stated that it was noted that the kitchen is becoming very tired and the owners should seriously consider thinking about refurbishing. All areas of the home seen during our visit were clean and tidy. There is a separate laundry. There are new commode pan washers on the first and ground floors of the home to ensure people who live in the home are protected from risk of infection. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of care and nursing staff on duty to meet their needs. Sound recruitment practice ensures people are protected from harm. Outcomes indicate there are sufficient cleaning staff to maintain a pleasant and hygienic environment for people who live in the home. Training is provided to ensure staff are suitably qualified and competent to meet the specific needs of people who live in the home and refresher training is provided as required. Evidence: People who live in the home benefit from the support of the committed and caring staff team. They can be confident there are sufficient numbers of care and nursing staff on duty to meet their needs. The owner mainly employs students who work at the home for part of their time as paid care staff and part of their time on placement as part of their college courses. Staff observed during our visit were gentle, kind and patient with people who live in the home. The staff rota shows there are sufficient numbers of staff on duty at the home, including qualified nursing staff, throughout the day and night. In addition to care and nursing staff the home employs 2 cleaners. The owner also employs a chef and a maintenance person. Outcomes seen during our visit indicate there are sufficient cleaning hours allocated to ensure good standards of hygiene are Care Homes for Older People Page 20 of 27 Evidence: maintained and people are protected form risk of infection. The Annual Quality Assurance Assessment provided by the manager before this inspection shows that at least 50 of care staff have a National Vocational Qualification or equivalent. People who live in the home are protected through the recruitment policies and procedures in operation in the home. One new member of staff has begun working in the home since our last visit. The staff file shows all the information and checks required are carried out to ensure people in the home are protected. Checks are carried out through the Criminal Records Bureau and references are obtained before staff begin work in the home. The staff training matrix shows that staff are trained in house in infection control. basic food hygiene, first aid, fire safety, health and safety and moving and handling. They are also provided with training in dementia, mental health and other specialist needs. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements in the service in the last year mean that people who live in the home can now be more confident the service is managed in their best interests. Further work is needed to ensure the homes quality assurance systems are effective and that improvements are sustained and built on to ensure people who live in the home receive a good service. Evidence: The provider has worked hard towards achieving compliance with the requirements made at the last two Key Inspections. People who live in the home can now be more confident the service is managed in their best interests. There has been no registered manager in day to day control of the home for the last 3 years. The provider is now in process of applying to register as manager of the service. There remain some concerns about the effectiveness of management systems. Care Homes for Older People Page 22 of 27 Evidence: Progress to achieve compliance with requirements made in June 2009 has been slow and reactive over the last year and further work needs to be done to develop care planning and risk management processes to a good standard. We looked at the new quality assurance system. This mainly consists of tick boxes relating to basic elements of the service. Discussion took place about the need to develop this to ensure the system is effective in monitoring and assessing the quality of all aspects of the service, identifying shortfalls, maintaining the improvements made to date and building on those improvements in the future to ensure that people who live in the home are provided with a consistently good service. People who live in the home and their representatives can be confident their views will be taken account of in the way the service is run. Customer satisfaction surveys are sent out by the home and returns are evaluated as part of the quality assurance system. The person in charge told us at our last key inspection that they do not act on behalf of people who live in the home in relation to their finances. He said the home pays for services such as hairdressing and chiropody and then invoices relatives or representatives. The safety and welfare of people who live in the home is promoted through safe moving and handling techniques. Staff are trained in safe working practices and safety checks are carried out on all equipment and installations. All accidents that occur in the home are recorded. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Partial compliance with a 30/08/2010 previous requirement in relation to risk assessments has been achieved. However risk assessments must be further developed to ensure that all risks, including those associated with cognitive, psychological and sensory impairment are identified and minimised. To ensure people who live in the home are protected from harm. 2 7 12 Partial compliance with 30/08/2010 previous requirements in relation to care planning has been achieved. However care plans must be further developed to include detailed information about how people want to be cared for and supported. To ensure staff have clear guidance on how to meet each persons needs in a Page 25 of 27 Care Homes for Older People 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 consistent and personalised way in line with their individual preferences, wishes and expectations. 3 33 24 Partial compliance with a previous requirement has been achieved. However quality assurance systems must be further developed to ensure that improvements made over the last 12 months are sustained and built on and shortfalls in the service are quickly identified and addressed. To ensure the outcomes for people who use the service are consistently good. 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 30/08/2010 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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 27 of 27 - 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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