Care Home: Moriah House Care Home

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What the care home does well Effective pre admission needs assessment are performed prior to potential service users moving into the home to ensure their needs can be identified and met. Medication management promotes service users safety. Service users are afforded appropriate levels of privacy and dignity and feel safe at the home. Service users said they are able to express their views and concerns to a receptive management team. Recreational activities are provided within the home and opportunities are available for service users to interact within the broader community. Service users expressed satisfaction with the quality and variety of meals provided at the home. Service users benefit from a well-maintained environment, which is comfortable, clean and safe throughout. A staff training programme is in place to ensure staff are competent in meeting the needs of service users and staff recruitment practices are robust. The management structure is effective in supporting staff to promote the health and wellbeing of service users. What has improved since the last inspection? Plans of care and risk assessments are in place in respect of each service user to ensure that their needs are fully met. Visitors to the home no longer have access to the kitchen area. What the care home could do better: The registered provider must ensure that the homes electrical circuits are tested in accordance with legislation. Key inspection report Care homes for older people Name: Address: Moriah House Care Home Deep Furrow Avenue Carlton Nottingham NG4 1RS     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: Steve Keeling     Date: 0 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Moriah House Care Home Deep Furrow Avenue Carlton Nottingham NG4 1RS 01159110078 01159110028 susan.broddel@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Moriah House Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Moriah House is a care home for older persons, providing accommodation and personal care for up to thirty-nine service users. The home is situated in Carlton, close to shops and local amenities. Accommodation is on two floors, the upper floor accessed by shaft lift, stair lift or stairs. There are five lounges available to service users and a large conservatory. Dining space is included in these areas. There are twenty-five single rooms and seven shared rooms in the home. Some rooms offer ensuite facilities. There is patio area to the front of the home with seating available. Car parking is available at the rear of the property. The current weekly fee range from £355 - £410 these do not include the cost of hairdressing, newpapers or podietry services. 0 Over 65 39 Care Homes for Older People Page 4 of 25 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: The focus of the inspection undertaken by the Quality Care Commission is upon outcomes for service users and their views on the service provided. The process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that needs further development. One inspector conducted the unannounced visit. The main method of inspection used is called case tracking which involves selecting service users and looking at the quality of care they receive by speaking to them, observation, reading their records and asking staff about their needs. The registered manager and members of staff were spoken with as part of the visit, records relating to medication management was also inspected to form an opinion Care Homes for Older People Page 5 of 25 about the quality of care provided. A partial tour of the building was undertaken which included service users bedrooms and communal areas they frequent to make sure that the environment is homely and safe. A review of all the information we have received about the home since the last key inspection was performed on the 11.12.2007 was considered in planning this visit, which included the Annual Quality Assurance Assessment which was provided by the registered manager in June 2009. We also used six responces we had to the ten Have Your Say Pre inspection questionnaires which were distributed to service users at the home prior to the visit and the two responces to the five Have your Say staff surveys. Care Homes for Older People Page 6 of 25 What the care home does well: 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 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 7 of 25 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 8 of 25 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. Effective needs assessments are undertaken prior to potential service users gaining residency at the home to ensure their needs can be identified and met. Evidence: Information provided by the registered manager in the Annual Quality Assurance Assessment states We offer an invitation for potential service users to come to the home for a visit prior to admission. An exceptional amount of time is taken with families and relevant others during the independent assessment process. Families are invited to have inclusion in the care planning process at the outset. We have a comprehensive and well thought out Statement of Purpose and Service Users Guide. Contracts are drawn up between the home and the service user once the trial period is over, this ensures that the service user have the time and space to settle into the new environment and decide whether they wish to remain at Moriah House. Similarly the trial period offers the staff and Management of the Home the opportunity to fully understand the care needs of the new service user and ensure that these can be met. Care Homes for Older People Page 9 of 25 Evidence: Those service users admitted for Interim/Respite care also have the same detailed assessment to include any specialist needs they may have to rehabilitate them back to the community. Independence is always promoted to all service users. Service users spoken with on the day of the visit confirmed that pre admission assessments were undertaken by representatives from the home prior to gaining residency. Relatives visiting residents also confirmed that an assessment process was performed and stated that the manager and staff keep them fully informed of any developments in relation to their relatives care needs. We looked at the records of two service users, each had an assessment of their needs. The assessment process was effective in providing the opportunity to identify service users needs, in relation to promoting their health and wellbeing. The assessment proces also uses information provided by other agencies, such as Adult Social Care and Health when available. Intermediate care is not provided at the home. Care Homes for Older People Page 10 of 25 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. The health care needs of service users are recorded and met. Medication is managed appropriately and service users are afforded appropriate levels of privacy and dignity. Evidence: Information provided by the registered manager in the Annual Quality Assurances Assessment states Our ethos is to draw up a care plan that is needs led. We always ensure that a comprehensive independent assessment takes place with all parties whether the service user is to be privately funded or local authority funded. Community Care Assessments are also retained for those service users who are local authority funded. This ensures that the potential service user is correctly placed. Our care planning strategy is extremely comprehensive but user friendly. Three monthly reviews take place where the service user themselves (if possible), are involved. Families are always informed of this review by letter and signatures obtained if they were not able to take part. We also perform two to four weekly reviews by key workers/supervisors. All health care needs/social needs are adhered to in line with current legislation. Changes in care needs are fully documented and the relevant action taken. Annual care reviews also take place with service users and their Care Homes for Older People Page 11 of 25 Evidence: families/relevant others, whether privately or local authority funded. These reviews are duly documented and held on file. We have in place a self medication procedure. We have two secure medication trolleys sited in a lockable facility and extensive medication policies and procedures in place. All staff who administer medication are suitably qualified to do so. Privacy and dignity is respected at all times and personal care takes place in the confines of the service users room/bathroom. The care planning and risk assessments examined on the day of the visit contained sufficient information for staff to carry out the tasks required to meet service users needs. Staff confirmed that they have access to the care plans at all times for guidance and reference. The care plans and risk assessments were reviewed appropriately to ensure they remain pertinent to the needs of the service users. The care plans also made reference to the Mental Capacity Act (2005) to ensure that that service users rights and choices are respected. Records showed and service users confirmed that they have access to external professionals such as Doctors, Social Workers, Community Dietitians, Dentists, Opticians and Chiropodists. A service user stated The staff at the home will always call a Doctor if we are feeling unwell. We asked service users if they get their medication on time, the response was They are very good with our tablets. We observed a medication round and it was evident that medication was administered appropriately by the qualified care staff and appropriate medication storage facilities are available in the home. We asked service users if they receive the care and support they need, responses included Its wonderful here, the staff are all very nice, They are all very good, its a home from home. We asked the service users if the staff promote their respect and dignity, responses included Yes all the time and I cannot fault it here, its lovely. Service users also confirmed that staff promote their privacy and dignity by ensuing that curtains and doors are closed when performing personal care interventions. Through observations throughout the day, which included meal times, it was evident the care staff promoted service users respect and dignity at all times. Service users who required help to have their meals were assisted in a kind, considerate and unrushed manner and the interactions between staff and service users were kind and understanding. A visitor to the home also stated The quality of care is very good and all the staff are patient and caring. Care Homes for Older People Page 12 of 25 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. Recreational activities are provided within the home and opportunities are available for service users to interact within the broader community. Service users expressed satisfaction with the quality and variety of meals provided at the home. Evidence: Information provided by the registered manager in the Annual Quality Assurances Assessment states Service users are given free opportunities with regard to daily living including when to get up and go to bed, what to wear and what to eat etc. Records retained demonstrate that service users are given choice with regards to menus and activities provided. We pride ourselves on our extensive activities programme. Our recreation officer provides a wide range of activities tailored to each individual. We hold special recreational activities throughout the year where service users and families are all involved, eg summer fair, Christmas fair, shopping and meals out. Our meals are to an excellent standard, the cook provides a wide range of nutritious home made meals, and delicious home made baking, taking into account personal preferences. Church services are held in the Home on a monthly basis. We discussed the social activities provision with service users who confirmed that they Care Homes for Older People Page 13 of 25 Evidence: include dominoes, guest entertainers, religious interventions, meals out, keep fit, bingo and film events. Service users also confirmed that special events such as Christmas and Easter are celebrated together with service users birthdays. Service users also stated that staff respect there wishes if we dont wish to participate in the planned activities. The manager stated that an open door policy in relation to relatives and friends visiting the home is encouraged. Service users and relatives visiting the home on the day of the inspection confirmed the open door policy and confirmed that visitors are made very welcome by all the staff at the home. A menu was on display in the home and service users confirmed that the menu is amended on a daily basis. On the day of the inspection the lunch time menu consisted of corned/ham salad or meat balls with potatoes and vegetables. We asked service users if they like the meals provided at the home, comments included The meals are very good and a choice is provided and The food is lovely. Visitors to the home also stated that the meals are Very nice and well presented. A service user who required a specialist diet stated I like the food, its very good. Its very nice to think that my diet is catored for, its reassuring. The Chef confirmed that she is made aware of any specialist diets on service users arrival to the home and stated that previsions are readily available such as fresh fruit and vegetables. Care Homes for Older People Page 14 of 25 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. Service users feel safe at the home and feel confident in expressing their views and concerns. Evidence: Information provided by the registered manager in the Annual Quality Assurances Assessment states All records are kept of any complaint and logged through our complaints procedure to include any relevant investigation documentation. Complaints are dealt with sensitively and appropriately and a conclusion drawn within 28 days (Where possible). All staff are given copies of all Policies and procedures at induction, this includes the complaints and whistle-blowing policy. Similarly all new service users are given a copy of our Service User guide which contains a copy of our complaints procedure. All service users bedrooms have a copy of the complaints procedure in an appropriate font size. A complaints procedure is displayed in the foyer of the home and the procedure is also supplied in the Service user Guide which is provided to service users and their relatives on admission. The Care Quality Commission has not received any complaints about the service since the last inspection took place. We examined the homes complaints book, which showed that complaints are documented, and referrals to social services Safeguarding Adult services are made when required. The Have your Say pre inspection questionnaire asked service users Do you know how to make a complaint all six respondents stated Yes. We asked service users if they felt Care Homes for Older People Page 15 of 25 Evidence: confident in highlighting any concerns or complaints to the manager, responses included Yes very confident, I feel safe all the time, Yes its very safe, I cannot think of anything to complain about and We can talk about anything at the service users meetings and it is sorted out. We also asked the relatives of service users if they know how to make a complaint about the care provided by the home, the responses included I have never made a complaint, but I have confidence that the manager would address any issue I have. Records showed, and staff confirmed, that training in Safeguarding Adults has been provided. We spoke to a member staff to determine her level of understanding in this area. The member of staff demonstrated a good level knowledge of Safeguarding Adults procedures. In addition the member of staff said that the revised Nottinghamshire Safeguarding Adults policy is available at the home if further guidance if required. Information provided by the registered manager in the Annual Quality Assurance Assessment states All service users finances are fully documented with all transactions being signed/counter signed and checked on the day along with weekly auditing by the Manager. Records were available to support this. Care Homes for Older People Page 16 of 25 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. Service users benefit from a well-maintained environment, which is safe, comfortable, clean and fresh throughout. Evidence: Information provided by the registered manager in the Annual Quality Assurances Assessment states We employ two maintenance men who ensure the maintenance of both the outside and inside of the building. The home is well laid out providing accessible, safe and well maintained areas. The home is always clean and free from any malodours. The housekeeper has a comprehensive cleaning schedule which is endorsed on a daily basis. Bedrooms are redecorated when empty and is evidenced through our maintenance and redecoration programme. All other areas of the building are redecorated on a rotation basis. Bedrooms remain a private domain to service users and are decorated and personalised to service users liking. Daily fire checks are carried out alongside weekly fire alarm checks. These are all documented as per current legislation. Soft furnishings and all equipment is replaced as and when necessary.Nurse call checks are performed on a weekly basis to ensure safety to all service users. Infection control training is carried out with all staff. The Have your Say pre inspection questionnaire asked service users Is the home fresh and clean. All six respondents stated, Yes, a service user commented The cleanliness is very good. We asked service users if they are satisfied with the Care Homes for Older People Page 17 of 25 Evidence: standard cleanliness in the home, they all said they were and confirmed that their bedrooms are cleaned on a regular basis, as are the communal areas in the home. Comments made by service users included Its always nice and clean here, Yes its lovely here all the time and I went to look at other homes befor coming here, some were a bit smelly but not this one, its always lovely and clean. We performed a partial tour of the building, which included service users bedrooms and communal areas. All areas were safe, well maintained, clean, fresh and warm. Service users bedrooms were homely, safe and personalised. We saw that some of the carpets in the upstairs corridors would benefit from being replaced as they were slightly stained, following a discussion with the manager it was confirmed that the carpets are due to be replaced and were on the refurbishment plan. Staff said that gloves and aprons are worn at all times when providing personal care to promote infection control, we observed that gloves and aprons were available in bathroom areas together with hand sanitisers and staff were using them appropriately to promote infection control within the home. Care Homes for Older People Page 18 of 25 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 levels are sufficient in meeting the needs of service users. A staff training programme is in place to ensure staff are competent in meeting the needs of service users and staff recruitment practices are robust in protecting vulnerable adults. Evidence: Information provided by the registered manager in the Annual Quality Assurances Assessment states All staff are committed to providing needs led approach to care. More than 50 of the work force are trained to NVQ 2 level or above and NVQ 2 and NVQ3. Training is ongoing with new recruits being enrolled as soon as is practicably possible. Equal opportunities are practised throughout the home and are evidenced through our equal opportunities policy and the fact that we have a diverse age range of staff. Extensive training programmes take place as and when needed ensuring each category of staff receives the relevant training which pertains to their post. The recruitment and selection process is robust, with application forms being vetted, interview notes retained with our offer of employment being made once satisfactory references are received coupled with the required police checks. Shadowing and supervision of new recruits then takes place alongside a recognised standard induction prior to commencement of National Vocational Qualification programme. A review of trial period then takes place some 13 weeks later. Support and supervision sessions are ongoing, both informally and formally. Care Homes for Older People Page 19 of 25 Evidence: On the day of the visit,twenty six people were in residency at the home supported by the registered manager, an administration assistant, four care staff, the chef, a kitchen assistant, a handyman, a laundry assistant and two housekeepers. We asked service users if the staff are available when needed, comments included Yes always and We have a call button in our rooms which is very good the staff always come if needed. All service users spoken with on the day of the inspection expressed confidence in the staffs abilities and comments included I have only been here for a couple of days, I am very comfortable here, the girls are very helpful, the meals are lovely and the choice is very good, they [care staff] go to every extreme to make me comfortable, I cannot fault anything here, its a god send. We asked visitors to the home if they thought the staff were confident and competent in performing their duties, the response was Yes they are all very good, they always inform us of any developments, the care they give is very good. Staff files showed that recruitment processes are effective in promoting service users safety. Staff files contained, Protection of Vulnerable Adult checks, Criminal Record Bureau Checks,an application form, two written references and proof of identity. Records showed and staff confirmed that an induction process is provided when they commence employment to promote the health and well being of service users. Records also showed, and staff confirmed that training is provided to ensure staff can perform their duties in a safe and competent manner. Care Homes for Older People Page 20 of 25 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. The home is a safe place to live and service users are asked their opinion so that the home is run in the way they want. Evidence: The registered manager has attained a degree level Registered Managers Award and demonstrated a good level of knowledge and skills to perform her managerial duties effectively. Information provided by the registered manager in the Annual Quality Assurances Assessment states Our Registered Manager currently holds the relevant Care Management award and has 12 years experience in the caring industry. All staff are encouraged to make suggestions to the Management with regarding improvements. All staff are compliant with the leadership of the Management team. All service users are aware of the management structure and are confident and comfortable to voice opinions and problems. Regular service user meetings are held which provide the opportunity of all to have their say, points noted and action taken. We have in place a Care Homes for Older People Page 21 of 25 Evidence: quality assurance programme, anonymous questionnaires are given to all service users, issues are noted and appropriate action taken. The Have your Say service users survey asked What does the home do well. Comments included I get looked after very well, the cares are helpful, the food is very nice and the cook is very pleasant, I also enjoy the recreation times and I think to me its a god send, I could not be without it and Our care home is excellent the staff are second to none my friends say that if they have to go into a care home it would be Moriah House. The Have your Say staff survey asked What does the home do well comments included Moriah House offers a home from home environment in as mush as that is possible. Each client is assessed and cared for according to their individual needs and all are afforded patience , dignity and respect. Regular courses for staff ensure we are up to date with all training necessary to continue to provide good quality care. Records showed and staff confirmed that staff supervision and annual appraisals are performed and staff stated that the manager is very supportive and they feel valued. A member of staff commented She is wonderful and supportive, she will sort anything out, I feel 100 confident in the manager. The residents love her she is excellent both professionally and personally, the support I have received from her is excellent, I would not want to move from here because of all the help and support I receive. Records showed and service users confirmed that formal quality assurance systems are in place such as service users and relatives meetings. In addition, annual quality assurance questionnaires are distributed to ensure that the views of service users are obtained to identify any potential shortfall in service provision. Information provided by the registered manager within the Annual Quality Assurance Assessment shows that Policies and Procedures are available and have been reviewed appropriately to ensure they remain pertinent. A member of staff confirmed that the policies are accessible at any time for reference and guidance. The Annual quality Assurance Assessment also showed that service users health, safety and wellbeing is promoted by the provision of effective routine maintenance apart from the five yearly electrical circuits test which were slightly out of date. Care Homes for Older People Page 22 of 25 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 23 of 25 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 38 23 The registered provider must ensure that the homes electrical circuits are tested in accordance with legislation. To promote the health and wellbeing of service users. 31/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!