Care Home: Morton Close

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What the care home does well Written information about the home is of a very good quality - the Statement of Purpose contains up to date information about the Mental Capacity Act and Deprivation of Liberty Safeguards, and the Service User Guide contains a copy of the last inspection report. People are involved in their own care planning if they are able. There is evidence that staff respect people`s wishes, even if they are contrary to good advice, and carefully record them. The home is also good at involving families in their relative`s care, particularly if there are specific cultural or religious needs that must be met. The home has widened the choice that people have about what activities they can do and what they eat. People feel they have a say in how their daily lives are, which satisfies their social, cultural, religious and recreational needs. The cook is very involved in communicating with people regarding the meals. One area of very good practice is the file of photographed meals, so that people can be shown the photos of the two choices at lunchtime. The cook also liaises well with families to ensure people`s dietary needs are met, eg, supporting people who have a Halal or vegetarian diet. People said on the surveys: "I`m happy living here", "I think the home is good and I am very happy here", "I think the home is good, I have no complaints", "they look after me", "I am happy with things at the home", "the home does everything good", "I can`t think of anything they could do better". People are protected by the recruitment practices in place, making sure that the home only employs people who have been thoroughly vetted for suitability. People are looked after by a staff team who are well trained and supported to do their jobs. The home is well managed and run in the best interests of the people living there, who feel they are listened to and their suggestions acted upon. What has improved since the last inspection? Improvements to the care plans have been made, meaning that the full range of people`s abilities and needs are identified and plans put in place to meet their needs. Improvements have also been made to the way that pressure relief is managed. At the random inspection staff said they had had recent training in safeguarding vulnerable adults. This was confirmed in the AQAA the manager completed for this inspection. Improvements continue to be made in the building - on the day of the inspection visit, decorators were in the home, working on the ground floor. The servery area of the top floor dining room has also been refurbished since the last inspection. The noticeboard in the hallway has also been improved as a result of suggestions by visitors. This provides good quality information for people, including photographs of the staff. The results of the home`s quality surveys are now posted on the noticeboard for people to see. What the care home could do better: One person made a suggestion to improve the daily routine - they would really appreciate having an early morning cup of tea, as it could be some time between them waking up and getting their first drink at breakfast. This was passed on to the manager. The manager should regularly review the arrangements for people to access the front door key code, to make sure that security is not compromised. The provision of activities and social stimulation to people with dementia should also be kept under review, to ensure that they have opportunities to take part in activities appropriate to their needs. The manager completed the AQAA, but it was very brief and lacking in detail. The manager has idenified further ways to improve the service, and outcomes at this inspection have been found to be good, but the manager seems reluctant to actually say how good they are. Key inspection report Care homes for older people Name: Address: Morton Close Morton Lane East Morton Keighley BD20 5RP     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: Stevie Allerton     Date: 1 3 1 0 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 28 Information about the care home Name of care home: Address: Morton Close Morton Lane East Morton Keighley BD20 5RP 01274565955 01274510392 mortonmanager@adlcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Barleyglow Limited c/o ADL plc care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 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 category: Old age, not falling within any other category - Code OP, maximum number of places 40 Date of last inspection Brief description of the care home Morton Close Care Home is a large detached property set in substantial grounds. The home is situated in the Cross Flats area of Bingley, approximately two miles from the town centre. The home is registered to provide personal care only for up to 40 older people. Accommodation is on three floors with single and some double rooms available; the communal lounges and dining areas are all situated on the top floor. The home is well served by public transport. There is level access into the home and Care Homes for Older People Page 4 of 28 Over 65 40 0 2 2 0 8 2 0 0 9 Brief description of the care home one passenger lift. The Statement of Purpose and Service User Guide providing information about the service are available from the home. Please contact the home for information on the current range of fees. 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: The quality rating for this service is 2 stars. This means that people that use the service experience good quality outcomes. We made an unannounced visit to the home, which was carried out between 10.00am and 6.15pm. The inspection process included looking at information we have received about the service since the last key inspection. An additional random inspection had also been carried out in August 2009. The home had completed and returned their Annual Quality Assurance Assessment (AQAA) form and the information provided has also been used as evidence in the body of the report. The AQAA is a self assessment form that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. Care Homes for Older People Page 6 of 28 Surveys were sent out to people living at the home and health care professionals involved in their care. Surveys were returned by eight people and one health care professional. The methods we used included looking at records, observing staff at work, talking to people living at the home and visitors, talking to staff and looking around the property. Feedback was given to the manager at the end of the visit. Current fees are £397.95 - £455.00 per week. Further information on charges can be obtained from the manager. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Improvements to the care plans have been made, meaning that the full range of peoples abilities and needs are identified and plans put in place to meet their needs. Improvements have also been made to the way that pressure relief is managed. At the random inspection staff said they had had recent training in safeguarding vulnerable adults. This was confirmed in the AQAA the manager completed for this inspection. Improvements continue to be made in the building - on the day of the inspection visit, decorators were in the home, working on the ground floor. The servery area of the top floor dining room has also been refurbished since the last inspection. The noticeboard in the hallway has also been improved as a result of suggestions by visitors. This provides good quality information for people, including photographs of the Care Homes for Older People Page 8 of 28 staff. The results of the homes quality surveys are now posted on the noticeboard for people to see. 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 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. People are properly assessed prior to being offered a service, to make sure that the home can meet their needs. People have the right level of information to decide whether the place is right for them. Evidence: During the visit we looked at the Statement of Purpose and Service User Guide, and the pre-admission assessment information for someone who had been admitted within the previous month. Current fees are £397.95 - £455.00 per week. Extra charges are made for escorts to appointments, hairdressing, aromatherapy, chiropody, outings, newspapers and private phone installation. Written information was of a very good quality - the Statement of Purpose contained information about the Mental Capacity Act Deprivation of Liberty Safeguards. The Service User Guide contained a copy of the last inspection report. Care Homes for Older People Page 11 of 28 Evidence: The initial assessment and care plan for the person newly admitted showed that she had been involved in the care planning process and had signed her own care plans. These showed that she was at risk of falls due to her severe osteo-arthritis and needs two members of staff to mobilise and transfer her. Care plans are based on the Roper-Logan-Tierney model using the 12 Activities of Daily Living (ADL). Good practice was seen with the form asking for consent to keeping photo identification. In discussion with the person, she said she knew that she had a care plan and what was in it. 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. Improvements to the care plans mean that the full range of peoples abilities and needs are identified and plans put in place to meet their needs. Improvements have also been made to the way that pressure relief is managed, meaning that peoples health needs are being met. Medication is managed safely, which promotes peoples health. Evidence: We case tracked four people with a range of needs. We looked at the environment to check whether the equipment identified as being needed for people was in place. We looked at health related referrals and associated records. We spoke to people about their care. We spoke to staff about how they support peoples personal and health care needs and observed care where possible. We looked at medication. In general the care plans, based on the Activities of Daily Living, were good. They include end of life plans, as well as nutritional screening, continence assessment, falls risk assessment and pressure risk assessment tools. Where risk is identified, the tools trigger specific care plans, such as manual handling plans. Regular reviews of these Care Homes for Older People Page 13 of 28 Evidence: risk assessments are being documented. Where care plans document that bed rails and covers are in use, these were seen in place and appear to be managed safely. Some people have pressure relieving mattresses and cushions. Care plans identify the frequency at which night staff have to re-position people in bed and the night staff record these. There was evidence from a review of the care needs of a person with visual impairment, that staff took action to put in place suggestions from the Sensory Needs Team, such as adjusting the lighting in her room, providing her with a large clock and presenting her food on pink plates to help her to see what she was eating. This was later seen in practice in the dining room. It was clearly documented in one persons care plan that she would not wear heel protectors in bed, despite being at risk of pressure sores. Staff have explained the risks, however, they respect her wishes. Where care plans refer to other pieces of equipment in use, such as a lifting belt, pressure cushion, slide sheet, electric wheelchair, these were seen and available for use. Someone was case tracked who was admitted some years ago with moderate memory loss. They now have advanced dementia and cannot take part in the reviews of their care. Care plans seemed appropriate for their needs. There was good evidence on pre-admission assessment records that discussions take place with peoples families about meeting specific religious and cultural needs, and these were clearly documented - food, prayers, gender of staff providing personal care, medical intervention, washing and bathing, etc. There are some staff that can converse in Asian languages. Where people are smokers, their care plans document what the arrangements are to meet their needs in this area. One person spoken to has a ground floor room near to the entrance door and goes outside to sit and have a smoke. We spoke to members of the care team who were concerned that they were no longer allowed to use Kylies (absorbent draw sheets) during the night, so had to do a complete bed strip if people were found to have been incontinent. They felt that it was unfair to have to wake people up and disturb them to this extent, and that it was much better just to have to change a Kylie. One of the senior carers was observed as she gave out medication at tea-time, and we Care Homes for Older People Page 14 of 28 Evidence: looked at the storage, recording and training around medication. Some good practice was observed and the systems in place appeared to be thorough. A survey returned from a district nurse commented that they felt the home could do better by having more education on moving and handling and the importance of pressure relief. Training records showed that staff receive moving and handling training at the prescribed intervals. During the visit we observed staff moving people good practice was observed, all wheelchairs had footrests, etc. We spoke to a relative, who said she was very satisfied with the care provided to her husband. She clearly has a good rapport with the staff and said that she finds everyone approachable. 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. The home has widened the choice that people have about what activities they can do and what they eat. People feel they have a say in how their daily lives are, which satisfies their social, cultural, religious and recreational needs. Staff must make sure that people with dementia who cannot communicate so readily, do not miss out on having activities appropriate to their individual needs. Evidence: During the visit we looked at peoples care plans, lifestyle diaries and the monthly planner for evidence of social activities, and also spoke to people. Lunch was taken with the people in the dining room. We spoke to the cook and looked at the menus. We looked at minutes of residents meetings. We spoke to the administrator, who also does activities. Records showed that there are regular minibus outings, to places such as tea rooms, garden centres, Harry Ramsdens, etc. People that were spoken to referred to the most recent outing and said they were looking forward to the next one. The programme of activities was on display in the dining room, along with samples of craft items that people had made and photo collages of events and parties. Care Homes for Older People Page 16 of 28 Evidence: One of the people who was case tracked is unable to plan or organise her own social life, due to her advanced dementia. Staff said that she cannot actively join in group activities now, but seems content to sit and watch whats going on. Another persons care plan said that she dislikes socialising in groups and prefers one to one time with her daughter or the staff, who confirmed that they spend time with her, doing hand massage or chatting. The hairdresser was in the home on the day of the visit. The women we spoke to said that they really enjoy having their hair done and see it as a social event. One said it makes you feel better if you look presentable. The cook is very involved in communicating with people regarding the meals. One area of very good practice is the file of photographed meals, so that people can be shown the photos of the two choices at lunchtime. On the day of the visit the choices were Shepherds Pie or Fish Pie. The cook came in to the office to find out if there was a photograph of the Fish Pie yet (no), so took the camera away to photograph the plate of food. There was evidence that the cook also liaises well with families to ensure peoples needs are met, eg, supporting people who have a Halal or vegetarian diet. It was one mans birthday the following day - the cook had been to speak to him to ask what he wanted for his buffet tea and liaised with the manager about what foods could be made and what would need to be purchased. The forthcoming Halloween and Bonfire Night events were also being planned, with special food to mark the occasion. One persons care plan stated that she used special utensils to assist her to eat independently - these were seen in use by her in the dining room, as was the food served on a pink plate for the person with visual impairment. The lunchtime meal was very well presented, tasty and a good quantity provided (too big, according to some of the ladies). There was a nice atmosphere in the dining room. People we spoke to said they liked the food. They explained that they could order what they liked for breakfast and liked having this range of choices. The residents meeting minutes were on the noticeboard in the dining room. It could be seen that the timing of the meals had been discussed following the last inspection. People said that they didnt want any changes made to the current mealtimes. One person made a suggestion to improve the daily routine - they would really appreciate having an early morning cup of tea, as it could be some time between them waking up and getting their first drink at breakfast. This was passed on to the Care Homes for Older People Page 17 of 28 Evidence: manager. Care Homes for Older People Page 18 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. People living at the home are protected by the policies, procedures and training in place. People feel comfortable about raising concerns and are confident that they will be treated seriously. Evidence: At the random inspection staff said they had had recent training in safeguarding vulnerable adults. This was confirmed in the AQAA the manager completed for this inspection. The manager has a copy of the local authoritys procedures for reporting allegations of abuse. There is information and guidance for staff on handling abuse and complaints, backed up by training, for all grades of staff. The Whistleblowing procedure is displayed on noticeboards and is discussed at interviews and during induction training. Information about Advocacy services, Deprivation of Liberty Safeguards and the homes Complaints procedure are also prominently displayed on the notice board in the entrance hall. Relatives spoken to said they found the manager very approachable and always willing to hear about their concerns. Of the eight surveys returned by people living at the home, six said they knew how to make a formal complaint if they had one. One said they would speak to their family. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and comfortable home and the provider continues to make improvements to the decor and facilities. Good systems are in place to make sure that the home is hygienic. The location of the home is particularly pleasing to people who enjoy watching wildlife and living in a more rural setting. Evidence: On the day of the inspection visit, decorators were in the home, working on the ground floor. The servery area of the top floor dining room has been refurbished since the last inspection. The bedrooms of the people we case tracked were looked at, amongst others. All of the equipment stated in the care plans as being needed was seen in place. Some people have Dorguards in place, hold-open devices that will close if a fire alarm sounds, to avoid isolation in their rooms. All of the areas seen were clean, comfortable and well furnished. There were no unpleasant odours in evidence. The laundry facilities are very well managed, the space used to good advantage to maintain good hygiene, and the whole area kept to a high standard of cleanliness and order. There are designated housekeeping staff, who are trained appropriately in Health and Care Homes for Older People Page 20 of 28 Evidence: Safety and COSHH regulations. There is a maintenance man (who was spoken to during the course of the day) and the home appears to be in a good state of repair. People living at the home said they really like the location, which is rural, with gardens that are attractive to birds and other wildlife that can be seen from the windows. In response to suggestions from relatives, there is now a large noticeboard in the ground floor entrance hall with useful information displayed, including photographs of the staff. The office is located some distance from the main entrance. Access to the home is gained via intercom or regular visitors have the keycode. There is a question mark about how secure this is, as so many people have it and the manager said that it has not been changed for some considerable time. 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. People are protected by the recruitment practices in place, making sure that the home only employs people who have been thoroughly vetted for suitability. People are looked after by a staff team who are well trained and supported to do their jobs. Evidence: On the day of the inspection visit, the manager and administrator were on duty with two senior carers and two care assistants, supported by two housekeeping staff, the cook, the laundry assistant and the maintenance man. There were 26 people in the home at the time. The manager said that there was a plan in place to increase the numbers on the staff rota when the numbers of residents increase (the maximum number accommodated in practice is 31, although if the double rooms are used the home is registered for up to 40). When the random inspection was carried out in August, staff said they had recently had training in Moving & Handling, Health & Safety, Fire Safety, POVA (Safeguarding) and Dementia, and that lots of training is provided. The homes training matrix was seen. They use Age Concern and Bradford Social Services for training input as well as the companys own training. Training was seen to include client specific topics as well as National Vocational Qualifications (NVQs) and the mandatory courses. More than 50 of the staff now have NVQs. Care Homes for Older People Page 22 of 28 Evidence: We looked at the recruitment documentation for two staff members, both of whom started work at the home during the summer. They contained evidence that two written references had been taken up, along with an exploration of gaps in peoples employment history and verification of identity. Background checks into peoples suitability to work with vulnerable adults had also been carried out. Workers had been issued with a copy of the General Social Care Councils Code of Conduct and the companys Health and Safety Handbook. Completed induction training checklists were contained in the files. 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. The home is well managed and run in the best interests of the people living there, who feel they are listened to and suggestions acted upon. Evidence: The Manager is aware of the requirements of the Mental Capacity Act and the Deprivation of Liberty Safeguards (DoLS) and how these apply to care homes. She said that she was actively looking for some more in depth training about the DoLS. Some of the staff had had training in the Mental Capacity Act and the home had received the paperwork about DoLS, but no training as yet. A selection of records were looked at, including care plans and daily records, accident records, fire safety and other health & safety records, medication records, menus, training records and minutes of residents meetings. These showed that there are efficient systems in place for the effective running of the home. The results of the homes quality surveys are now posted on the noticeboard for Care Homes for Older People Page 24 of 28 Evidence: people to see. The manager completed the AQAA, but it was very brief and lacking in detail. The manager has idenified further ways to improve the service, and outcomes were found to be good, but the manager seems reluctant to actually say how good they are. 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 12 Staff should make sure that appropriate activities are regularly offered to people with dementia, who cannot communicate their needs so readily. This is to make sure that their abilities and preferences are given consideration and they have opportunities for stimulation. The manager should regularly review the arrangements for people to access the front door key code, to make sure that security is not compromised. 2 19 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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