Care Home: Nora Chase House

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What the care home does well The home provides stable and consistent support, which enables residents to lead fulfilled lives over long periods. Residents enjoy the personal care and attention they get in what they perceive as a safe, cosy, and friendly environment. There is a strong commitment to ensuring that residents maintain positive links with their relatives and friends. Residents are supported to make decisions in maintaining their independence and control in their lives. Residents continue to hold in high regard, the inputs of the management and staff in caring for them, which they openly talk about. What has improved since the last inspection? The home now provides care and support to residents with a diagnosis of Dementia. Full and detailed assessments were carried out on all residents. Timely interventions were made to ensure that residents receive appropriate services from external professionals. A good record was made of drugs that are dispatched to the home. The safeguarding adults policy was reviewed in line with guidance. Several improvements were carried out to the environment since the last inspection. Appropriate action was taken to ensure that the potential hazard identified in a resident`s room at the last inspection, was removed. The frequency of staff supervision had improved, although further improvements should be made. Recruitment practices, generally provided better safeguards for residents. A development plan for the home has been established. What the care home could do better: The registered manager should seek to provide more specialist activities for the residents with a diagnosis of Dementia. The registered manager should continue increase the frequency of supervision for all staff in line with the minimum requirement. The registered manager should confirm in writing to the Commission, whether her current qualifications are equivalent to the NVQ level 4 in Management and Care. Key inspection report Care homes for older people Name: Address: Nora Chase House 50 Valentines Road Ilford Essex IG1 4SA     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: Stanley Phipps     Date: 1 1 0 3 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 26 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 26 Information about the care home Name of care home: Address: Nora Chase House 50 Valentines Road Ilford Essex IG1 4SA 02085180336 F/P02085549129 norachasehouse@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Mary Louise Crosdale Name of registered manager (if applicable) Mrs Mary Louise Crosdale Type of registration: Number of places registered: care home 9 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 who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Norah Chase House is registered as a care home for nine (9) older people with or without a diagnosis of Dementia. It is owned and run by the Proprietor/Manager - Mrs Crosdale since its opening in 1985. The aims of the service are to offer high standards of care in a homely atmosphere. Care Homes for Older People Page 4 of 26 Over 65 0 9 9 0 Brief description of the care home There are now nine single rooms on the ground and first floor, as the registered person carried out some restructuring work to the physical environment. Therefore, all service users currently have their own room and do not share. As part of the homes development a conservatory was added in 2005 to give additional communal space to service users. There is no lift and most of the service users are mobile and self-caring. There is a main lounge, which is separate from the dining area and the conservatory gives an option for service users to meet relatives. There is a rear garden with handrails from the fire exit on the right of the building - along the length and width of the garden to enable service users to maintain their independence while mobilising. The home is near Valentines Park with reasonably close access to public transport and the centre of Ilford. The fees range from £465.00 to £521.00 and exclude dry cleaning, hairdressing, outings, newspapers, toiletries, personal activities and personal phone installations all of which are variably priced. The homes statement of purpose is made available to service users prior to their admission and is a copy is also kept in the home. A copy of the service user guide is given to each individual admitted to the home. Care Homes for Older People Page 5 of 26 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: We carried out an unannounced site visit on the 11/03/09 and conducted a key inspection of the service. In doing so we focused on the key minimum standards and all outstanding requirements that were made at the last inspection. We also held interviews and discussions with: residents, the deputy manager and staff on duty, as the registered manager was on annual leave. An assessment was carried out on a range of records required by regulation in relation to: care plans, complaints, menus, staffing recruitment, training and supervision, residents finances, health and safety, policies and procedures, activities, residents health care, accidents/incidents and quality assurance. We undertook a tour of the building and considered information provided in Regulation 37 notifications, submitted by the registered manager. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The registered manager should seek to provide more specialist activities for the residents with a diagnosis of Dementia. The registered manager should continue increase the frequency of supervision for all staff in line with the minimum requirement. The registered manager should confirm in writing to the Commission, whether her Care Homes for Older People Page 7 of 26 current qualifications are equivalent to the NVQ level 4 in Management and Care. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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. Residents are now assured that detailed assessments would be carried out to determine whether the home is best suited to provide for their needs. More importantly full assessments of their specialist needs are carried out before they are admitted into the home. This is reassuring to residents, their relatives and external professionals involved in supporting residents in taking up residence at Nora Chase House. The home does not provide intermediate care services. Evidence: The admission records of three of the most recently admitted residents were assessed. They contained all the basic information relating to each of the residents concerned including and importantly so, information relating to their specialist needs. The assessments looked at areas such as: behaviour, levels of dependency, sleeping patterns, nutritional status as well all the key aspects of their health to include cognitive abilities. This is an improvement from the last inspection particularly in the Care Homes for Older People Page 10 of 26 Evidence: quality of the assessment records held by the home. The records viewed, also indicated varying levels of involvement by the residents and their relatives. It was clear that the registered manager gathered as much information as possible from the referring agencies. It was also more evident that with the wide range of information gathered, that staff not only had a better picture of each resident, but a clearer platform on which the most appropriate care could be provided for each individual. Residents and their relatives were hence more assured that the home would do better in meeting their needs. Norah Chase House does not offer intermediate care and if a decision was taken to so do, then changes would have to be made to the environment, staffing resources, and policies and procedures. Care Homes for Older People Page 11 of 26 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. Residents have the benefit of a care plan, which sets out how their needs were provided for. They now receive good support with their health care, which is enhanced by the safe support provided by staff with their medication. They remain pleased with the manner in which their privacy and dignity is maintained and promoted. Evidence: From a sample of three of the residents files, plans detailing the personal, health and social care needs of the individuals were set out. The plans were formulated from the assessments that were carried out with the residents and where possible with relatives. Residents preferences were detailed in the care plans and staff spoken to had an understanding of their specialist needs for example; those with a diagnosis of dementia. The care plans continued to be reviewed monthly or as and when needs changed. One resident stated; I am not always able to take part in the care planning, however, I am aware and know what is in it and I am happy with that. Three other residents spoken to were happy with the care planning process in the home. Residents were receiving better support with their health care, which was reflected in Care Homes for Older People Page 12 of 26 Evidence: their health records. They were all registered with a GP and continued to receive services from the chiropodist, dentist, and opticians. In one case consideration was given to enable a resident to have a mental state assessment as her quality of life was thought to be deteriorating. On the day of the visit, staff took a resident to have her ear syringed and the resident commented: I feel much better now - its amazing. Documented evidence was in place to confirm that on a weekly basis the well-being of residents was monitored. A very good record of residents health appointments were in place and this indicated that the support provided with their health care, was a priority. There was also an improvement in the support provided with medication, in that a record of drugs coming into the home was appropriately held. In this respect staff were providing the support to ensure that residents health and welfare was promoted and maintained. As a matter of fact the quality of most of the residents lives depended on the use of medication of some sort. Staff had the benefit of training prior to carrying out this task and a medication policy/procedure was in place to guide them. The inspector observed medication administration which was generally good apart from when the staff attempted to serve medication to more than one person at a time. Guidance was given to the staff by the deputy manager, which helped to minimise the risk of errors being made. Medication storage was of a good standard. The staffing engagement with residents throughout the day indicated that they were caring and sensitive in promoting their dignity and respect. This is particularly important when supporting residents with specialist needs e.g. Dementia. Residents were addressed by their preferred names and chose their style of dress, which they were all happy with. One resident maintained that she is a very private person, which she claimed was respected by the manager and all the staff working in the home. Another resident spoke positively about the dignified manner in which his personal support was provided. It was conclusive that the residents were pleased with how they were treated and cared for by the staff. Care Homes for Older People Page 13 of 26 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. Residents enjoy a range of activities that were in line with their interests. They are also encouraged to maintain links with their families and friends, and supported to exercise choice and control in their lives. Meals are provided in line with the choice and nutritional needs of residents. Evidence: From discussions held with the residents, they were encouraged to pursue their interests and this was determined through an assessment of their personal preferences. In this way, staff had an individual picture of each resident. Their choices were varied and the home provided a range of group and individual activities. They were primarily carried out in the mornings between ten and twelve midday in the conservatory. This ensured that residents had alternative spaces, should they not wish to participate. Some of the group activities included: puzzles, exercises, discussions, story-telling and a general question and answer session relating to reminiscence. Seasonal and religious celebrations were also formed a part of the activities that residents enjoyed. Residents had good support to pursue their personal interests, be going for a walk to the nearby park, visiting the theatre, listening to the radio, doing crosswords, reading Care Homes for Older People Page 14 of 26 Evidence: or viewing television programmes of their choice. They enjoyed taking it easy in the afternoons, but also enjoyed the flexibility provided by the staff. A daily log was maintained of the activities that residents participated in and through discussions with them, they were all pleased with the activities provided at Nora Chase House. Given the fact that the home now provides a service for Dementia sufferers, most of the activities provided, were not specific to that group. Although staff were observed spending quality one to one time with residents, the registered manager should explore greater opportunities for providing more activities for people with Dementia. Wherever possible residents were encouraged to maintain links with their friends and families. One of the residents receives telephone calls and visits from his relatives and in discussion with him, he really looked forward to this. Another spoke of having a female friend who visits him at the home, which he enjoys. In discussion with another she happily recounted visits though irregular, from her daughter. It was clear that the management continued to make it possible for residents to maintain their personal and family networks. The homes visiting policy is widely advertised and from records seen, appropriate contact was made with relatives to keep them informed of developments with their loved ones. In some cases, relatives were actively involved in the financial affairs of residents, which also served to maintain their networks. This remains a strong area of the homes operations. Residents do get good opportunities to take control of their lives. Their preferences were identified and recorded as part of the assessment process, which was useful for staff who supported them. Residents were observed being called by their preferred names, and staff were knocking on their doors before entering their rooms. They chose their activities, the times they went to bed, when they got up and, basically how they spend their day. An integral part of enabling residents, was the various types of risk assessments and risk control measures that were carried out with them. This ensured that they could retain as much of their independence as possible without compromising their safety. One resident spoke of; going for walks in park, collecting her money and doing puzzles to keep her brain going, all of which represented her autonomy and choice. A four week rolling menu, chosen by residents remained in place. In discussion with some of them, they expressed a great deal of satisfaction with the meals provided by the home. Residents were observed enjoying afternoon tea with home-made cakes. Some of them remarked: We have some good cooks in the home who really makes some great dishes. Supper was observed, which consisted cheese on toast with home-made soup, which again was enjoyed by all the residents. The experience of having meals was pleasant and cosy as residents sat around a table that was Care Homes for Older People Page 15 of 26 Evidence: traditionally set. They were observed chatting while enjoying their meal. The menus were assessed and found to be varied and in line with the choices and nutritional requirements of the residents. They were current and widely advertised, so that all residents knew what they were going to have. Feedback received from residents who were supported with their meals was positive. They also indicated that they could request a snack whenever they felt like it, which included hot and cold drinks. There was a good supply of dry and frozen foods in the home. Fresh fruits and vegetables were in better quantities, when compared to the previous visit, which was greater nutritional value to the residents. Food storage in the home was of a good standard. Care Homes for Older People Page 16 of 26 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. Residents and their relatives know that they can raise concerns about any aspect of the services provided at Norah Chase House. The safeguarding protocols that are in place, now gives a greater assurance that residents would continue to remain safe from harm or abuse. Evidence: A satisfactory complaints procedure remains in place and available to residents and their relatives. A record for logging complaints was also in place and there were no complaints noted. In discussion with residents they demonstrated a good understanding of how to complain. Most stated that they felt comfortable with raising any concern they had with the manager or the deputy, but that things are normally okay at the home. Staff spoken to understood their role in supporting residents to complain. The deputy manager informed that residents are encouraged to express their views about the home in an open manner at all times. Compliments about the quality of the service were available, most of which were positive. There were no safeguarding issues in the home and safeguarding training was provided for staff. Discussions with staff indicated that they understood their role in safeguarding residents, including how and when they would raise concerns about care practice or any event which would cause harm to a resident. The safeguarding policy now reflects the various types of abuse and this was widely available to staff. Residents are therefore generally safe at Norah Chase House. Care Homes for Older People Page 17 of 26 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. Residents enjoy living in an environment that is homely, accessible, comfortable and generally safe. This has been enhanced by some improvements that were carried out both to the communal and private spaces in the home. Norah Chase House remained a pleasant and hygienic place to live. Evidence: Despite this being an unannounced inspection, the home was found to be airy, bright and in a good state of repair. All residents were observed using the environment with ease, including those that needed support from the staff. Speaking with two of the residents with Dementia, they were quite familiar with the layout of the home, including the location of the main communal areas, the toilets and their private bedrooms. This was enabled by appropriate signage that was put in place, as part of promoting greater orientation and residents independence. A good system remained in place for maintaining the environment. Some improvements were identified at the last inspection, most of which were carried out to include: replacing the floor covering in the kitchen and staff toilet, and making ramps available in key areas of the home to promote accessibility and safety. Residents were happy with the lighting, heating and ventilation in the home. The inspector viewed some of the residents rooms by invitation and in all cases, they were well-maintained, and reflective of their personal effects and taste. One resident Care Homes for Older People Page 18 of 26 Evidence: showed off a new television, while another showed family pictures and her soft toys. Residents were quite pleased with their individual spaces, which they could use as and when they wish. It was noted that action was taken by the registered manager to ensure greater safety in one of the bedrooms, which was identified at the last inspection. In this case the residents choice was in conflict with her safety. However, this was resolved with the resident in her best interests, which was positive. The home was clean and hygienic throughout the course of the inspection and feedback received from residents, again strongly supported this. The laundry facilities remained appropriate for the size and nature of the service. Staff supported residents with their laundry and they had a good understanding of infection control, as a result of their training. Handwashing facilities were appropriately cited in the bathrooms, toilets and the laundry. A good system remains in place to ensure that the home is clean and hygienic. Care Homes for Older People Page 19 of 26 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. Residents continue to receive a good standard of care from a staff team that is motivated and in sufficient numbers to meet their needs. Improvements in the recruitment practices and the support provided from staff supervision, ensure that residents continue to receive a good service. Evidence: At the time of the visit, there were nine residents in the home and there were three staff on duty including the deputy manager. The staffing rosters indicated that there is usually three staff on shift, which was suitable for the dependency levels of the resident group in the home at the time. The deputy manager gave the assurance that this would be reviewed if and when residents needs required a higher level of staffing input. Residents spoken to were satisfied with the staffing levels which could be summed up by one of their comments being: staff are always available when you need them. Discussions with members of staff indicated that they felt able to manage their workloads and that they had good support from both the manager and her deputy. The staff training records were assessed and there was an improvement in the number of staff with at least an NVQ level 2 in Care, which stood at around seventy per cent. At least one staff was in pursuit of the NVQ Level 3 qualification with the deputy manager having completed the NVQ Level 4. Staff spoken to had a good Care Homes for Older People Page 20 of 26 Evidence: understanding of the residents needs, including those with a diagnosis of Dementia, as they were also provided with Dementia Care training. They generally receive from hands-on support from both the manager and the deputy manager. It was noted that formal supervision for staff had improved, although is some cases, it was not up to the minimum requirement of six times per year. This piece of work should be continued and could include an annual appraisal meeting and group supervision, to enhance the staffing development and competence. The recruitment of staff did also show improvements that would ensure the protection of residents living in the home. Completed application forms were in place along with key security checks e.g. Criminal Records Bureau (CRB) along with the acquisition of two satisfactory references. Of the three files sampled, there was one that did not have their second reference on file and the deputy manager took immediate action to ensure that the individual did not continue to work until that was rectified. This action ensured that residents were not further at risk of coming into contact with staff that may be unsuitable to work with them. A staff training and development profile was in place for staff working in the home. Staff had the benefit of a structured induction, and further training such as: health and safety, fire, food hygiene, oral hygiene, medication awareness, Dementia Care, manual handling, safeguarding vulnerable adults and infection control. As stated earlier, most of the staff did complete at least an NVQ level 2 in Care and so the combination of the additional training provided, was geared towards providing a safe and quality service to the resident group. The registered manager would need to ensure that refresher training is provided in the key mandatory areas, to ensure that staff are kept updated and skilled to provide good quality care. Care Homes for Older People Page 21 of 26 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. Residents continue to benefit from living in a home that has good management systems, which positively impact on the quality of services they receive. Quality monitoring systems were in place to develop the service and residents get good support to manage their finances. Sound health and safety practices ensure that residents live in a safe environment. Evidence: At the time of the visit, the registered manager was on annual leave and the home was run by the deputy manager who has worked in the home for a considerable number of years. The deputy manager did complete the NVQ Level 4 qualification and so ran the home pretty comfortably. She had the respect and support of the staff team and had a good understanding of the residents needs. There was stability and continuity, which was reflective of the deputys input. Feedback received from the residents indicated that they were satisfied with the arrangements made by the registered manager for running the home. Given the absence of the manager, the inspector was unable to determine whether the registered manager undertook the Care Homes for Older People Page 22 of 26 Evidence: task as recommended in the last report to verify whether her qualifications were equivalent to an NV Level 4 in Management and Care. Despite this, the home was relatively well-managed. On the day of the visit the inspector saw evidence of a development plan for the service. There was evidence that the views of residents and relatives were obtained as part of a quality monitoring process. The views gathered covered all aspects of the service and the inspector had an opportunity to assess some of the outcomes of surveys that were completed. The common view was that the service was excellent and one of the quotes made included: Wonderful atmosphere of caring people. Residents views were also gathered at their meetings and they were pleased that their inputs had a positive impact on how the service was developed. The financial records of three residents were assessed and were found to be well maintained. Detailed records were held of transactions made with, and on behalf of the residents. Residents also received support with their finances from their relatives. There were good arrangements in place for the security of residents finances and valuables. The inspector was satisfied with the arrangements in place to support the residents and safeguard their finances. A wide range of health and safety records were examined, which were found to be in order. Safety checks were carried out frequently and in line with guidance. Risk assessments, fire drills, fridge/freezer temperature monitoring and the maintenance of fire equipment were satisfactory. Gas and electrical certificates were also valid and a record of accidents and incidents was maintained in the home. Safety signs were appropriately posted throughout the home and staff demonstrated a good understanding of their role in maintaining a safe environment. Residents are therefore assured of living in a home that was generally safe and suited to meet their needs. Care Homes for Older People Page 23 of 26 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 26 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 The registered manager should explore and develop activities that were more specific to service users with Dementia. The registered manager should continue to provide supervision for all staff in line with the minimum standard of six sessions per year. The registered manager should verify with the appropriate authorities as to whether her qualifications meet the equivalent of the NVQ Level 4 in Manageent and Care. 2 28 3 37 Care Homes for Older People Page 25 of 26 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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