Care Home: Northcourt Lodge

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What the care home does well Prospective residents and their families are provided with the necessary information about the home to help them decide if it will be appropriate to the needs of the individual. The home undertakes an appropriately detailed assessment prior to admission in order to establish that it can meet the identified needs of the person seeking admission. The information gathered is incorporated into an individual care plan, which addresses the social, emotional and healthcare needs of the resident. The home also has an appropriate system in place to manage their medication on behalf of residents. The dignity, privacy and rights of residents` are supported by the staff through their systems and ways of working. Residents have opportunities to take part in appropriate activities and outings, and their spiritual and cultural needs are addressed.. Residents are provided with an appropriately varied diet and are consulted about their likes and dislikes with regard to food. The home has an appropriate complaints procedure in place which is readily available to residents and visitors. Complaints are appropriately addressed. The home also has appropriate systems in place to help safeguard residents from abuse. The physical environment provided is homely and meets the needs of residents. The home has an appropriate level of staffing to meet the current needs of residents. Levels of NVQ are improving as increasing numbers complete their NVQ award. Staff have received most of the required training, and the recruitment system helps to safeguard residents. The home is managed effectively by a competent management team, who have the necessary skills and experience. An appropriate quality assurance system is in place to seek the views of residents and relatives alongside the monthly monitoring visits. The health, safety and welfare of residents is safeguarded by the systems and practices in operation. What has improved since the last inspection? The home continues to develop. The manager plans to further improve the care plans to provide a more individualised plan for residents. What the care home could do better: An overview of staff training should be maintained at all times. The quality assurance system could be broadened to include seeking the views of care managers and healthcare professionals with whom the home has regular contact. One of the bathrooms could be redecorated and facilities would be improved by the provision of an additional bathing facility as planned. Key inspection report Care homes for older people Name: Address: Northcourt Lodge 65 Northcourt Avenue Reading Berkshire RG2 7HF     The quality rating for this care home is:   three star excellent 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: Stephen Webb     Date: 1 7 1 1 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 27 Information about the care home Name of care home: Address: Northcourt Lodge 65 Northcourt Avenue Reading Berkshire RG2 7HF 01189875062 01189755007 rozinah99@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dr Ramnath Narayan,Mr Harbhajan Surdhar Name of registered manager (if applicable) Type of registration: Number of places registered: care home 22 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 to be accommodated is 22 The registered person may provide the following category of service only:Care home with Nursing (N) to service users of the following gender:Either whose primary care needs on admission to the home are within the following category :Old age, not falling within any other category(OP) Date of last inspection Brief description of the care home Northcourt Lodge is a care home accommodating 21 older people, with nursing for up to 17 of the 21 older people. The home is not registered to provide intermediate care or care for older people suffering from a diagnosed mental illness. The home is situated in a suburb of Reading and privately owned by Mr Harbhajan Surdhar and Dr Ramnath Narayan. Service users are accommodated in 21 single bedrooms, eight of Care Homes for Older People Page 4 of 27 Over 65 22 0 Brief description of the care home which have en-suite facilities. The current fees can be obtained from the home manager. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 3 star. This means the people who use this service experience excellent quality outcomes. This inspection included an unannounced site visit from 09.30am until 17.15pm on the 17th of November 2009. This report also includes reference to documents completed and supplied by the home, and those examined during the course of the site visit. The report also draws from conversation with the manager. Residents also provided some verbal feedback and the inspector also observed the interactions between residents and staff at various points during the inspection. Feedback about their experience of the home from residents was positive. The inspector also examined the premises. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: An overview of staff training should be maintained at all times. The quality assurance system could be broadened to include seeking the views of care managers and healthcare professionals with whom the home has regular contact. One of the bathrooms could be redecorated and facilities would be improved by the Care Homes for Older People Page 7 of 27 provision of an additional bathing facility as planned. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their families are provided with the necessary information about the home to help them decide if it will be appropriate to the needs of the individual. The home undertakes an appropriate assessment prior to admission in order to establish that it can meet the identified needs of the person seeking admission. Evidence: The home has detailed Statement of Purpose and Service User Guide documents, both of which had been recently reviewed and updated. Copies are provided to prospective residents/ their relatives, along with other documents. The home has a detailed pre-admission assessment format which is completed with input from the resident and/or next of kin as appropriate. The format is needs-focused and identifies areas where the prospective resident will require some support. Some Care Homes for Older People Page 10 of 27 Evidence: information on individual wishes and preferences was also evident in the assessments sampled for inspection. There is also a form entitled Getting to Know You which supports the assessment process and identifies an individuals personal wishes and preferences and any specific likes and dislikes, in order to enable more individualised care to be provided. The home does not specifically provide an intermediate care service. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of each resident are identified within their individual care plan to enable staff to meet these. The care plans also address the healthcare needs of residents and they are supported to make decisions about their day-to-day lives. The home has an appropriate system in place to manage their medication on behalf of residents, none of whom is currently able to manage this for themselves. Residents dignity. privacy and rights are supported by the staff through their systems and ways of working, including where care is provided to a resident who is dying. Evidence: Information from the preadmission assessment and the getting to know You form is used to compile a post admission assessment and the initial care plan. Care plans are currently within a proprietary format and tend towards a needs focus, with limited information on the individuals wishes and preferences, though this information is provided to some degree by the other formats. Though the care plans identify the residents needs in detail; at present they do not include a lot of detail on how the identified support should be provided, relying to some extent on staff knowledge Care Homes for Older People Page 12 of 27 Evidence: about the wishes of individuals. However, the manager is planning to introduce a more person-centred care plan format which will address both aspects and provide detailed information to carers on how to support the individual with regard to any expressed wishes, and choices. This will enable staff to ensure they are fully addressing the dignity of residents on an individual basis. Personal care records are maintained on each resident which enable tracking of the care provided, and additional information may be provided within the general daily notes. The files include evidence of regular review of the care plans. Any changes are found via amendments within the various sections or in the nurses review notes. Records of healthcare appointments are maintained within the multi-disciplinary record though they are held collectively rather than within separate disciplines. Records include nutritional screening and various health-related risk assessments, and the care plan addresses health issues including mental health, skin integrity and infection control. The home provides adjustable beds in all but two rooms, which are also soon to be provided with this equipment, and obtains pressure relief equipment via the GPs when necessary. Medication records include a medication information sheet with details of the residents GP and a record of any allergies. The home uses a proprietary blister pack system for managing medication, provided by the local pharmacy. Appropriate medication administration records are used which include an audit trail for each medication. Medication is checked at each handover between nurses and is only administered by the nursing staff who have all received training from the pharmacist, apart from prescribed creams which are often administered by the carers. Carers are also offered the opportunity to attend medication training to support their knowledge. An appropriate controlled drugs record is also in place. Medication is checked regularly for expiry and proper administration, and the pharmacy also audit the homes system and records, most recently in August 2009. A separate record is maintained of the application of prescribed creams which tend to be held within the individual residents bedroom, to ensure that these are regularly applied. None of the current residents is able to self-administer their medication but the manager was clear that this would be supported where a resident was able and wished to do so. The current care plans do include some references to aspects of residents dignity. One care plan notes the importance of weekly hairdresser appointments to help maintain the individuals dignity; others identify individuals preferred form of address, Care Homes for Older People Page 13 of 27 Evidence: and other similar references were seen. Residents privacy is provided for by single bedrooms and appropriate locks on bathroom and toilet doors, though bedroom doors do not have locks fitted. The rights and opinions of residents are also respected through seeking their views in regular residents meetings and through quality assurance surveys. A regular visitor to the home also confirmed that the residents are treated with respect, and compared the home very favourably to others they had visited. Staff were observed to attend to the needs of individuals discretely and unobtrusively respecting their dignity and privacy in so doing. For example staff were seen to sit next to a resident when assisting them to eat lunch, and made this the focus of their attention. One staff member was seen taking the time to reassure a resident by explaining that they were going to the hospital. Residents are asked if they wish to celebrate their birthday and a cake is provided if desired. One residents wedding anniversary was recently celebrated with a party. The interactions observed were respectful, using appropriate forms of address and there was also evidence of warmth and humour between residents and staff. Staff also offered choices and encouraged residents to make decisions. The manager also undertook an assessment under recent legislation to establish suitable arrangements to enable a resident who wished to go out, to do so with support, having arranged additional funding to enable this. The home also addresses the dignity of residents when they are dying. Staff follow the Liverpool Care Pathway system which focuses well on the individuals needs and dignity. Though this was not applicable to any residents at the time of this inspection, appropriate records were seen relating to a past resident. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to take part in an appropriate range of activities and some outings, and their spiritual and cultural needs are addressed. Contact with family is supported and visiting encouraged. Residents are enabled and supported to make decisions and choices in their day-today lives. Residents are provided with an appropriately varied diet and are consulted about their likes and dislikes with regard to food. Evidence: The interests of residents with regard to activities and hobbies are sought through the completion of the Getting to Know You form at admission. The home has a part-time activities coordinator who leads activities when she is in the home and at other times the care staff will lead these. The regular activities are advertised on the door to the lounge in large print format. The activities coordinator was working on the day of inspection and the activities were seen to be popular with residents. Individual activities records are kept by the activities coordinator, and there were photographs of some events posted in the home. Activities recorded include visiting musicians and residents confirmed that various musical events had taken place in the home. Feedback from residents indicated that they enjoyed the range of activities provided, Care Homes for Older People Page 15 of 27 Evidence: and they confirmed there was a choice about whether an individual wished to participate. One resident said you could stay in your room if you wanted, or could join in with the group and the activities on offer. Residents were aware of an upcoming visit to a Christmas carol concert. The home provides for the cultural and spiritual needs of residents, with support from families and appropriate external agencies, which may include places of worship. One residents family brings in culturally appropriate papers and a visitor speaks to him in his native language when they visit. The resident also has a culturally relevant TV channel available in his bedroom. Specific spiritual needs can be addressed through visiting clergy and local clergy visit fortnightly to take a service at the home. Three residents also go out to a service at a local church every week via Readibus accompanied by a carer from the home. In the past a Buddhist visitor has also visited the home to meet with a resident. Residents family and friends are encouraged to visit freely. One visitor gave positive feedback about the home and the support provided by the staff. Residents are encouraged to make decisions and choices on a daily basis, and are encouraged to bring in items to personalise their bedroom. The home has a four week rotating menu and there is a choice of main course at each meal. Additional options were available should a resident not like either of the menu choices. As noted earlier, staff sat with a resident when they were offering support with feeding and gave this their full attention. Residents confirmed there was a choice at mealtimes and this was seen to be the case during the lunchtime meal. A list of residents breakfast preferences was also seen in the kitchen and highlighted by the cook who uses it for reference. Where residents wish to celebrate a birthday or another event, a cake is provided if desired and the option of a party is offered. The home will provide for special diets and was providing a suitable diet for several diabetic residents at the time of this inspection, as well as hight calorie options for others. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an appropriate complaints procedure in place which is readily available to residents and visitors. Complaints are appropriately addressed. The home has appropriate systems in place to help safeguard residents from abuse. Evidence: The home has an appropriate complaints procedure which is posted about the building, including within the bedrooms, and a copy is given to residents or their relatives with the other information they receive. Complaints forms are available in the homes reception hall without recourse to staff. Residents indicated that the manager was always available to them and was approachable if they had any concerns. The records indicate that there had been one recorded complaint in the previous twelve months, which had been appropriately resolved. No other complaints have been reported to the Commission over the past twelve months, for referral to the home. The home has a copy of the local multi-agency procedure for safeguarding vulnerable adults. One matter had been reported to safeguarding, as a precaution by the manager, in the previous twelve months, but this led to no further action being necessary. The home does not manage funds on behalf of any residents, preferring that families Care Homes for Older People Page 17 of 27 Evidence: manage this where residents are unable, or for court of protection arrangements to be established. In some cases family are billed periodically for expenses such as newspapers and hairdressing, and families may sometimes leave small amounts of funds with a resident for an upcoming outing. No safeguarding issues have been brought to the attention of the Commission in the past twelve months for reporting to the local safeguarding team. All staff have received training on safeguarding vulnerable adults. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and homely environment for residents and has been adapted to support independent mobility and to meet the support needs of residents. The laundry facilities meet the needs of the home and standards of hygiene are good. Evidence: The main part of the home is a converted period property with a modern purpose-built extension providing some rooms with en suite toilets. The front hallway is welcoming and the decor and furnishings throughout are homely. All but one of the bedrooms are single occupancy with one double room available should two people specifically wish to share. Bedrooms were personalised to varying degrees by their occupants, and the doors identified with both the name and photograph of the resident. All but two of the bedrooms(by resident preference), are equipped with fully adjustable beds. Corridor fire doors were held open during the day with electromagnetic holdbacks linked to the fire alarm to facilitate residents mobility about the home. The holdbacks release the doors to close in the event of the fire alarm beng triggered. Ramps are also provided at changes of level to assist resident mobility. The home has a dining room and two lounge areas one of which leads off from the other, providing a choice Care Homes for Older People Page 19 of 27 Evidence: of communal facilities. Activities are provided in these areas. The home has a well run kitchen which attained a four star hygiene rating at a recent environmental health inspection. New fly screens were reportedly on order for the windows. At present the home only has two bathrooms, which is beneath the level recommended within the national Minimum Standards for its size. However, the manager indicated there were plans to convert her current office into an appropriately adapted wet-room shower facility. This would be a very positive addition to the current facilities, adding the option of a fully accessible shower for residents, and the provision of a further toilet therein would also be beneficial if space allows. Both of the existing bathrooms were provided with bath hoists to aid bathing, but one bathroom would benefit from refurbishment. The home has two communal toilets and six of the bedrooms have their own en suite toilets. The home has a pleasant garden with level paths and a patio area. The manager indicated that they make good use of the garden in the summer, and two of the residents confirmed that they had done so. Bird feeders had been sited outside the patio doors of one resident who enjoys watching the birds. The laundry facilities are rather cramped but the equipment meets the needs of the home. Standards of hygiene about the home were observed to be good. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an appropriate level of staffing to meet the current needs of residents. Levels of NVQ are improving as increasing numbers complete their NVQ award. Staff have also received the majority of the required training, providing a well-trained team able to meet residents needs. The homes recruitment system helps to safeguard residents. Evidence: The homes staffing complement comprised eight full time carers (one had recently resigned), two full time nurses, three bank/part-time nurses and two RGN nurses, who lead most of the shifts between them. The regular shift pattern was reported to be one nurse and four carers during the mornings, one nurse and three carers for the afternoon and evenings and one nurse and one carer each night on waking night duty. In addition the manager likes to be actively involved in care delivery and the home also employs domestic and catering staff. Feedback from a sample of residents and one visitor was positive about the qualities of the staff. One resident commented that staff were very good another that they were all friendly and kind. Staff were observed to work calmly and respectfully with residents and to spend the time necessary to reassure a resident where they were anxious. Interactions included humour and warmth and respected the preferred forms of address of residents. Care Homes for Older People Page 21 of 27 Evidence: The completed pre-inspection information stated that of the sixteen permanent staff, seven had attained at least an NVQ level two award. One other staff member had completed their level 3 since then, a further two were undertaking level 2 and one was doing their level 3. Examination of a sample of three recent recruitment records indicated an appropriately thorough system and the required evidence of the process was present within the records. The home attained the Investors In People award in 2006 and retained the award following reassessment in 2009. The home did not have an overall record of the position with regard to staff training, though records were held individually. The manager compiled an overall record following the inspection and provide a copy to the Commission. The records supplied indicated that mandatory training had been attended by the vast majority of staff with the exception of training on the Mental capacity Act and Deprivation of Liberty, which still needs to be provided to a number of staff. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed effectively in the interests of residents, by a competent management team, who have the necessary skills and experience. An appropriate quality assurance system is in place to enable monitoring of the views of residents and relatives alongside the monthly monitoring visits. The home does not become involved in managing residents finances. The health, safety and welfare of residents is safeguarded by the systems and practices in operation. Evidence: The home is managed by an experienced and appropriately qualified manager and her senior team. The manager has obtained her NVQ level 4 and is currently undertaking the Leadership and Management course. She has also attended a variety of training to maintain her current practice knowledge. Residents described the manager as approachable and readily available to them. The home has a quality assurance system in place, though only residents and their Care Homes for Older People Page 23 of 27 Evidence: relatives are currently surveyed. Consideration should be given to extending surveys to care managers and healthcare professionals with whom the home has regular contact. Two surveys had been undertaken in the twelve months before this inspection, one of which had been completed and the forms from the most recent survey were still awaited. The forms are seen by the home manager and sent to head office for analysis. A summary report is produced and fed back via the next resident and family meeting. At present the Regulation 26 monthly monitoring visits have been delegated to a shift supervisor working within the home, which is an unusual arrangement as they are normally undertaken by a member of the external senior management. However, the system appears to be working well. The visits take place as required and the reports include feedback from residents as they should, and relevant issues have been raised appropriately via the reports. The home elects not to manage funds on behalf of residents, preferring these to be managed by the resident or their representatives. As noted already, additional expenses are billed to the resident or their representative. None of the residents is currently able to manage their own funds. Examination of a sample of health and safety-related service certification indicates that servicing takes place within required timescales. There was no individually itemised certification for electrical appliance testing but a schedule was devised following the inspection to be utilised for the next round of testing. The certificate for the periodic testing of the electrical installation could not be located. The provider should place a copy of this on file at the home. Fire alarm servicing was regular and staff fire drills take place at the same time as the weekly alarm testing. A deficiency notice arose from the last fire officer visit in April 2009. Some issues had been addressed and others were subject to further discussion and agreements with the fire officer, though no written confirmation had been received of agreed outcomes.The provider will seek written clarification of the satisfactory resolution of the remaining items in the notice. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!