Care Home: Oak House

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What the care home does well The home is very well managed and has a stable and well trained staff team. This ensures that service users receive a consistent quality of care provided by staff that they know. The manager is proactive in their approach and is continually reviewing and seeking ways to improve and develop the service offered by the home. Oak House offers a relaxed, supportive and friendly home environment for service users with a range of needs. Staff within the home work well as part of a team, and the management arrangements ensure that there is clear leadership and direction. Care plans are informative and help staff to understand the level of assistance service users want and need. The entrance hallway at the home is used to display a wide range of information for service users and visitors. What has improved since the last inspection? The care plan format had been developed to ensure that service users assessed needs were clearly recorded with guidance for staff on how to meet peoples needs. There were detailed risk assessments in place covering the environment, with instructions for staff on how to minimise any perceived hazards. One of the home`s mini buses had been changed for a newer vehicle. New furniture and chairs had been installed in the lounge. New lifting hoists had been purchased. There were new blinds in the lounge and redecoration had taken place to many communal areas, and to service users rooms. What the care home could do better: The floor tiles in the ground floor rear toilet, and the floor covering in the upstairs bathroom should be cleaned or renewed. Key inspection report Care homes for older people Name: Address: Oak House 103 Corringham Road Stanford Le Hope Essex SS17 0BA     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: Alan Thompson     Date: 1 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Oak House 103 Corringham Road Stanford Le Hope Essex SS17 0BA 01375673104 01375673104 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Christian Care Homes Name of registered manager (if applicable) Mrs Lesley Venables Type of registration: Number of places registered: care home 13 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: 13 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 Oak House is owned and managed by Christian Care Homes, a Registered Charity. The home is registered to provide care and accommodation for thirteen older people, including people who have dementia. Day care is provided in a separate lounge area and is not part of the registered establishment. However some service users do enjoy joining up with the day centre clients for activities or meals. Care Homes for Older People Page 4 of 26 Over 65 0 13 13 0 Brief description of the care home The home has the use of two mini buses which are used to run trips out and holidays for service users. Oak House has seven single rooms and three shared rooms on two floors with passenger lift access. There is a large lounge/dining room and a pleasant garden. The day care lounge is also available as additional communal space for Oak House service users to use. The hallway area of the home provides a wealth of information for service users, relatives and other visitors. Copies of the homes Statement of Purpose and Service Users Guide were available in addition to the most recent inspection report and a report following a contracts monitoring visit undertaken by the Local Authority. The current scale of charges advised to us at this inspection are, £392.70 as a contract price and £460.00 as a private rate. Additional charges to service users include chiropody, hairdressing and holidays. 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: 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: This unannounced key inspection took place on Friday 12th March 2010. The content of this report reflects the inspectors findings on the day of the inspection along with information provided by the service and feedback by service users, staff and other parties. The manager was at the home throughout our visit and assisted us in a professional and helpful manner. Our most recent inspection prior to this visit was on 17th April 2007. The manager completed and returned their Annual Quality Assurance Assessment (AQAA) to us in time for the inspection. This is a self-assessment required by law which gives homes the opportunity of recording what they think they do well, what they could do better, what has improved in the previous twelve months as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. Care Homes for Older People Page 6 of 26 Discussions were entered into with the management of the home, service users, visitors and staff on duty. CQC survey questionnaires were also provided to service users, staff and stakeholders. We received nine completed surveys and reference to feedback from these has been made within this report. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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. People considering moving into Oak House can be confident that the admission processes ensures that the home can meet their needs. Evidence: The manager said that staff from Oak House will visit prospective new service users to undertake an assessment of their needs. This will be done by the manager or a senior carer. Evidence of this process was seen in two files for people admitted since the last inspection. Assessment headings looked at included personal background information, personal hygiene, communication, behaviours, medication, mobility, social contacts, continence, sight, medical, mental health, sleep, falls, hearing, pressure care and eating and drinking needs. Files seen contained the information needed for staff to provide the right initial support when the service user first moves in. Copies of assessments carried out had been signed by the assessor. Care Homes for Older People Page 10 of 26 Evidence: Prospective new service users are welcome to look around the home and the manager confirmed that people are offered to stay for a meal. Discussion with service users and relatives confirmed that people are able to visit the home before moving in. They also told us that many service users had been attendees at the day centre before deciding to become a resident in the home, and that this helped reduce the effect of change when they did move into Oak House. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in care plans ensures that peoples needs could be met in a way they would wish. Evidence: Two care plans were looked at. Included was a profile of the person with background information, personal details, and next of kin contacts. Care plans were person centred and showed the service users identified care need with instructions to staff on how they can meet this need. Headings covered included, personal care and physical wellbeing, diet preferences and weight, sight, hearing, communication, oral health, foot care, mobility, personal safety and risk, history of falls, continence needs, medication, mental state, social interests, spiritual needs and family involvement. The persons preferred daily routines were also recorded, along with how they wanted to be supported by staff both throughout the daytime and at night. Care plans seen by us contained detailed information on peoples needs to enable staff to be able to offer the right support to service users. Care files had records of reviews Care Homes for Older People Page 12 of 26 Evidence: and of daily staff observations. Records of service users weight had also been kept along with records of GPs visits and treatment and on any other medical consultations. Service users night time needs were included in care plans. Care plans and risk assessments had been reviewed every three months, or sooner if needed. Care notes recorded any changing needs. Care plan reviews included the service user and appropriate relative and had been signed as agreed by the staff key worker and service user or relative. The manager said that currently no service users needed to be seen by District Nurses. However when there is this need the home has had good support and advice from District Nursing services on pressure care needs, and with the supply of appropriate aids and treatment. Continence issues are supported by the community continence team with a senior carer at the home acting as link to this service. This is to ensure there is regular communication and updates on service users continence needs. Hearing needs are provided for by GP referral to a local hospital. The home does not have a visiting dentist but service users are supported by staff in accessing local community dentists when the need arises. The manager said that there are also some service users in the home who continue to see their own dentist. GP services are provided by several local practices as some people had kept their own GP from before they moved into Oak House. A chiropodist and an optician visit regularly, and again some service users see their own chiropodist and optician outside the home. Records had been kept of of all healthcare visits by service users with written notes of the visit seen. The homes medication policies and procedures were seen and included instructions and guidance on ordering, receipt, storage, administration, self medicating and returns of unused stocks. Staff told us that they been trained on medication practice and there were certificates seen on staff files to evidence this. Only senior carers or the manager deal with medication. Practice competency tests were seen to have been carried out annually by the manager to ensure staff remain competent for this role. Medication administration records were looked at no shortfalls were noted. Discussions with individual service users and comments made in surveys returned to us confirmed that they thought they were well cared for and were treated with respect by staff. Staff on duty were seen to be attentive and helpful in their dealings with service users. Comments made to us included, the staff here are brilliant, staff are very caring, staff are always cheerful, the staff are ever so friendly, I cannot fault the care and attention my mother receives at Oak House, the care is excellent. 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. People living in Oak House can expect to have a lifestyle that matches their expectations through opportunities for activity, and enjoyable food. Evidence: Service users meetings are held regularly to enable people to be involved in the planning or the service, and to express their views about the home. Minutes were seen from meetings in October 2009 and February 2010. Areas covered included food, activities and the environment. The home encourages contact between service users and their families and many service users receive regular visitors. When asked, service users told us that their family and friends could visit at anytime and that staff always made them welcome. Comments in surveys and from relatives spoken with confirmed that they visit regularly and at any time, and that the atmosphere in the home is always friendly. Oak House does not have a full time activities coordinator however care staff had received training on providing activities in the home, and several service users go into the adjoining small day care centre each day to join in the activities there. Records had been kept of things people took part in, these included, quizzes, board games, Care Homes for Older People Page 14 of 26 Evidence: talking newspaper, nail care, gardening in the summer, one to one discussions, arts and crafts and bingo. The manager told us that entertainers are brought into the home approximately every three months and that some service users go out to local shops with staff support. The home has the use of two mini buses and these are used to take people out on trips, usually in the summer months. Service users are offered an annual holiday from the home, accompanied by the manager and staff. The holiday planned for this year is to Potters in Norfolk. Regular community visitors to the home include two volunteers, one helps with activities and the other helps in the office. People spoken with said they were satisfied with activities offered. The majority of people confirmed in surveys returned to us that home always or usually always arranged activities that they could take part in. Inspection of private rooms evidenced that service users had been permitted to bring their own personal items with them on admission, and some people told us they brought their own items in with them. Information for service users and their relatives on how to access independent advocacy support was seen displayed in the entrance hallway of the home. The manager said that this service is used by some for advice relating to individual service users. Nutrition records looked at evidenced choice and variety. The manager confirmed that the main daily meal is lunch with one menued meal and an alternative. Teas are usually sandwiches or a hot dish. The manager said supper snacks are always available and that a cooked breakfast is menued in every Saturday, and also confirmed that hot breakfasts are available every day is people wished. Food stocks were good and service users spoken with at the inspection were satisfied with the food. Actual comments made included, the food is good and I get enough to eat, the food is very good, the food here looks good. Comments about the food in surveys returned to us all confirmed that people always or usually always liked the meals at the home. Detailed records had been kept of peoples nutritional intake so that any changes in eating habits can be looked into without delay. Care Homes for Older People Page 15 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. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. Evidence: The complaints procedure was displayed in the home and was included in the Service Users Guide. These contained guidance on how to make a complaint and who to complain to. Also included were timescales for responses from staff and a book for staff to record any complaints and concerns. Information in the AQAA shows no recorded complaints in the 12 months leading up to 2nd March 2010, the date the AQAA was sent to us. The manager also confirmed at the inspection that no complaints had been made but assured us that if any complaints are received records would be kept of the issues raised and of the investigation and outcome. The service had received a number of written compliments which the manager showed us. These are kept as evidence of positive feedback from service users and their relatives. Service users spoken with said they knew who to speak to if they had any concerns, and they seemed very confident that any concerns would be looked into properly. Comments from relatives also indicated that they were confident that complaints or concerns would be dealt with appropriately. Care Homes for Older People Page 16 of 26 Evidence: The homes policies on adult protection were inspected. There was written guidance for staff on recognising and reporting abuse, and the actions to be taken by staff if abuse is suspected, The guidance included types of abuse and a whistleblowing policy reminding staff of their responsibilities to report suspected poor practice. Staff spoken with displayed awareness of this subject and procedure and confirmed that they had received training on adult protection procedures. Records of this training were seen. The homes induction training also covered adult protection and safeguarding vulnerable people. The manager and some senior carers had been trained on deprivation of liberty and on the Mental Capacity Act. Mental Capacity Assessments were seen to have been completed for service users where appropriate. 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. Service users live in a comfortable, clean and homely environment Evidence: Oak House provides a comfortable and homely environment. The site visit included a tour of the premises with the manager, when it was noted that the home was clean and there was no evidence of any unpleasant odours. The bedrooms and lounge were well decorated. The kitchen was also acceptably maintained as were the bathrooms, except for some marked or stained tiles in the rear ground floor wc, and some stained floor covering in the upstairs bathroom and wc. We have recommended that these areas receive some attention to make then look cleaner. The carpet in the day care lounge, which is an area used by some Oak House service users, was also a little stained but this was being cleaned on the afternoon of our visit. The manager advised us that this carpet gets a lot of wear and is cleaned regularly. There are three bathrooms in Oak House and all had hoists and adaptations to meet the needs of the people using the service. Bathrooms had wcs and there were also three separate wcs around the home. Bedrooms seen looked clean, comfortable and had been made homely with peoples personal possessions. Several bedrooms on the ground floor benefit from having an additional door that provides service users with direct access to the rear garden. Care Homes for Older People Page 18 of 26 Evidence: Discussion with service users and comments in surveys returned to us all confirmed that the home is kept clean and fresh. Actual comments made included, yes my room is always kept clean, my room is cleaned regularly by staff, the environment is very clean, rooms are kept spotless and clean. The communal space in the home included one main lounge/dining room with further communal space available in the adjoining lounge in the homes small day care centre. The garden looked well maintained and in 2009 the home won a Thurrock in Bloom Gold Award for the garden. The gardens are maintained by staff, service users and volunteers. The laundry is accessed off the lounge and the manager confirmed that staff ensure good hygiene practice is maintained when transferring laundry through the lounge. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a properly recruited and well trained staff team. Evidence: The homes staffing rota was looked at and showed daytime staffing levels as a minimum of three carers on daytime shifts, with one awake and one sleeping in at night. The managers hours are supernumary with on an call support contact number shown for when the manager is off duty. In additional to the care staff there is a cook on duty seven days a week working 0800 to 1330 hours, and a domestic person working mornings. The home also has a maintenance person who is shared between Oak House and another Christian Care Home service. Staff spoken with confirmed that regular team meetings take place to ensure that all are kept informed of relevant issues, and are able to take part in planning and decision making in the home. Minutes of past meetings were seen. Discussion had included service user care, key worker role, menus, cleaning and other staffing issues. Two staff recruitment files were inspected for people employed since our last inspection. Evidence was seen to confirm that staff had been properly recruited with application forms completed, written references obtained, written terms and conditions issued, and criminal records checks undertaken. Copies of proof of ID and photographs were also on files and evidence was seen to show that job descriptions Care Homes for Older People Page 20 of 26 Evidence: had been issued to staff. Staff are supported in undertaking NVQ training, and information provided with the AQAA states that twelve out of twenty four permanent care staff have achieved their NVQ 2 awards. This figure meets the recommended 50 per cent number of staff with this award. Two senior carers also had their NVQ 3 award and the manager had the NVQ 4 award. Staff records seen showed that all new staff undergo thorough initial two day induction training covering health and safety, infection control, hygiene, fire safety, moving and handling, personal care and emergency aid. After this staff move on to full induction based on the Skills for Care Common Induction Standards for social care staff. Staff said that they received induction training and that this very well covered what they needed to know when they started their jobs at the home. Staff also told us that the manager is very supportive and will respond quickly to any queries or concerns they may have regarding service users well being. Staff at Oak House are well trained, and all staff have individual training records. The manager also has a central training record which shows training undertaken for the whole team, as well as when updates are due. Records seen and discussion with staff confirmed that staff had been provided training on, dementia awareness, activities, food hygiene, manual handling, first aid, NVQ, health and safety, infection control, challenging behaviour, fire safety, abuse awareness safeguarding, medication, death and dying, role of the support worker, continence awareness and the Mental Capacity Act. Staff confirmed that they were very satisfied with the training they received. This was also confirmed in surveys returned to us when they wrote that their training was constant, was relevant to their roles and helped them to understand and meet the individual needs of people in the home. 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 excellent 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 very well run home that is managed in their best interests. Evidence: The manager at Oak House is very experienced and competent in her role. The manager has worked for more than 20 years in residential care and has been the registered manager of this home for 10 years. The managers qualifications include a City and Guilds Care Management award, the Registered Managers Award and the NVQ level 4 award. The manager is also a trainer in moving and handling and risk assessment. The quality assurance (QA) process used at Oak House involves sending surveys to service users and relatives at least once a year. A report is then written summarising the feedback received and of any resulting actions taken by the home. We looked at surveys sent out in February 2010. These included questions on the environment, the care provided, staff attitudes, food, activities and day to day preferences. We also saw the annual QA report that had been compiled by the senior carer responsible for Care Homes for Older People Page 22 of 26 Evidence: collating QA feedback. This evidenced to us that service users and stakeholders views on the service provided are listened to and acted upon. The manager confirmed that personal allowance monies are held for safe keeping for all service users. Records had been kept of the balances held and of receipts for expenditure. A random sample of these were checked and found to satisfactory. The manager provides regular three monthly 1 to 1 supervision support and an annual appraisal to all staff at the home. Records of this process were seen and included discussion on key worker role, workloads, training, professional development and any other issues raised. We asked staff if they felt properly supported by the manager and all who responded agreed that they were. Actual comments made in surveys returned to us included, my manager is always available to speak to staff if they have any problems, the manager is very approachable and that is why Oak House is a happy home to work and live in, there is a lot of support to staff from the manager, the manager is excellent. Random samples of records required to be kept were looked at. These included, the Statement of Purpose and Service Users Guide, Regulation 26 reports (monthly reports required to be carried out by the registered provider), assessments, care plans, staff rotas, staff recruitment, visitors book, nutrition, medication, background information and next of kin details and fire procedures. All of these seen were satisfactory. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling, fire safety, food hygiene, first aid and health and safety. There was also a detailed premises risk assessment in place to try to minimise risks in these areas. Certificates and service records were seen to confirm that the homes hoists, passenger lift, emergency lighting, fire equipment and alarms, electrical installation supply, gas boilers and portable electrical appliances had all been tested/serviced. Hot water temperature is regulated to reduce the risk of scalding, and manual temperature checks are also carried out regularly. These were seen. 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 19 The floor tiles in the ground floor rear toilet and the floor covering in the upstairs bathroom should be cleaned or renewed. This is to ensure a clean and well maintained environment for service users. 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. 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. 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