Care Home: Oakfield

What the care home does well The service provided a homely, welcoming and friendly environment. During this visit staff were spending time, positively interacting and engaging with people. A relative surveyed said, "Staff communicate, they find time to talk to residents personally". People are provided with care plans, which they or their representatives have been consulted about . People, their representatives and social and health care professionals said, "The provision of care needs to the individual clients of our team are very effective and according to the care plan set up" and " The service communicates well with families and all professionals involved in people`s care"; "The home caters for my needs well";" I am always happy with everything";"The service provides good nursing care and individual assessment of needs"; "Excellent standard of care given to resident`s in this home". The home has an activities organiser and arrangements are in place for people to access local community facilities including, visiting the shops, local restaurants and visiting places of interest. Two people living in the service told us that home provides "Good activities" and a social and health care professional said, "The service organise social activities, groups, outdoor activities for residents and encourage them to maintain their Independence whenever this is possible". People are provided with varied and well balanced meals. People and their representatives said, "Good food","Good choices"and "We have a very good cook who makes us delicious meals". The home benefits from being run by an experienced registered manager and a stable staff team who know and are able to meet the needs of people living in the service. A majority of care staff hold National Vocational Qualifications. People and/or their representative`s said, "The staff are very helpful and they respect me";"The staff look after me well";"The staff are very cheerie and caring" and "The staff are lovely and always helpful"."All the staff are amazingly patient, very caring and kind"; "They are very responsive and understanding of people`s changing needs" and "The staff are extremely polite and helpful". What has improved since the last inspection? There were no requirements made as result of the last key inspection. Some good practise recommendations were made at the last inspection,which the manager has acted upon. This included the provision of photographs with people`s medication administration record for identification and permission has been sought from people to agree to staff administering their medication. Staff personal files sampled during this visit contained all the required information. What the care home could do better: The manager must ensure that all events in the care home, which adversely affects the wellbeing or safety of any person living in the service is reported immediately to the Commission as required by the legislation. The manager was advised to ensure that the home`s safeguarding vulnerable adults from abuse procedure includes reference to the local authority procedures and to attend the local authority safeguarding training. Key inspection report Care homes for older people Name: Address: Oakfield 30 Oakfield Road Ashtead Surrey KT21 2RD     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: Lisa Johnson     Date: 2 6 0 1 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Oakfield 30 Oakfield Road Ashtead Surrey KT21 2RD 01372272540 02086427729 trilodge@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Trilodge Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 29. The registered person may provide the following category/ies 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 categories: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Oakfield is a care home that provides nursing care for 29 people with mental disorder. It is located in a residential area close to the village of Ashtead in Surrey. The home can accommodate twenty nine people both male and female. The accommodation is on three floors, which can be accessed via a lift and comprises of two communal lounges, bathrooms and shower rooms, a kitchen, a laundry, a designated smoking area, an office and a staff room. There is a well maintained back garden with mature trees and a large raised patio area. Private parking is available. Current fees range from £ 650- £800 per week Care Homes for Older People Page 4 of 28 Over 65 0 29 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 site visit was part of a key inspection. The visit was unannounced. We arrived at 9:10am and left at 4:20 pm. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment( AQAA). This is a self assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which gave us all the information we asked for. Reference is made to this assessment throughout this report. We sent out surveys to people living in the service to gain their views and nine were returned to us. We received feedback surveys from seven relatives/ friends and four were returned from social and health care professionals. We also received surveys from five members of staff. These comments are reflected in this report. Care Homes for Older People Page 5 of 28 During this visit we were introduced to and spoke with some people who live in the service and discussion took place with the registered manager and four members of staff. During this visit we spent time some time observing activities and staff interaction. We sampled staff recruitment and training records, care plans, risk assessments,menus, complaint, accident incident records, quality assurance systems, medication administration practises, health and safety records and policies and procedures. We also reviewed other information that we have received since our previous visit including any notifications. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The manager must ensure that all events in the care home, which adversely affects the wellbeing or safety of any person living in the service is reported immediately to the Commission as required by the legislation. Care Homes for Older People Page 7 of 28 The manager was advised to ensure that the homes safeguarding vulnerable adults from abuse procedure includes reference to the local authority procedures and to attend the local authority safeguarding training. 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people considering the service as a place to live are provided with information they need to know to enable them to make an informed choice about the suitability of the home as a place to live. Peoples needs are assessed prior to admission ensuring that the home will be able to meet them. The service does not provide intermediate care. Evidence: During this visit we looked at the information provided to people who use the service to see whether if is able to describe everything that they or their representatives need to know. The service has a statement of purpose and service user guide, which is provided to each person that details the aims and objectives of the home and the services that they are able to offer. Six people surveyed said they were given enough information about the home before they moved in. Any person being considered for a place at the home has a full needs assessment and Care Homes for Older People Page 10 of 28 Evidence: evaluation of their needs prior to admission ensuring that the home will be able to meet them. People make several visits to the home before a final decision is made about their suitability. During this visit we saw evidence of peoples pre admission assessments, which were available in their files. Five social and health care professionals surveyed said that the services assessment arrangements ensure that accurate information is always gathered and that the right service is planned for people. The home does not provide intermediate care. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met and their preferences for support are respected. Peoples privacy and dignity is respected and the home supports people with their medication in a safe way. Evidence: Each person has a care plan in place,which is based on assessment covering health, emotional, personal, communication and social needs. Care plans were supported by a person centred care plan, which contained peoples life history, likes , dislikes and preferences. One person likes to get up later in the day, which is respected and a member of staff spoken with during this visit also said people can choose their preferred times for getting up and going to bed. Each person has a key worker and their care plans are discussed in consultation and agreed with them or their representative. Regular care plan reviews take place, which was confirmed by information seen. Social and health care professionals surveyed said,The provision of care needs to the individual clients of our team are very effective and according to the care plan set up and The service communicates well Care Homes for Older People Page 12 of 28 Evidence: with families and all professionals involved in peoples care. Care plans outlined how peoples mental health needs were to to be met, which were supported by risk assessments and guidelines. A number of people also have a Care Programme Approach (CPA) in place as well. Moving and handling, tissue viability and nutritional assessments had been completed. Information seen at the time of this visit indicated that people are supported by a range of health care professionals including, General practitioner, chiropody, optician, dentist and other health care professionals including psychiatry and social workers. Records were maintained of all health screen checks and consultations. A range of positive comments were received from social and health care professionals including, The service provides good nursing care and individual assessment of needs; Excellent standard of care given to residents in this home;The staff meet the different needs of people and can be quite complex and they tailor the care to suit each person individually; At this moment I feel the services provided by the team have been very good and individually tailored according to their care needs and From my visits to my clients they appeared to be well cared for; The service meets the ongoing complex needs of residents(health and social needs);The service works in partnership with residents to reduce any risks and provides a safe, homely environment. Care plans outlined how peoples personal care needs were to be met. During this visit people were observed to be appropriately dressed and presented. A person living in the service said, The staff help look after my needs well and they help me to have a bath. Seven people surveyed confirmed that they were happy with the care and support provided. Comments included, The home caters for my needs well: I am always happy with everything; The staff are very helpful and they respect me;The staff look after me well;The staff are very cheerie and caring and The staff are lovely and always helpful. Relatives/friends surveyed all said that that they feel the service meets the needs of their relative/friend. Comments included, I am very happy with Oakfield;All the staff are amazingly patient, very caring and kind and They are very responsive and understanding of their changing needs;The staff are extremely polite and helpful and The home cares for residents in a genuine, family orientated manner. During this visit peoples privacy was respected. Staff were observed knocking on peoples doors before entering. Two people spoken with also confirmed this. Care Homes for Older People Page 13 of 28 Evidence: Throughout this visit staff were observed to be attentive, caring and respectful.A relative surveyed said,I see the staff team as working well together and being very friendly and dedicated to all of the residents and a social and health care professional said, The service has proved to be most reliable, professional, enthusiastic and respectful of our clients During this visit we looked at the homes medication administration practises. Medication was stored appropriately. Records were maintained of the receipt and disposal of medication. Staff administer medication directly from bottles and boxes, therefore they dont use the monitored dose system (MDS). We were informed that this system works well for the service due to regular changes of medication. Medication administration records are transcribed by staff, although systems are in place to ensure that these are checked and signed by two members of staff. We were informed that the pharmacy visits the home to carry out audits. Medication administration records contained a photograph of the person for identification and a signatory list was maintained of staff who are trained and authorised to administer medication.We were informed that currently people living in the home are assessed as being unable to self administer their medication. The service has obtained agreement from people for staff to administer their medication. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples recreational social, cultural, diverse and religious needs are met. People maintain contact with their family , friends , representatives and the local community. People are supported to exercise choice over their lives and they are provided with varied and well balanced meals. Evidence: A programme of activities was seen on display in the home and a full time activities coordinator is employed . People living in the service are consulted about their daily plan to meet their preferences and wishes. In house activities include, reality orientation, music therapy exercise, quizzes, arts and crafts,painting, quizzes, , dancing, games such as dominoes and scrabble, and visiting entertainer. During this visit we observed a number of people taking part in the activities and some people went out shopping. People are supported to participate in activities in the local community and the AQAA has identified that external activities have increased. Some people go out for meals to local restaurants and visit the pub. People are supported to go shopping for clothes. A person told us about a particular shop they enjoy visiting. Some people go out independently to the town centre and go to the bank and visits take place to the Care Homes for Older People Page 15 of 28 Evidence: seaside and places of interest. Two people who live in the service said that the home provides good activities. A social and health care professional said, The service organise social activities, groups, outdoor activities for residents and encourage residents to maintain their Independence whenever this is possible. A person told us that they enjoy visits from the local school children when they attend and peoples religious needs are respected.Roman Catholic as well as Church of England priests visit the home every two weeks for Holy communion and service. The service also supports people with other cultural and religious backgrounds and arranges religious support where this is required. People maintain close links with their family and friends and social events are held in the home, which they are invited to attend. Six relatives/friends surveyed all confirmed that the home helps their relative /friend keep in touch with them . A relative also said, The home makes family and friends very welcome, nothing is to much for them. People are supported to make choices and preferences . The home organises weekly meetings, that are minuted, which we sampled during this visit.People have been able to choose the decor of their rooms and preferred colour schemes. One person living in the home has two cats, which they were permitted to bring into the home, which they told us they help take care of. Throughout this visit staff were observed spending time and interacting with people. A relative/friend surveyed said, Staff communicate, they find time to talk to residents personally. The service has a rotating menu in place, which was observed to be varied and well balanced. The homes chef has worked in the home for a number of years and has a good knowledge of peoples dietary requirements and preferences. people are provided with a choice of meals and the chef told us that people can come to the kitchen and request any preferences, this was also confirmed by a person living in the in the service. A vegetarian alternative was provided for one person who prefers this. One person was observed to have a pureed meal, which was attractively presented. Cakes and pastries were home made, which we saw at the time of this visit. We were told that one person has a personal preference for meals, which reflect their cultural background, which is catered for. People take their meals in a separate dining room, although some people prefer not to have their meals in this area and were served in the sitting room and provided with trays. The meal time was relaxed, unrushed and people were provided with appropriate support and aids to maintain their independence such as plate guards. Care Homes for Older People Page 16 of 28 Evidence: People living in the service spoke positively about the meals provided including, Good food,Good choicesand We have a very good cook who makes us delicious meals. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns they know how to complain and they are safeguarded from abuse. Evidence: We looked at information provided to people, which tells them about how they can make complaints. During this visit we saw a copy of the homes complaints procedure, which is also made available in the service use guide. Since our last visit no complaints have been received by the service. The manager maintains a complaints log book where any complaints or concerns would be recorded should they arise. People spoken with during this visit and surveys received confirmed that they were aware of the homes complaints procedure and whom they would speak to if they had any concerns. Relatives surveyed also confirmed that they would know how to make a complaint if they needed to and that the service responds appropriately if they have raised any concerns. The service has safeguarding vulnerable adults from abuse procedures in place, although the manager was advised that they should obtain the most recent local authority multi agency safeguarding vulnerable adults from abuse procedure, which was not available at the time of this visit and reference should be made to this document within their own procedure. During this visit we sampled three members of staff training records, which confirmed Care Homes for Older People Page 18 of 28 Evidence: that they receive safeguarding training although the manager has not attended the local authority multi agency safeguarding vulnerable adults from abuse training,which they are advised to do so. During this visit we looked at the homes accident incident records and noted that a past incident had occurred between two people living in the service, which resulted in a person sustaining some bruising to their hand. We were informed that the care manager had been informed of this incident, although this had not been reported to the Commission at the time. (Refer to standard 42) Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an environment that is safe, well maintained comfortable, homely and clean. Evidence: The service is situated in a residential area in Ashtead and is an older style property. There is a continuous maintenance and refurbishment plans in place. Since our previous visit the home has been extended, which has provided extra bedrooms. A new kitchen has been fitted and new carpets, curtains, beds and wardrobes have been purchased. The home provides a large sitting room and a second smaller seating area and there is a separate dining room. There is a garden to the rear of the property and a raised patio area, which currently has an old bath stored there awaiting disposal and we were informed that arrangements are being made for this to be removed. Bedrooms in the new extension are comfortable, well furnished and provide en suite facilities. Some people invited us to see their bedrooms, which were comfortable and personalised to their preference. The home has three double bedrooms, which provided sufficient screening to maintain peoples privacy. We were informed that peoples agreement is sought before these bedrooms are occupied. Call bells are installed and an assisted bathroom is available. Care Homes for Older People Page 20 of 28 Evidence: At the time of this visit the home was seen to be clean and hygienic,sufficient hand washing facilities and equipment were in place. Infection control procedures were in place and staff receive training. Feedback from people living in the service indicates that the home is always clean and fresh . A relative/friend commented, The home is tastefully furnished. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by staff that are competent and trained to meet their needs and they are protected by the homes recruitment policies and practises. Evidence: Six members of staff are available throughout the day lead by a registered nurse. At night time people are supported by a registered nurse and two carers. The duty rota and numbers of staff seen on duty at the time of this visit confirmed this. People living in the service benefit from a stable staff team, where there has been minimal turnover and many of the staff have worked there for a number of years. The service does not use any agency staff. People living in the service are mixed gender that are also supported by a mixed gender staff team. The service also employs an activities coordinator, chef and domestic staff. Information supplied in the AQAA states that ninety percent of carers employed in the service have obtained National Vocational Qualifications (Level 2 )or above and two other members of staff are in the process of completing this. We were informed that new care staff employed receive induction and foundation training following skills for Care induction standards. Staff have a development plan in place and training is arranged including both Care Homes for Older People Page 22 of 28 Evidence: statutory and specialist training including mental health awareness. The manager maintains written records of courses attended and applied for, although maintaining an schedule for each member of staff with their records would make this clearer to see. Members of staff surveyed stated that they feel they have enough support, experience and knowledge to meet the different needs of people who live at the home and that the manager meets with them regularly to discuss how they are working. Comments included, All staff are trained regularly;The service does well by helping and supporting staff in developing their skills and I am given training appropriate to do my job. During this visit we sampled three members of staff personal files, which contained the required information including, a fully completed application form, two written references and enhanced criminal records bureau checks (CRB) Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run in the best interests of people living there and their financial interests, safety and wellbeing is protected. Evidence: The service is run by an experienced registered manager who has obtained the registered managers award. The manager is a qualified mental health nurse and is qualified as an internal verifier for National Vocational Qualifications. During this visit the manager was observed to have an open, friendly and accessible approach with both people living in the service and staff. A person living in the service said, The manager is nice and very approachable.Staff feedback has indicated that they enjoy working in the home. Comments included, Good communication between the staff and manager who makes sure that we are informed of any changes; We have regular meetings and the morale of the staff is very good;Good team work; We have meetings and we feel free to talk to our manager; The home is well organised and well run because of good man management. Care Homes for Older People Page 24 of 28 Evidence: The service carries out annual quality assurance feedback surveys to gain the views of people living in the service, their representatives and other stake holders, which we sampled during this visit. The manager has implemented some self audits to monitor and measure standards in the home. The manager has implemented a deprivation of liberty safeguarding procedure, and has a good knowledge and understanding of this. At the time of this visit one person living in the service is subject to a deprivation of liberty safeguards authorisation. Records sampled for this person demonstrated that the correct procedures had been followed and that liaison had taken place with the deprivation of liberty safeguarding team. Systems are in place for protecting peoples financial interests. Some people or their families manage their finances. Where people are supported by staff wit their monies records were maintained,which included the reasons for expenditure, balances and receipts. Systems were in place ensuring the safety and well being of people living in the service including, regular health and safety audits and checks, regular water temperature monitoring and regular servicing and maintenance of equipment are carried out. Staff receive statutory training including moving and handling, first aid and health and safety. The home maintains incident and accident records, although one matter was identified needing improvement,which was not reported to us at the time, which is required by the legislation. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 37 The registered person must 02/02/2010 ensure that any event in the care home, which adversely affects the well- being or safety of any person living in the service is reported with out delay to the Care Quality Commission. This is to ensure the welfare and safety of people living in the service 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 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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