Care Home: Orchard Court Residential Home

What the care home does well People in the home are provided with a warm, safe and comfortable place to live that welcomes visitors and makes them feel at home. The home is clean and staff work hard to make sure the building is odour free. The home is welcoming and has a relaxed atmosphere. People living there said they are happy with their bedrooms and can bring in their own possessions, making it feel more like home. People being cared for have good access to professional medical staff and are able to access external services such as dentists, opticians, physiotherapists, chiropody and dieticians, so their health is looked after and they are kept well. What has improved since the last inspection? The complaints policy and procedures are regularly audited and people and staff are given regular updates and reminders about the process to follow and who to speak to should any issues arise. The information on how to make a complaint has been produced in a number of different formats to ensure everyone using the service is able to read, understand and access the procedure should they need to. What the care home could do better: The home continues to meet the standards within this report and in some areas the minimum standard level has been exceeded. Staff morale is good and individuals told us they work as a team to provide a consistently high standard of care. We would like to thank everyone who completed a survey or spoke to us during this visit. Your comments are very important to us and ensure this report includes the views of people who use the service or work within it. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Orchard Court Residential Home Bacchus Lane South Cave East Yorkshire HU15 2ER     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eileen Engelmann     Date: 1 0 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Orchard Court Residential Home Bacchus Lane South Cave East Yorkshire HU15 2ER 01430421549 01430421630 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Shelphen Care Limited care home 42 Number of places (if applicable): Under 65 Over 65 42 dementia Additional conditions: Date of last inspection Brief description of the care home 0 Orchard Court is a care home offering personal care for up to forty-two older people who have dementia care needs. The home is purpose built and accommodation is provided over two floors. The majority of the accommodation is provided in single rooms, some with en-suite facilities. Building work was taking place at the time of this visit to create more single, en-suite rooms. There are communal areas for the people using the service and gardens with seated areas for people to enjoy. The home is situated in South Cave village, close to the local bus route, and is within walking distance of the shops and local amenities. The home is part of a family run group of homes. Information provided by the manager on 10 June 2009 indicates that weekly fee prices range from 362.04 to 410.20 GBP and that a top-up fee from 0 to 50 GBP is applicable depending on the room chosen and the care needs of the individual. Care Homes for Older People Page 4 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: Information has been gathered from a number of different sources over the past 23 months since the service had its last key inspection visit (3 July 2007), this has been analysed and used with information from this visit to reach the outcomes of this report. We completed an Annual Service Review (ASR) for Orchard Court on 2 July 2008. We only do an annual service review for good or excellent services that have not had a key inspection in the last year. An ASR is part of our regulatory activity and is an assessment of our current knowledge of a service rather than an inspection. The published review is a result of the assessment and does not come from our power to enter and inspect a service. Care Homes for Older People Page 5 of 27 This unannounced visit was carried out with the manager, staff and people using the service. The visit took place over 1 day and included a tour of the premises, examination of staff and peoples files, and records relating to the service. Questionnaires were sent out to a selection of people living in the home and staff. Their written response to these was good. We received 10 back from staff (100 ) and 10 from people using the service (100 ). Informal chats with a number of people living in the home took place during this visit and comments from the questionnaires and face to face conversations have been put into this report. The manager completed an Annual Quality Assurance Assessment and returned this to us within the given timescale. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 set out 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 7 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 8 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wanting to use the service undergo a needs assessment and are given sufficient information about the home and its facilities prior to admission, to enable them to be confident that their needs can be met. Evidence: Four peoples care and records were looked at as part of this visit, they each have been provided with a statement of terms and conditions/contract on admission and these are signed by the person or their representative. These documents give clear information about fees and extra charges, which are reviewed and kept up to date. Each person has his or her own individual file and the funding authority or the home, before a placement is offered to the individual, completes a need assessment. The home develops a care plan from the assessments, identifying the individuals problems, needs and abilities using the information gathered from the person and their Care Homes for Older People Page 9 of 27 Evidence: family. Discussion with the manager indicated he goes out to assess individuals who have expressed an interest in coming into the home, and each person is given information about the service and life in the home. Staff members on duty were knowledgeable about the needs of each person they looked after and had a good understanding of the care given on a daily basis. Information from the peoples surveys showed that they were satisfied with the care they receive and have a good relationship with the staff. One person told us the staff are very helpful and friendly, I am satisfied with everything they do. Information from the Annual Quality Assurance Assessment and discussion with the manager and people living in the home indicates that all of the people using the service are of White/British nationality. The home does accept people with specific cultural or diverse needs and everyone is assessed on an individual basis. Discussion with the manager indicated that the home looks after a number of people from the local community, although placements are open to individuals from all areas. The home is able to offer a limited choice of staff gender to people who express preferences about care delivery, as they employ 2 male care staff. The information about peoples preferences is recorded onto their care plan. Information from the training files and training matrix indicates that the majority of staff are up to date with their basic mandatory safe working practice training, and have access to a range of more specialised subjects that link to the needs of people using the service. Five senior care staff completed a distance learning course around dementia in March 2008, other care staff have accessed an in-house programme for dementia awareness in the past year. Staff who completed our surveys said that their training was good and that they felt they provided a high quality of care, which promoted peoples rights to individuality, privacy and dignity. The home does not have any intermediate care beds and therefore standard six does not apply to this service Care Homes for Older People Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal and social care needs of the people living in the home are clearly documented and are being met by the service and staff. The medication at the home is well managed promoting good health. Evidence: Information given to us in peoples surveys, and during discussions on this visit with people using the service, indicates that individuals are satisfied with the care they receive and enjoy life in the home. Nine people said that they received the care and support they needed and that staff listened and acted on what they said and were available when assistance was requested. On the whole the care plans detailed the needs and abilities of individuals and set out the actions required by staff to ensure peoples wishes and choices are respected and their care needs met. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Information about the persons social interests, likes and dislikes, spiritual needs and Care Homes for Older People Page 11 of 27 Evidence: wishes regarding death and dying are included within the individuals care plan. People and relatives are able to input to their plan and changes to their care is discussed with the individual where possible. In addition to this information there are risk assessments to cover daily activities of life and clear information about health and input from professionals and the outcomes for people. Discussion with the manager indicated that he has recognised the need to ensure the care plans become more person centred, to reflect each individuals wishes and choices regarding their care. In order to improve this aspect of the care plans the staff have started to update the information in the plans and replace the personal profile documentation with a more descriptive format. The manager told us that he hopes to have all the plans updated by the end of July 2009. People said that they have good access to their GPs, chiropody, dentist and optician services, with records of their visits being written into their care plans. They all have access to outpatient appointments at the hospital and records show that they have an escort from the home if wished. Comments from the people using the service indicate they are satisfied with the level of medical support given to them. One person told us that the staff are extremely good at getting the GP out to see you if you are unwell, I cannot fault the service. The staff weighs everyone on a regular basis and evidence in the plans show that dieticians are called out if the home has particular concerns about an individual. Information given in the Annual Quality Assurance Assessment, completed by the manager on 20 May 2009, says that senior staff have attended training in First Aid, dementia awareness, diabetes awareness and palliative care. The home has also instigated weekly exercise classes to improve the mobility and health of the people living in the home. The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. All of the people spoken to prefer to have staff administer their medication. Checks of the medication records showed these are up to date and accurate, including those for controlled drugs and refrigerated items. However, we recommend that where staff are handwriting medication onto the MAR charts (transcribing), that two staff members check that what is written (name of the medication, strength, doseage and administration times) is accurate with what is printed on the box or bottle and that they both sign next to the written information. This will reduce the risk of errors occurring and protect the health and wellbeing of people receiving medication. Care Homes for Older People Page 12 of 27 Evidence: Chats with people revealed that they are happy with the way in which personal care is given at the home, and they feel that the staff respect their wishes and choices regarding privacy and dignity. Our checks of the care plans showed that the home completes risk assessments for activities of daily living to ensure people are kept as safe as possible, whilst accommodating their decisions and choices around their day to day care. Observation of the service showed there is good interaction between the staff and people; with friendly and supportive help being given to assist individuals in their daily lives. Care Homes for Older People Page 13 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 good 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 provided with choice and diversity in the activities and meals provided by the home. Individual wishes and needs are catered for and people have the option of where, when and how they participate in both eating and leisure activities. Evidence: The home employs an activities co-ordinator who works Mondays to Fridays (16 hours in total). There is some flexibility in her hours to accommodate trips out, evening events and the occassional weekend activity. At the moment there is a range of group activities and one to one sessions taking place, which reflect the interests of the people living in the home and also their gender. Information from the Annual Quality Assurance Assessment indicates that two relatives visit weekly to hold a bingo session with people using the service, this is very popular and between 10 to 15 people participate. A local gardening company have agreed to work with some people living in the home to arrange flower beds in the homes gardens and one person with strong links to a national charity arranges regular fundraising events with the help of her daughter and staff. Care Homes for Older People Page 14 of 27 Evidence: The mobile library service visits the home every two months and provides large print and talking books as well as the usual reading material. There is a weekly programme of events on display and this includes physiotherapy and dance, dominoes and cards, hair and nail therapy, bingo and the day after our visit a barbecue was planned for the afternoon. Nine people who answered our survey questionnaires said that they were satisfied with the level of activities on offer and one person commented that there is a good atmosphere in the home, with genuine caring staff and the menus are good. Three people said we would like more trips outside of the home and discussion with the manager indicated that staff do take people into the local town and community, but the lack of a minibus meant organised trips were infrequent. Informaton from the manager, indicates that people have access to a Church of England service held in the home every two weeks and individuals can attend outside services as wished. The Catholic priest will visit people in the home on request. The home provides special meals and cakes for birthdays and helps people celebrate all major Christian festivals such as Easter, Harvest Festival and Christmas. Discussion with the people living in the home indicates that they have good contact with their families and friends. Everyone said they were able to see visitors in the lounge or in their own room and they could go out of the home with family. Visitors who spoke to us said they were always made welcome whenever they came to the home. People spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. There is information and advice on advocacy on display in the home. Information from the Annual Quality Assurance Assessment indicates that the home holds regular meetings for relatives and people using the service. The cook and maintenance person attend the meetings so that discussions on diets/menus and the environment can be held and any issues raised are dealt with straight away. The manager told us that some staff have attended training on the Mental Capacity Act, Deprivation of Liberty, Safeguarding of Adults and those doing NVQs have done equality and diversity sessions. This type of training ensures that staff have sufficient knowledge about human rights legislation, so they understand individual rights within the care home and out in the community. Leaflets with information about the current legislation and how to access advocates is on display in the home and copies are available from the manager. Observation of the midday meal showed it to be well prepared and presented. Staff were organised when serving the meal and a number of individuals were seen to offer Care Homes for Older People Page 15 of 27 Evidence: assistance to people who need help with eating and drinking. People and relatives are pleased with the quality and quantity of the meals served, saying the food is very good and there is always a choice given. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals and others associated with the home say they are extremely satisfied with the service, feel safe and well supported. All staff working at the home know the importance of taking the views of the people using the service seriously, and of listening to and responding to raised issues. Evidence: The home has a complaints policy and procedure that is found within the statement of purpose and service user guide. It can be found in every bedroom and is also on display within the home. The policy and procedure are available in a variety of formats such as easy read, large print, braille and different languages, these can be provided on request. Peoples survey responses showed individuals have a clear understanding about how to make their views and opinions heard and those people spoken to said the manager comes round every day to see us and will discuss any problems at this time. Checks of the complaints record showed that there have been no formal complaints in the past 12 months and that the manager deals with minor niggles/grumles on a daily basis. The home regularly audits the views of people using the service and ensures that individuals are aware of who to make a complaint to and what the procedure is, there is an open door policy to enable the manager to deal with concerns before they become complaints. Care Homes for Older People Page 17 of 27 Evidence: The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of peoples money and financial affairs. The staff on duty displayed a good understanding of the safeguarding of adults procedure. They are confident about reporting any concerns and certain that any allegations would be followed up promptly and the correct action taken. Information in the minutes of the staff meetings indicates that complaints and safeguarding are regular topics discussed as a team to ensure that individuals understand the ethos of the home and follow the aims and objectives of the service. Information in the Annual Quality Assurance Assessment completed by the manager on 20 May 2009, indicates there is an ongoing training programme for staff to attend sessions around safeguarding of adults from abuse, equality and diversity, mental capacity act, deprivation of liberty and dementia. The home has a no restraint policy within the workplace and does not use bed rails, wheelchair belts, bedroom door locks or reclining chairs. 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 standard of environment within the home is good, providing people with a comfortable and homely place to live. Evidence: Walking around the home it was seen that there is internal building work in progress. The service is putting en-suite rooms into three bedrooms and creating two additional bedrooms. There will be an initial loss of a small lounge, a bathroom and the kitchen staff toilets, however further work is being done to turn an existing double room into a lounge and hairdressing room and a new extension to the kitchen will replace the lost toilet facilities. The manager told us that the work should be finished by the end of July 2009. The home had a new nurse call system fitted in 2008 and the walls throughout the building, where the call system was replaced, require patching up and redecoration. Discussion with the manager indicated this decoration work would be completed at the same time as the decoration for the new facilities (end of July 2009). The home has well kept gardens with seating areas and flat walkways around the building. People told us they enjoy sitting outside in the better weather and were looking forward to having an outside barbecue the day after our visit. Care Homes for Older People Page 19 of 27 Evidence: Doorways to bedrooms, communal space and toilet/bathing facilities are wide enough for wheelchairs, and corridors are spacious and have enough room for people in wheelchairs or with walking frames to pass by comfortably. The home has assisted bathing facilities and a shower room, and eleven of the bedrooms have shower ensuites. There is ample communal space provided throughout the building, including four lounges and two dining rooms. All areas seen during our visit were clean, tidy, odour free and decorated to a good standard. Discussions during this visit indicate that people using the service are satisfied with the laundry service provided by the home. Infection control policies and procedures are in place, and staff have access to good supplies of aprons and gloves for use in personal care. The staffing matrix supplied to us on 10 June 2009 indicates that infection control training is part of the rolling programme of training and that staff are booked to attend sessions in September 2009. 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 staff induction, training and recruitment practices are good, resulting in an enthusiastic workforce that works positively with people to improve their whole quality of life. Evidence: Checks of the staffing rotas and observation of the service showed that the home employs thirteen staff from overseas. Discussion with the manager indicated that the home is an equal opportunities employer and there is a diverse mix in the staffing group. Staff members told us that they work as a team and this includes covering shifts when others are on leave or sick. Staff feel that their induction and training helps them meet the needs of people who use the service. We spoke to two people who use the service during this visit, and they were satisfied with the care they receive and said that they did not have to wait too long for staff to come when they needed assistance. Individuals told us that staff are friendly, helpful and supportive. At the time of this visit there were 40 people in the home and the staffing levels were Care Homes for Older People Page 21 of 27 Evidence: as follows, in a morning from 7am to 2pm there are seven care assistants, in an afternoon from 2pm to 9pm there are five care assistants and at night from 9pm to 7am there are three care assistants. Information from the annual quality assurance assessment about the number of staffing hours provided, and information gathered during the visit about the dependency levels of the people using the service, was used with the Residential Staffing Forum Guidance and showed that the home is exceeding the minimum hours asked for in the recommended guidelines. All of the care staff at the home have an NVQ 2 or above in care and all new starters have to complete an induction which meets Skills for Care criteria. Staff have access to a mandatory training programme, as well as a range of specialist subjects which reflect the diverse needs of the people using the service. Training booked for 2009 includes First Aid in July, Customer Care in Augusst and Infection control in September. Three staff files were looked at and they contained evidence of a variety of training events attended over the past year including safeguarding of adults, moving and handling, fire management, mental capacity act, palliative care and health and safety. The home has an equal opportunities policy and procedure. Information from the staff personnel and training records and discussion with the manager, shows that that this is promoted when employing new staff and throughout the working practices of the home. The home has a recruitment policy and procedure that the manager understands and uses when taking on new members of staff. Checks of three staff files showed that police (CRB) checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is satisfactory overall and the home regularly reviews aspects of its performance through a good programme of audits and consultations, which includes seeking the views of people using the service, staff and relatives. Evidence: The registered manager is a registered nurse and has completed an NVQ level 4 and the Registered Managers Award. Mr Waltham the owner is based at Orchard court and is available for support and advice on a daily basis. The home has an up to date quality award from the local council (QDS) parts one and two. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. The manager and senior staff complete in-house audits of the home and its service on a monthly basis, and the registered individual does spot checks and completes the regulation 26 visits. Care Homes for Older People Page 23 of 27 Evidence: Feedback is sought from the people living in the home and relatives through regular satisfaction questionnaires, and the manager produces a development report as part of this process to highlight where the service is going and/or indicate how the management team is addressing any shortfalls in the service. The home does not handle peoples personal allowances, instead the individual responsible for the payment of the monthly fees is billed for any additional costs incurred by the person using the service. People we spoke to are satisfied with the financial arrangements in the home and are confident they have access to their monies at all times. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. The Safety Officer for the home is IOSH and NEBOSH qualified and is also based in the home. A Health and Safety management system is in place. There are weekly and monthly audits conducted, ensuring the home is fit for purpose. The Safety Officer also takes responsibility for the training of staff with regard to Health and Safety matters, including moving and handling and fire training. His role also covers maintenance and there is a rolling programme of maintenance. The Safety Officer undertakes statutory tests and uses contractors when required. Comprehensive service documentation and records are kept and reflected the information given in the Annual Quality Assurance Assessment document (20 May 2009). 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 1 9 Where staff are handwriting medication onto the MAR charts (transcribing), two staff members should check that what is written (name of the medication, strength, doseage and administration times) is accurate with what is printed on the box or bottle and they should both sign next to the written information. This will reduce the risk of errors occurring and protect the health and wellbeing of people receiving medication. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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