Care Home: Osborne House

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What the care home does well The home understands the importance of having sufficient information when choosing a care home. Admissions are not made to this home until a full assessment of needs has been carried out by a suitably trained person. Prospective residents and their families are encouraged to visit and spend time at the home prior to admission. Personal support is responsive to the varied and individual needs and preferences. Individuals needs are clearly identified in care plans, and regular reviews ensure that all changes in personal needs are addressed efficiently and effectively. Each file also contained a care plan that identified the care and personal wishes of the individual in the event of serious/ terminal illness and dying. This is a delicate subject which is being sensitively addressed by the home. All interactions that we observed during this visit were unhurried and respectful, and relationships between staff and residents were relaxed and familiar, contributing to a homely atmosphere. We examined the Medication Administration Record (MAR ) sheets in this home, and found them to be generally in good order. Signatures and omission codes were appropriately recorded. People who live in this home have the opportunity to maintain important personal and family relationships. Staff practices promote individual rights and choices, and where assistance is required, staff are sensitive and understand the importance of ensuring people feel unhurried and comfortable. The activities in this home are incorporated into the daily routine. Visitors are welcome into the home at any time. The complaints policy is easily accessible to everyone entering the home. The home has an open culture and encourages opinions from residents and their relatives. Staff were able to demonstrate their understanding of the safeguarding procedures. This home provides a clean, safe and comfortable environment for the residents who live here. People have confidence in the staff that care for them. The home is staffed efficiently focusing on periods of the day when residents require more support. Staff undertake external qualifications beyond the basic requirements. This is supported by the manager who recognises the benefits of a well skilled workforce. The manager has a clear understanding of the key principles of running this home, she has good people skills and understands the importance of person centred care, which results in effective outcomes for people who use this service.We looked at the records for the residents personal monetary transactions. All were clearly recorded, and had two signatures to witness each transaction. Account balances all accurately corresponded to funds remaining in each individual`s account, and there were receipts to support each transaction. What has improved since the last inspection? Since the last inspection, the manager has introduced a weekly audit system to monitor medication administration processes. When this is completed, a log of any anomalies is formalised on record, and addressed with the staff concerned. What the care home could do better: There is an information file that contains various documents including the Service User Guide and the Statement of Purpose. We noted that some of the details in these two documents, such as ownership details of the home, and Commission for Social Care Inspection(CSCI) needed to be up dated to reflect recent changes. There is no second choice or alternative, identified on the menu on a daily basis, however as this is only a small home, the cook was able to identify the likes and disikes of most of the residents individually, and care plans and records also identify personal preferences. This was supported by individuals being served alternatives on the day of the inspection. However with the number of residents with Dementia on the increase, it is important that all residents have the opportunity to indicate a choice, even if they are unable to spontaneously request an alternative. This could be addressed with picture menus. The manager was mindful that training on the Mental Capacity Act and Deprivation of Liberty safeguarding is a high agenda subject for training. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Osborne House 18 Compton Avenue Luton LU4 9AZ     The quality rating for this care home is:   two star good 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: Louise Trainor     Date: 2 2 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Osborne House 18 Compton Avenue Luton LU4 9AZ 01582493376 F/P01582493376 osbornehouse.1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kairmoore Limited care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Osborne House was converted from a large suburban property that was originally used as a domestic dwelling and a doctors surgery before conversion to its current use. It is located in a pleasant suburb of Luton near to local railway and bus services. At this inspection the standard of the decor and furnishing were high throughout. The accommodation was arranged over two floors. It had a shaft lift for access to the upper floor. The house provided for older people and also those who have physical disabilities and dementia in fourteen single rooms and one double room The bedrooms were located on each floor, each having a washbasin and a call bell system. En-suite toilet and washbasin facilities were provided in four rooms. Communal accommodation was located on the ground floor and consisted of a comfortable lounge, a lounge/diner and an all weather conservatory. Toilet and bathing facilities were available on each floor. The ground floor bathroom had a fixed hoist to aid service users with physical disabilities. Care Homes for Older People Page 4 of 27 Over 65 16 16 16 0 0 0 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out in accordance with the Commission for Social Care Inspections CSCI policy and methodologies which require review of the key standards for the provision of a care home for older people that takes account of service users views and information received about the service since the last inspection Evidence used and judgements made within the main body of the report include information from this visit. This is a two star home and has therefore not recieved a Key Inspection since January 2007. This inspection was carried out on the 22nd of December 2008 by Regulatory Inspector Mrs Louise Trainor, between the hours of 10:00 and 14:00 hours. Care Homes for Older People Page 6 of 27 The home manager was present to assist throughout this inspection. During this inspection we picked two residents to case track in detail, and spoke at length to another resident about the care they recieved. We examined three staff files, and other doumentation relating to staff training and supervision, and had the opportunity to talk informally to two members of staff. A full tour of the premises was carried out, and documentation relating to health and safety checking procedures, medication administration, complaints, accident and incident reporting and residents finances were also inspected. Feedback was given periodically throughout, and at the end of the inspection. We would like to thank everyone involved for their assistance and support. What the care home does well: The home understands the importance of having sufficient information when choosing a care home. Admissions are not made to this home until a full assessment of needs has been carried out by a suitably trained person. Prospective residents and their families are encouraged to visit and spend time at the home prior to admission. Personal support is responsive to the varied and individual needs and preferences. Individuals needs are clearly identified in care plans, and regular reviews ensure that all changes in personal needs are addressed efficiently and effectively. Each file also contained a care plan that identified the care and personal wishes of the individual in the event of serious/ terminal illness and dying. This is a delicate subject which is being sensitively addressed by the home. All interactions that we observed during this visit were unhurried and respectful, and relationships between staff and residents were relaxed and familiar, contributing to a homely atmosphere. We examined the Medication Administration Record (MAR ) sheets in this home, and found them to be generally in good order. Signatures and omission codes were appropriately recorded. People who live in this home have the opportunity to maintain important personal and family relationships. Staff practices promote individual rights and choices, and where assistance is required, staff are sensitive and understand the importance of ensuring people feel unhurried and comfortable. The activities in this home are incorporated into the daily routine. Visitors are welcome into the home at any time. The complaints policy is easily accessible to everyone entering the home. The home has an open culture and encourages opinions from residents and their relatives. Staff were able to demonstrate their understanding of the safeguarding procedures. This home provides a clean, safe and comfortable environment for the residents who live here. People have confidence in the staff that care for them. The home is staffed efficiently focusing on periods of the day when residents require more support. Staff undertake external qualifications beyond the basic requirements. This is supported by the manager who recognises the benefits of a well skilled workforce. The manager has a clear understanding of the key principles of running this home, she has good people skills and understands the importance of person centred care, which results in effective outcomes for people who use this service. Care Homes for Older People Page 8 of 27 We looked at the records for the residents personal monetary transactions. All were clearly recorded, and had two signatures to witness each transaction. Account balances all accurately corresponded to funds remaining in each individuals account, and there were receipts to support each transaction. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made to this home until a full assessment of needs has been carried out by a suitably trained person. Prospective residents and their families are encouraged to visit and spend time at the home prior to admission. Evidence: During this inspection we thoroughly examined the files of two residents presently living in the home. Both contained very detailed pre admission assessments, that had been carried out prior to admissions being confirmed. One of these residents had been admitted over a year ago, and the pre admission assessment had been used to generate the care plans. The assessment gave details relating to the reasons for admission, and gave a clear overview of the individuals needs. It advised that this person had been prone to falls, and had suffered a Cerebral Vascular Accident (CVA) Care Homes for Older People Page 11 of 27 Evidence: some years previously. The level of assistance required relating to, personal hygiene, nutirition, communication, mobility and elimination was documented. Personal information relating to likes, dislikes and routines, such as likes to see the optician once every six months were clearly recorded as were any allergies or special requests. The second file that we looked at was a recent admission and was equally well completed. It contained sufficient information to enable staff to deliver care with continuity whilst the care plans were being formulated in consultation with the resident and their family. From this persons assessment, we could identify that this person was partially sighted (right side), hypertensive, had a history of a Heart Attack, and was prone to Urinary Tract Infections. We knew that this person was very independent and although needed assistance, liked to do whatever they could for themselves. They prefered a bath to a shower, and felt the cold, consequently liked to dress warmly. They had a top set of dentures and enjoyed their food, however did not like curry, and liked to drink through a straw. This information provided a firm foundation for the care plans, and identified the necessary information to ensure the staff could deliver care in a way that this resident preferred. We looked at the contract of terms and conditions for residents in this home. These contained the appropriate information relating to the accommodation, fees and service in general. These were appropriately signed and dated. People that we spoke to had had the opportunity to visit the home prior to making a final decision about a permanent move. There is a coloured brochure which is sent out to anyone enquiring about care in this home. There is also an information file that contains various documents including the Service User Guide and the Statement of Purpose. We noted that some of the details in these two documents, such as ownership details of the home, and Commission for Social Care Inspection(CSCI) needed to be up dated to reflect recent changes. Care Homes for Older People Page 12 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. Personal support is responsive to the varied and individual needs and preferences. Individuals needs are clearly identified in care plans, and regular reviews ensure that all changes in personal needs are addressed efficiently and effectively. Evidence: During this inspection we case tracked two residents, which consisted at looking at their files in detail, and chatted at length with another person who lives in the home. The files contained care plans, and assessments that had all been reviewed on a monthly basis to relect the changing needs of the individual, and were written in sufficient detail to enable all staff to deliver care with continuity. One persons care plans ranged from, hygiene and dressing, where the level of assistance was clearly identified, as were personal preferences such as sits on a commode by the sink to wash. To communication, which involved the input from a speech therapist, and sleep pattern, which identified restlessness and the need for a hospital bed, which had recently been ordered by the home. This persons dietary needs had been identified, and made staff aware that this individual did not enjoy the pureed meals presently Care Homes for Older People Page 13 of 27 Evidence: required and was loosing weight. All these issues were being closely monitored. Each file also contained a care plan that identified the care and personal wishes of the individual in the event of serious/ terminal illness and dying. This is a delicate subject which is being sensitively addressed by the home, both with residents and their families, ensuring that when this time arises, everyone is aware of how the situation needs to be managed, and what the personal wishes of the individual are. We chatted at length with one resident, who expressed that she was very satisfied with the care she recieved. She confirmed that although she had the opportunity to join others in the dining room for meals, she preferred her own company and her choice was generally to spend most of her time in her room. This resident has special dietary requirements that were being addressed efficiently, she said. The food is good and I have never been served anything I dont like or cant eat. All interactions that we observed during this visit were unhurried and respectful, and relationships between staff and residents were relaxed and familiar, contributing to a homely atmosphere. We examined the Medication Administration Record (MAR ) sheets in this home, and found them to be generally in good order. Signatures and omission codes were appropriately recorded, however some PRN (as required) medication such as Paracetamol could not be reconcilled as stocks are not always being carried forward from month to month. Since the last inspection, the manager has introduced a weekly audit system. When this is completed, a log of any anomalies is formalised on record, and addressed with the staff concerned. Staff advised me that if they make an error three times, they are withdrawn from administering medication until they are reassessed as being competent by the manager. We looked at the error log and were encouraged to see very few errors identified. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home have the opportunity to maintain important personal and family relationships. Staff practices promote individual rights and choices, and where assistance is required, staff are sensitive and understand the importance of ensuring people feel unhurried and comfortable. Evidence: This home operates a six week rolling menu plan, which includes a variety of home baked meals, such as beef bourginon, chicken casserole, roast pork and fish and chips. There is a seperate supper menu with lighter alternatives, such as hot dogs, cheese on toast or sandwiches, and homebaked desserts and cakes are also available. On the day of the inspection the midday meal looked and smelt appetising, and residents appeared to enjoy it. There is no second choice or alternative, identified on the menu on a daily basis, however as this is only a small home, the cook was able to identify the likes and disikes of most of the residents individually, and care plans and records also identify personal preferences. This was supported by individuals being served alternatives on Care Homes for Older People Page 15 of 27 Evidence: the day of the inspection. However with the number of residents with Dementia on the increase, it is important that all residents have the opportunity to indicate a choice, even if they are unable to spontaneously request an alternative. This could be addressed with picture menus. The activities in this home are incorporated into the daily routine. Although there is an activity programme that offers specific activities and outings, staff encourage the residents to become involved in daily tasks such as setting and clearing the dining tables and watering the plants. This provides both mental and physical stimulation for individuals, and provides an opportunity for people to maintain skills they have used all their lives. Visitors are welcome into the home at any time. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints policy is easily accessible to everyone entering the home. The home has an open culture and encourages opinions from residents and their relatives. Staff were able to demonstrate their understanding of the safeguarding procedures, and the manager was mindful that training on the Mental Capacity Act and Deprivation of Liberty safeguarding is a high agenda subject. Evidence: This home has a complaints procedure that is summarised in the service information documents and easily accessible to residents and visitors to the home. We did notice some minor ammendments were required to this document, such as contact details for the Commission for Social Care Inspection (CSCI) There had been no formal complaints to this home since the previous inspection in January 2007, and the manager told us that if anyone has a problem, they try and resolve it immediately and this prevents issues escalating to complaints. As at the previous inspection there was an array of complimentary cards and letters indicating the appreciation and satisfaction of residents and their relatives. One card read. People like you are very rare, there are too many takers but you prefer to give. Another read. I know I couldnt have found anywhere better for Mum, bless you all for Care Homes for Older People Page 17 of 27 Evidence: looking after her so well. I cant put into words how much I appreciate your thoughfulness and kindness. Safeguarding is addressed with staff in this home through the induction process, and is also included in the mandatory training schedule. All staff have attended this training, and interviews with staff, indicated that they have a clear understanding in their role of the safeguarding reporting process. The manager also advised us that the Mental Capacity Act (MCA) and the Deprivation of Liberty, are also being address through managers training, that will lead to a related in- house training programme. 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. This home provides a clean, safe and comfortable environment for the residents who live here. Evidence: This home is clean and homely and well maintained throughout. On the day of this inspection, christmas decorations gave a festive feel to the home. The communal lounge and dining areas were warm and inviting and residents looked relaxed and comfortable. Corridors both on the ground and first floor have recently been decorated and there is a programme to continue decorating other areas of the home in the new year. All shower and bathing facilities were clean and tidy, with assistive aids appropriately checked and serviced. Staff were mindful of the need for safety and cleanliness in the home, and one member of staff showed us an environmental check list that was her responsibility to complete each month. Individuals bedrooms were decorated and furnished to personal taste, and reflected residents life histories and personal choices. Some had furniture that they had brought in from their own homes, others had personal telephone facilities, mobility and transfer Care Homes for Older People Page 19 of 27 Evidence: aids and evidence of indivduals hobbies and interests, such as talking books, other audio equipment and plants. Residents were encouraged to spend some time socialising in the home, however some residents were equally as comfortable, doing what they wished in the privacy of their own rooms. 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. People have confidence in the staff that care for them. The home is staffed efficiently focusing on periods of the day when residents require more support. Staff undertake external qualifications beyond the basic requirements. This is supported by the manager who recognises the benefits of a well skilled workforce. Evidence: During this inspection we examined the personnel files of three members of staff. All contained documentation to indicate that the recruitment procedure was robust and being followed appropriately. Documents included, fully completed application forms, including an employment history, a completed health questionnaire, a contract of terms and conditions, signed and dated, Criminal Record Bureau (CRB) checks, two references from appropriately nominated referees, induction documents, a coloured photograph and various forms of identification, such as passports and birth certificates. We looked at the training file which identified a wide variety of training available and being attended by staff. Mandatory subjects such as fire training and moving and handling had been attended by all staff, however some staff are due to attend refresher courses imminently. Other more specialist training such as Dementia and nutrition is also being well attended. More than 50 of the staff in this home are either working towards, or have achieved NVQ level 3 in care. The manager also Care Homes for Older People Page 21 of 27 Evidence: informed us that training in the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguarding (DOLS) is high on the agenda for next year. Observations of care indicated that staff are competent and confident in their roles, and conversations indicate that some are keen to progress their careers. Comments from residents indicated that they feel safe being cared for by these staff, however one person told us that some do have a problem with understanding English at times. 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 manager has a clear understanding of the key principles of running this home, she has good people skills and understands the importance of person centred care, which results in effective outcomes for people who use this service. Evidence: The manager of this home is one of two co directors/owners. She works with the staff on a daily basis, so is able to lead by example as a role model, and also observe, identify and address immediately any care practices which may require attention. The manager and her co director carry out supervision with all staff every two or three months, and the staff that we spoke to were able to identify their supervisor and discuss the benefits of this support. One carer told us. Were always well supported, we can go to the manager any time with any problems. The staff were knowledgeable about the individuals they care for and the procedures they must follow. Communication between staff is promoted in this home through handover meetings Care Homes for Older People Page 23 of 27 Evidence: and a communication book, so that staff are always made aware of any specific changes to individuals care. This home holds small amounts of money for most of the residents in this home, although they do not act as appointee for anyone. We looked at the records for the residents personal monetary transactions. All were clearly recorded, and had two signatures to witness each transaction. Account balances all accurately corresponded to funds remaining in each individuals account, and there were receipts to support each transaction. All records in this home were securely stored, they were in good order and had been kept under review. Risk assessments were in place to promote the safety of all the residents living in Osborne House. Accidents and incidents were clearly recorded in an accident book, and we were able to cross reference these incident reports with entries that had been made in the individuals daily records log. There was however one incident record that we checked, where the resident had required medical tratment at the hospital. Although this was very clearly recorded in the residents file, we had not recieved a regulation 37 notification regarding this matter. We reminded the manager that this was also identified at the last inspection, and that these notifications must be sent to CSCI, in order for us to monitor trends on incidents in the home. Quality assurance is addressed by surveys being sent to both residents in the home and other professionals such as district nurses and GPs that work with the home. The most recent survey carried out was in July 2008. This addressed issues relating to, Life in the home, Diet, Complaints, Environment, Hygiene and Staffing and Management. In all areas more than 70 of responses indicated that in their opinion the home offered and provided an excellent service. The remainder were all good with the exception of a few no responses. 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 1 38 37 The registered person shall 23/01/2009 give notice to the commission without delay of the occurence of any event in the care home which adversly affects the well being or safety of any service user. People who live in this home must be protected by reporting processes. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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