Care Home: Osbourne Court Care Home

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What the care home does well The home provides good quality personal and health care support to meet the individually assessed needs of each service user. The home is effectively managed and staff are well trained and supported to enable them to provide a good level of service within a homely and safe environment. Without exception service users consulted confirmed that they were well cared for .`Iam very well looked after here and am quite happy`, one said. A relative said ` They do a really good job at caring for my relative nothing is ever too much trouble and they allow me to help them too if I wish when ever I visit`. The environment is spacious well equipped and well maintained and the home had a noticeable happy and relaxed atmosphere at the time of our visit. The home retains a stable staff group whose numbers are adequate to meet the needs of the people living there and were seen to be doing so in an unhurried manner. Recruitment procedures for new staff are thorough with evidence that all the required checks are made to ensure the protection of the people who use the service. What has improved since the last inspection? Since the last inspection extra Activity Organizer hours have been employed which has enabled the range and duration of activities to be increased. The care plans have all been reviewed and more detail of peoples early life history and current interests, likes and dislikes included. The home has benefited from various works of redecoration and refurbishment and an enclosed Courtyard Garden area has been created. What the care home could do better: The development of Picture Menus would enhance the understanding for some people at meal times. The home should develop and regularly practice a full fire evacuation plan to ensure safety for the service users at all times. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Osbourne Court Care Home Park Drive Baldock Hertfordshire SG7 6EN     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: Claire Farrier     Date: 0 1 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: Osbourne Court Care Home Park Drive Baldock Hertfordshire SG7 6EN 01462896966 01462896967 osbourne.court@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Belinda Webb Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category physical disability Additional conditions: The home may accommodate one named service user with a learning disability. This condition will no longer aply once the service user ceases to reside at the home. This home may accommodate 34 older people with dementia who require personal care. This home may accommodate 35 older people who require nursing care. This home may accommodate 69 older people who require personal care This home may accommodate 69 older people with physical disability who require personal care. Care Homes for Older People Page 4 of 27 care home 69 Over 65 34 1 69 69 0 0 0 0 Date of last inspection Brief description of the care home Osbourne Court is owned and operated by Four Seasons Homes Ltd, and it is registered to provide personal care and accommodation for 69 older people. The ground floor accommodates 34 residents who may also suffer from dementia, and the first floor accommodates 35 residents who need nursing care. Osbourne Court is a purpose built two-storey building situated in a residential area close to the centre of Baldock. It is adjacent to a health centre and a large superstore, which provide good access to medical and shopping facilities. Accommodation is provided in single rooms. All rooms have an en-suite toilet and washing facilities and there are a number of assisted bathrooms throughout the home. The first floor is served by a passenger lift. There is ample car parking space at the front of the building. There are two small gardens with patio areas to the rear and side of the home. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The current charges range from £420.14 per week for residential care to £538.93 per week for nursing care. 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 unannounced inspection took place over eight hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act relating to Older People. This report is written using accumulated evidence gathered prior to the inspection including information contained in the AQAA ( Annual Quality Assurance Assessment) completed by the Manager, information given in any pre-inspection questionnaires and also takes account of statutory notifications sent periodically to the CQC ( Care Quality Commission) by the home. A tour of the building was made, in depth discussions were held with the homes Manager and staff who were on duty were spoken with.We also met and spoke with a number of people who use the service and with their visitors. Spot checks were made on a number of the homes records and care plans. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 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 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have an assessment of their needs prior to entering the home and to have an opportunity to visit and assess the services offered for themselves.They will also have access to sufficient information about the home to help them to make an informed choice. Evidence: Good information about the home and the level of services offered is given to all prospective applicants. People wishing to move into the home will have a full assessment of their care and social needs carried out by the manager who will visit them at their home or in hospital. Relatives or representatives may be involved in this assessment if the applicant wishes them to be. Information from medical and social care services are gathered so that the home can be fully informed about all aspects of the applicants needs. Care Homes for Older People Page 10 of 27 Evidence: The records of two new residents were seen during this inspection and each one had a pre admission assessment fully documented. Areas of care need that were covered included personal hygiene, diet, mobility, communication, medication and night care needs. Other information was about behaviour, likes and dislikes and relatives involvement in the care given prior to admission. Special needs such as walking aids or a particular chair or bed were also noted and where needed areas of risk appropriately assessed. Information about past medical history and present medication was also included. The homes brochure information documentation was clear and informative and gave a good insight into life in the home. The Statement of Purpose was up to date and informative containing all the required elements. All the service users have a contract and information concerning terms and conditions of residency. Residents and relatives spoken with said that they had the opportunity to visit the home and assess the service before making the decision to move in. One relative said We chose this home over several others and we have found that all the staff have been exceptionally helpful and kind in assisting our relative to settle in quickly. There is great warmth and a very homely atmosphere. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their health and personal needs met in a dignified and respectful manner by staff who have a sound knowledge of their care needs and how these should be met. The home maintains a robust medication system and the homes medication policy, procedures and practice protect the people who use the service from any medication error. Evidence: Since the last inspection the home has revised all the care plans into a more structured and person centered format which gives better details of the assessed needs and how these should be met. Appropriate risk assessments are clearly documented and kept up to date. Better information is given about the persons early social history and life interests and circumstances this to enable staff to interact more appropriately with the whole person as was and to ensure that their individual likes and interests can be accommodated. The manager recognizes that these have enabled better targeted care to be given to people who have some degree of dementia. Care Homes for Older People Page 12 of 27 Evidence: All the care plans were seen to contain a good level of detail about the action required by staff to support the service users and to meet their assessed needs. References that reminded staff to assist people to do as much for themselves as they possibly could even if this took a little longer were noted to evidence good practice. Residents and relatives spoken with during this visit all said that they received the care and support that they needed including good medical support. They were also aware of their care plans and confirmed that they had opportunity to sign these and were regularly involved with the reviews of their plan. One service user who asked to speak with us said I am very well cared for here the home provides different things to do each day and the staff are wonderful nothing is ever too much trouble they always allow me to go at my pace and I feel secure and well cared for in this home. The care plans all contained clear records of contact with other health care professionals. Conveniently the local medical centre is very close to the home and this has enabled close and prompt working relations to develop. Doctors and community nurses were seen to be visiting service users during the day of this visit and records of their visits the care given and actions planned were found to be well recorded. Since the last inspection the home has worked with its local doctors and the local hospice to improve the end of life care services that they deliver. Training on this aspect is now undertaken by all staff. Staff were observed knocking on doors before entering bedrooms and bathrooms. Interactions between staff and residents were relaxed and friendly and several residents spoken with told us that their dignity was not compromised by poor practice. Part of the medication administration round was observed. Staff were seen to administer medication in a kindly manner working with the service user at their pace. The home uses a MDS monitored dosage system for medication this being supplied from a local pharmacy. The home has appropriate and secure storage facilities for medication including a controlled drugs cabinet and a medication fridge. The home has ordered an air conditioning unit so that a regular temperature can be maintained in the medication room during the summer months.The MAR administration records were seen to be well recorded with no omissions and evidence of regular management reviews of the accuracy of these records could be seen. A record of the audit of the medication received into and disposed out of the home was also seen. The records of the medication administered were generally clear and complete with appropriate identification codes and a written explanation of variations fully recorded on the reverse of the sheet. A check of the controlled medication found that the correct amount of medication measured against the recorded amounts were correct. 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 this service can be assured that the home will provide them with a good lifestyle that offers choice and meets their assessed social and recreational needs. People using this service are offered a choice of nutritionally balanced home cooked meals which residents confirmed their satisfaction with. Evidence: Following the adequate quality outcome achieved for this section at the last inspection the home has made strenuous efforts to improve this aspect of their service. Extra Activity Organizer hours have been employed and all the people using the service now have a recorded assessment of their activity needs and wishes and it could be seen that records of their attendance at sessions and whether or not they enjoyed these was also recorded. The manager explained that they had spent much more time talking with the service users asking them what it was they wanted to do if any thing. One resident wish to stay mostly in their room was respected and was the choice of others not to have to participate in large group activities. One to one recreational arrangements were found to be better suited to the more frail service users. A weekly programme of activities planned was seen displayed in the home as was photographic Care Homes for Older People Page 14 of 27 Evidence: evidence of recent outings to local places of interest. During our visit several service users were seen to be enjoying sitting in the homes recently completed secure Courtyard garden where both individual and small group activities were being carried out. Staff were talking with some residents and relatives about plans for future day outings during the summer months. The home has a sensory room which has been developed to provide an additional facility for offering people occupation and stimulation. The Activity staff explained that they had attended training on providing a range of activities including programmes that would be suitable for service users suffering from dementia. One member of staff explained how they had involved some of the residents in creating visual displays themed following areas of interest for example sport and old time music which have been placed on the corridor walls and which now provided stimulation as subjects for discussion. All the service users asked said that they had plenty of activities and that they enjoyed the variety. Comments about the food were entirely positive. One resident said it is delicious and attractively presented with a good number of choices, sometimes there is even a little too much. Cooked breakfasts taken in the dining rooms are popular with some service users whilst others prefer to take something much lighter in their rooms and do not come into the communal areas until later in the morning. The serving of lunch was observed and it was seen that staff had good knowledge of individual requests and preferences and portion sizes. Staff were seen to be assisting the more frail residents to eat going at their pace maintaining good eye contact and communicating with them throughout the meal. Picture menus would be advantagious for people whose reading skills have declined. Care Homes for Older People Page 15 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. Practices in this home ensure that people who use the service can be confident that the policies and procedures in place will ensure that if they raise concerns about the service they will be listened to and can be confident that they will be protected from abuse. Evidence: The home has a robust and effictive complaints procedure and service users and relatives consulted knew who to talk to if they were not happy and wanted to complain. Several said that if they did need to raise any issue they would do so first with the homes manager whom they felt sure would sort things out quickly. One said The manager is always very approachable she has an open office door and always seemed to welcome chats with residents.This was seen to be the case during the day of this visit. The homes Statement of Purpose and Service Users Guide gives information about the homes complaints procedure and the expected time frame for any issues raised to be dealt with. Information about how to access Advocacy Services is also given. The home keeps a log of all complaints and of the outcomes of the investigations. It was seen that a complaint about lack of cleaning of a bedroom had been promptly rectified and that following this the numbers of house keeping staff and the arrangement of their working times had been reviewed and strengthened. The home keeps records of any Compliments received and a number received since the last inspection were shown to us during this visit. They were complimentary about the Care Homes for Older People Page 16 of 27 Evidence: services received and the manner in which care had been delivered. The home has the Hertfordshire Guidelines concerning the Protection of Vulnerable Adults and a comprehensive Whistle Blowing policy to protect staff and residents. Staff interviewed confirmed that they were aware of these policies and of the steps that they should take if they suspected that any abusive practice was occuring. The homes training records evidenced that training covering these subjects was up to date and that further up dating courses had been arranged. No incidents concerning the Safeguarding of Adults had arisen in the home since the last inspection. The Manager confirmed that she and other senior staff had recently undertaken training concerning the Mental Capacity Act and its implications for the care of vulnerable service users.Mental capacity is now noted in all new care plans. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides spacious good quality accommodation and has a homely atmosphere. People who use this service benefit from a safe well maintained comfortable clean and hygienic environment which is well appointed with all the appropriate facilities to meet their needs. Evidence: The home was purpose built twelve years ago and a tour of the building identified that it is spacious well appointed and subject to a regular maintenance programme. The bedrooms were all personalized to reflect the tastes and interests of the residents. When there is a vacant room the home keeps this as a show room which prospective residents and relatives can view and it was seen that this accommodation was very well presented with crisp linen and fresh towels and the manager confirmed that it had been freshly decorated. New residents are able to bring small items of their own furniture pictures and ornaments and every room was seen to be individually personalized and residents asked all said that their rooms were very comfortable and were arranged to their liking. The home has two assisted bathrooms which the manager said were planned to be refurbished during the next year. A regular programme of redecoration is ongoing throughout the home with several of the bedrooms and some of the communal areas having been redecorated since the last inspection. Also since the last inspection notices Care Homes for Older People Page 18 of 27 Evidence: around the home had been discreetly placed so as not to detract from the homeliness of the environment and the use of the homes storage space had been reorganized so that the space provided more adequately meets the storage needs of the home. On the day of this visit the home was found to be very clean and tidy and to have no mal-odors. Since the last inspection new housekeeping arrangements have been introduced and the number of this staff group increased. Housekeeping staff spoken with all confirmed that this was an improvement and also said that they had plentiful supplies of cleaning products and reliable equipment. These staff also demonstrated a good awareness of the need for maintaining good infection control measures at all times.The homes training records evidenced that infection control awareness training had been undertaken by all staff. The home has a good sized laundry with dedicated staff and no complaints were raised with us about the laundry service during this inspection. The laundry area was suitably arranged with a pattern of soiled linen in and clean linen out that ensure sound infection control measures were being followed. However the staff all complained that the extreme heat in the room made it a difficult area in which to work and the manager agreed to look into this aspect promptly. Care Homes for Older People Page 19 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 who use this service can be confident that they will be supported by appropriate numbers of skilled and fully trained staff who have been safely recruited to give them protection and who are able to ensure the smooth running of the service. Evidence: During this unannounced visit it was seen that there were sufficient staff on duty to meet the needs of the service users in an individual manner and that the number of staff working tallied with the planned staff rota. Information given by residents and their relatives confirmed that there were always sufficient staff to meet their needs in a timely manner. One said if there are ever to be any delays they always tell us the staff are always very helpful and respectful. During this visit staff were observed to answer call bells within a reasonable time frame and residents said that they were always treated with respect and dignity. Staff were seen to be working well together as a team and to be providing support for the residents in a kindly and unhurried manner allowing them to do as much for themselves as it is safely possible for them to do. Staff were seen to be familiar with the needs of individual residents and a good rapport was seen to exist between them. The manager said that since the last inspection the staffing levels in the home had been increased to ensure that the increased needs of the residents could be adequately met. More waking night staff and an additional nurse or senior carer are now employed on each day time shift. However Care Homes for Older People Page 20 of 27 Evidence: she also said that staffing levels are constantly being reviewed and adjusted to meet the fluctuating needs of the service users. The home is fortunate is being able to retain a stable core group of staff many who have worked at the home for many years and offer dedicated and loyal service. A recent recruitment drive has resulted in several appointments of experienced and qualified staff so that now the home is virtually fully staffed and no longer has to call upon agency staff to fill gaps. Spot checks on the recruitment practices for these new staff showed that all the required checks had been made to ensure good protection for the service users. New staff commence duties only after appropriate CRB checks have been received and they then complete an induction programme and work initially shadowing another qualified and experienced member of staff. The nurse team is fully staffed it is a stable group and the manager said that there had been no nurse changes since the last inspection. The team of carer workers is now complete and is forty eight percent qualified at either NVQ levels 2 or 3. Five other staff are currently completing NVQ level 2 studies. Staff spoken with said that they were sell supported by the managers received regular supervision and had good training opportunities. A training needs profile is kept for each member of staff and since the last inspection it could be evidenced that training on a wide variety of subjects had been undertaken. Care Homes for Older People Page 21 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. People who use this service benefit from the sound management of the home and the homes person centered ethos ensures that it is run in their best interests. Administration practices in the home protect service users and promote a safe environment. Evidence: Since the last inspection a new manager has been appointed. She is a registered nurse with considerable management experience of residential care home settings who had previously worked at Osbourne Court as its deputy manager for several years. She has applied to the Commission for registration and is about to commence the registered managers award management training course. A new deputy manager has also been appointed she too is a registered nurse with several years experience of residential care home management. The home therefore benefits from a stable management team who are all well qualified and experienced professionals whose ethos is very clearly to put the needs of the people who use the Care Homes for Older People Page 22 of 27 Evidence: service first. Their confident and calm approach to their work positively influences the homely and relaxed atmosphere in the home where meeting the nursing and social care needs of the residents was found to be well integrated where the particular skills of each discipline positively influences the other. The management ethos is to operate using an open door policy of encouraging feedback and throughout this visit evidence from service users visitors and staff all confirmed that the home was well managed that they were well supported by their managers and that their opinions were listened to. One comment received said Overall I think that the home is a positive and happy place where the management help to create a positive and happy atmosphere. The home has appropriate systems in place to enable good communication between the various groups of staff. Records of staff meetings, nurse meetings and residents and relatives meetings evidenced that these were properly planned and recorded and had a good range of participation and that they covered all aspects of care delivery and personal development. The home sends residents, relatives, staff and external stakeholders quality assurance questionnaires from which an annual report is compiled this being available for existing and potential service users. Comments seen included from a relative I am very pleased with the care that my relative receives and another said All staff especially the nursing staff are very caring. The manager said that comments from these questionnaires are shared with all staff and are used to learn where improvements in their service delivery are needed. The service users all have lockable spaces in their rooms for the secure keeping of valuables and money and they can if they wish also have a key to their room. The home will keep small amounts of money for service users and sends a monthly statement detailing all transactions in and out of their account to them. Receipts for all monies spent and money deposited by family members are also kept. The administrator reconciles these records weekly and the manager makes monthly checks on the balances. Periodic spot audit checks are also made by the company all this to ensure that peoples monies are managed safely. The home have adequate facilities for the safe keeping of confidential records and since the last inspection when this aspect was found to be weak new arrangements have been put in place throughout the home to ensure that peoples right to privacy and confidentiality are fully protected. The home gives good priority to promoting the health safety and welfare of the service users through the regular maintenance of safety checks, training and record keeping. The records relating to the monitoring of water temperatures were found to be regularly completed along with servicing and safety checks of the homes equipment. Fire alarm testing is carried out regularly and regular testing and checking of equipment takes place. A fire risk assessment was also in place but no fire evacuation plan could be evidenced. The Manager was already aware of this deficiency and said Care Homes for Older People Page 23 of 27 Evidence: that this was going to be reviewed. Risk assessments for the environment were found to be kept and to be reviewed regularly. Staff consulted all reported that they had regular supervision meetings which they found helpful and enabled them to think about their own professional development as well as to talk through any day to day work problems. Spot checks made on the records of these meetings found them to be satisfactory. 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 15 The provision of picture menus would assist some of the people who use the service to have a better understanding of the choices available at meal times. So that peoples safety in the home can be assured at all times the home needs to develop an evacuation plan which would be used in the event of any fire. 2 38 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. 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