Care Home: Osmaston Grange Care Centre

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What the care home does well Individual needs assessments were made before people were admitted to the Service so that their diverse needs were identified, planned for and individually met. People who use the Service had individual plans of care which demonstrated that their health and care needs were being met. They were being treated with respect. The Service provided a programme of activities and services that benefited people living here. Meals were varied and generally enjoyed by people. Good practices for handling complaints and abuse were being followed ensuring that people who live at the Service are fully protected. People were living in a clean, comfortable and homely environment. The Service had a good level of well trained and recruited staff to ensure that the people living here were safe and their needs were met. The Service`s management ensured that systems were in place that promote the interests of people living here. What has improved since the last inspection? Reception, lounge and dining areas had been refurbished and 17 bedrooms redecorated with new carpets fitted. The way the Service responds to complaints had improved as well as the number of staff with a First Aid qualification. Staffing hours had been reviewed and additional hours allocated, including an Activities Co-ordinator post. The Investors in People Award had been gained in February 2010. What the care home could do better: There were no requirements made at this inspection. Good practice recommendations include the need to make improvements to recording and some staff training and health & safety practices. Key inspection report Care homes for older people Name: Address: Osmaston Grange Care Centre 5 - 7 Chesterfield Road Belper Derbyshire DE56 1FD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anthony Barker     Date: 2 1 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Osmaston Grange Care Centre 5 - 7 Chesterfield Road Belper Derbyshire DE56 1FD 01773820980 01773828536 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Osmaston Grange Limited Name of registered manager (if applicable) Mrs Judith Sissons Type of registration: Number of places registered: care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 80. The maximum number of nursing places is 20. The registered persons may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age - not falling within any other category - code OP. Dementia - Code DE 16 Date of last inspection Brief description of the care home Osmaston Grange Care Centre comprises a two storey older building and a two storey purpose built building on the outskirts of Belper town centre. The Service provides personal and social care for forty-four people aged sixty-five years and over, nursing care for up to twenty people and has sixteen places for people with dementia. It can Care Homes for Older People Page 4 of 28 Over 65 0 64 16 0 Brief description of the care home therefore cater for eighty people in total. The older building is used for residential care for forty-four older people and the new building accommodates people with nursing needs on the upper floor and people with dementia on the lower floor. The older building has forty-two single bedrooms and one shared room; all rooms except one have en-suite facilities. The first floor is accessed by stairs and a passenger lift. There are two lounges and dining rooms on the ground floor. The new building has twenty single rooms, all en-suite, on the upper floor and sixteen single rooms, all ensuite, on the lower floor. There is access to a garden area. Care Homes for Older People Page 5 of 28 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: The time spent on this inspection was 12.5 hours and was a key unannounced inspection. Survey forms were posted to people living at the Service, their relatives, staff and external professionals before this inspection and 7 people responded. The Service provided us with a summary of completed satisfaction questionnaires from people living at the Service and from external professionals. We spoke with several people living at the Service and to two in depth. We also spoke with one visiting relative, the Manager, the Lead Nurse, the Activities Co-ordinator and with one care staff member. Records were inspected and there was a tour of the premises. Four people living at the Service were case tracked so as to determine the quality of service from their perspective. This inspection focussed on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last key inspection on 5th and 6th April 2009. The Services pre-inspection, Annual Quality Care Homes for Older People Page 6 of 28 Assurance Assessment (AQAA), self assessment form was reviewed prior to this inspection. We saw that a copy of the Service Users Guide was in the nursing home entrance hall and this referred to the last inspection report being available in the office there. The Manager informed us that the Services fees range from £435 to £546 per week. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual needs assessments were made before people were admitted to the Service so that their diverse needs were identified, planned for and individually met. Evidence: We examined case tracked peoples contracts and found that the Manager had provided an itemised breakdown of what fees actually cover. However, this was not as per the Regulation, as required at the last inspection. We clarified, with the Manager, that contracts should specify fees payable for accommodation, nursing and personal care. One of the people case tracked had been recently admitted and their file was examined. We saw a comprehensive pre-admission needs assessment form completed by the Manager. Additionally, there was a comprehensive personal history and a summary sheet identifying personal details, health & social care needs, medication and family contacts. Care Homes for Older People Page 10 of 28 Evidence: The Service was not providing intermediate care. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience 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 the Service had individual plans of care which demonstrated that their health and care needs were being met. They were being treated with respect. Evidence: Four people living at the Service were case tracked so as to identify the standard of care provided from their own perspective and from individual records and discussions with them, the Manager and staff. The files of three of these people were examined in depth and were found to include the persons photograph and a good range of care plans which set out how peoples individual needs should be met by staff. The case tracked person most recently admitted to the Dementia Unit had a set of holistic and comprehensive care plan documents. However, on the file of one person living in the nursing home, very few details had been recorded on the Part 1 General Information form. Also, the Daily Living and Social Activities care plan had very few entries and there were no goals recorded. Neither was this care plan signed or dated. The Care Plan Agreement was blank, unsigned and undated. On discussion with the Manager we were reassured to hear of her efforts to improve the consistency of care plans across the three separate services and to ensure that care staff can understand them. Care Homes for Older People Page 12 of 28 Evidence: The file of one case tracked person, living in the residential home, had a good summary sheet and a better standard of social and emotional care planning documentation. None of these documents were person centred in their wording and did not reflect or support the person centred way that staff were clearly working with people. We discussed, with the Manager, future ways of addressing this matter. The Manager told us that she attempts to hold an annual meeting to review each persons needs regardless of whether they have a care manager or are privately funded. One member of care staff we spoke with confirmed that residents, and/or their representatives, are involved in the care planning process. She described an approach that is flexible and sensitive to the needs of people when considering their presence at review meetings. Monthly reviews of care plans were taking place. Recorded risk assessments covered areas such as risks associated with falling, personal handling, nutrition and Tissue Viability and provided a means of measuring and minimising these risks. Reviews of these risk assessments were being made at appropriate intervals and were being signed and dated. We also saw signed consent forms for the use of bed rails as well as risk assessments for their use. There was good evidence of involvement with external health and social care professionals. The Manager stated in her pre-inspection Self Assessment form that, We have excellent links with physiotherapists, dieticians, occupation therapists, speech therapists and the Mental Health Team through the Care Home Support Team, based at a local hospital, and can now have direct access to all these services without having to wait for a GP referral. She told us this system, works extremely well, and said the Team advises the Service and provides staff training. GP and district nurse contacts were being recorded. A notice was displayed on an office wall requesting staff to contact relatives if a GP is called out. However, one relative we spoke with told us of several occasions when she had not been notified following a call to a GP. The Manager described an adequate range of moving & handing equipment for use by those people with limited mobility. We assessed the medication administration, recording and storage practices in each of the three services. The administration of prescribed medicines was generally being recorded accurately although we found several gaps on medication sheets in the Dementia Unit. The Manager assured us that she regularly monitors these sheets. We spoke with the Manager about improving monitoring through staff attending to this on a daily basis. Two staff members initials were being recorded against handwritten entries, as recommended at the last inspection. Also, medication in the residential home was being stored in a different room to address the high room temperature Care Homes for Older People Page 13 of 28 Evidence: found at the last inspection. Medication requiring storage at a cool temperature was being stored in a dedicated refrigerator and its internal temperature was being recorded. Individuals photographs were beside medicine records. Medicine blister packs were being stored securely. We noted that controlled drugs were being safely stored and their administration recorded in a Controlled Drugs Register. We had been notified by the Service of a controlled drugs error in March 2009. The Manager told us that the member of staff concerned had left following other unacceptable practices. The Manager told us that all staff who administer medicines have had refresher training in the safe use and recording of medicines within the past three years. We observed that people living at the Service were well dressed. The Manager said that clothing companies visit every two to three months and these are popular with the people living here. Two people we spoke with said they are happy with the condition of their laundered clothing. One confirmed they get their own clothes back. However, one relative we spoke with had been concerned that the resident they visit was found wearing another residents clothes on one occasion and having other residents clothes in their wardrobe. All the people we spoke with confirmed that people living here have their need for privacy and dignity respected. One person told us that, staff knock on my door and wait to be invited in. One relative said that, staff speak respectfully. The staff we spoke with gave us examples of peoples dignity being respected. For example, we were told, we dont speak to them (ie. people with dementia) like children...we treat them as a grandma/grandpa and, I explain (to the person) what Im doing before doing it. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service provided a programme of activities and services that benefited people living here. Meals were varied and generally enjoyed by people. Evidence: The Manager stated in her pre-inspection Self Assessment form that, We have a trained Activities Co-ordinator. This person works for approximately 12 hours a week in the Dementia Unit and we observed her interacting well with people while ageappropriate music was being played. She told us she felt there was an appropriate amount of activities available for people with dementia to take part in. She also spoke of plans to improve the range of activities and increase the current frequency of visiting entertainers. We read her Activities Diary where she records her aims for the week and a description of activities undertaken. However, we could find no evidence of cross-referencing these activity descriptions with individuals care plans or daily records in order to provide a review of how peoples social and emotional needs are being met. The Manager told us that, We have accessed transport via Community Transport and our service users will now be able to go out more often. One case tracked person we spoke with said, I can choose to go to activities. Another told us, I like the older Care Homes for Older People Page 15 of 28 Evidence: music playing. One visiting relative considered that there are, very few activities, in the residential home. The Manager stated in her pre-inspection Self Assessment form that, We are in the process of liaising with occupational therapists from the Care Home Support Team to create an Activities Team (in the residential home). She told us that staff have expressed an interest in the idea. She described a range of activities and visitors who entertain the people living in the residential home - it was particularly clear that peoples religious needs are met on a regular basis. The two case tracked people we spoke with told us that they have regular visitors and there are no restrictions on the time they spend on visits. The relative we spoke with also confirmed this. We also saw evidence in the Visitors Books to confirm that people receive visits from relatives and friends on a frequent basis. The Manager stated in her pre-inspection Self Assessment form that, We will provide a staff member to assist and escort a service user who is unable to go out on their own. One of the care staff we spoke with gave us examples showing that people are helped to exercise choice over their lives. For example, she spoke of people being given the choice not to walk with a walking frame but rather to have two staff to escort them. One of the case tracked people told us, I have three showers a week - this was my preference. Another case tracked person said, I get up early...I wash and dress myself and come and sit in the lounge about 6am. The Manager told us that no external advocates were currently used by people living here: most people have a relative or friend to advocate for them. The Manager stated in her pre-inspection Self Assessment form that, We recognise that our service users have rights and choices and that some degree of risk is normal. She gave us several examples of people expressing their views on day to day matters - for example, whether they wish for photographs on their bedroom doors. The Manager said that many staff had attended training on the Mental Capacity Act (MCA) and she and some senior staff had received training on the associated Deprivation of Liberty Safeguards (DoLS). The Manager showed awareness of DoLS. We looked at food stocks in the residential home - these were at a satisfactory level and included fresh fruit and vegetables. The menus indicated that people were being provided with nutritious and varied meals and choices were being provided each day. The weeks menu was displayed. Tea-time tables were attractively laid out with artificial flowers and serviettes/rings. We also observed lunch being served and eaten in the nursing home and dementia unit and this looked very appetising. There was a relaxed atmosphere in both these dining rooms and we were told that people make personal choices as to where they eat their meal. This could be at the dining table, an easy chair in the lounge/dining room or their own bedroom. The menus displayed in Care Homes for Older People Page 16 of 28 Evidence: the nursing home and dementia unit covered three weeks and so it was not possible for people to read the days menu. The people we spoke with were generally positive about the quality of catering. One case tracked person told us, I can get any food I want...I can change my mind too. Another person thought the quality of the food was, variable. One staff member told us that some people have requested, and eat, a cooked breakfast. Peoples food preferences were being recorded on Eating & Drinking care plans. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good practices for handling complaints and abuse were being followed ensuring that people who live at the Service are fully protected. Evidence: The Services written complaints procedure was examined and found to be well worded. Copies of this were displayed in the entrance halls of the residential home and nursing home. The Service had a well-laid out complaints record. We had received one complaint from a relative, about the Service, in July 2009 and this had been addressed to our satisfaction. The Services quality assurance questionnaires summary sheet indicated that minor grumbles are listened to and dealt with appropriately. People, and their relatives, that we spoke with knew who to speak to if unhappy. One person told us, Id go to one or two particular staff...Ive not had to complain. We examined the Services Safeguarding Adults and Whistle Blowing policies. Both were appropriately worded except that the Safeguarding Adults policy made reference to Manchester services - the area in which the Providers other care homes are situated. The Whistle Blowing policy was very comprehensive. We were pleased to note that the Derbyshire Safeguarding Adults policy & procedures, together with Alert Forms, were displayed in the offices of both the nursing home and residential home. The Manager told us that all staff had received training in safeguarding adults. One staff member we spoke with did not know what whistle blowing is and neither staff Care Homes for Older People Page 18 of 28 Evidence: member we spoke with could recall reading the Services policy on this matter. One relative told us, I feel (my relative) is happy, safe and well looked after here. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were living in a clean, comfortable and homely environment. Evidence: All areas of the premises that were inspected were found to be pleasant and relatively homely with good standards of furnishing and decoration. Those bedrooms inspected were found to be attractively decorated and nicely personalised. Each person had a lockable facility in their bedroom and appropriate bedroom door locks were fitted. The privacy lock was not working on the door to the toilet off the light well. We found the premises to be clean with no unpleasant odours. The staff we spoke with described good infection control practices. The Manager confirmed that all staff had undertaken Infection Control training. One case tracked person we spoke with told us, Its lovely and clean here. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service had a good level of well trained and recruited staff to ensure that the people living here were safe and their needs were met. Evidence: Staffing rotas were briefly examined and these indicated that there were sufficient staffing levels at the Service. The Manager told us that agency staff are used on very few occasions. The Service was holding a 21 hour nurse vacancy at the time of this inspection: the Manager said these were additional hours. The two staff members we spoke with felt that there were usually adequate numbers of staff on duty. One staff member told us that each of the three units generally have the same staff working there, to provide continuity. The visiting relative, and the case tracked people we spoke with, also thought staffing levels were generally sufficient. The Manager stated in her pre-inspection Self Assessment form that 71 of the 51 staff had achieved a National Vocational Qualification (NVQ) in Care at least to level 2. This meets our Minimum Standards, which expect that a staff group with at least 50 qualified staff is maintained. The file of a recently appointed member of staff was examined. All matters relating to her recruitment were satisfactory, except that the person had not been asked for details of any criminal offences in respect of which the person had been cautioned by Care Homes for Older People Page 21 of 28 Evidence: a constable and which, at the time the caution was given, they admitted. The Services staff training record indicated that most staff had completed mandatory training courses, within the previous three years, and had had fire training within the past 12 months. However, five staff last undertook fire safety training in January 2009 - 15 months before this inspection; but we noted that the Manager took a responsible line on this matter. The Service had met a previous requirement to ensure that each shift has at least one person on duty with a First Aid qualification. However, only 30 of staff have completed this training, the Manager said. She also told us that all staff on the Dementia Unit have had a full days training on the topic of dementia, provided by Social Services, and most staff on the other two units. The Manager confirmed that new staff follow induction training to the required Common Induction Standards and we saw evidence of this. The two staff spoken with confirmed they had attended a good range of training courses over the past 12 months. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Services management ensured that systems were in place that promote the interests of people living here. Evidence: The Manager stated in her pre-inspection Self Assessment form that she has an NVQ 4 qualification in Care and a Registered Managers Award in Management. She has worked in the social care sector for 15 years and has been Manager here for six years. Staff we spoke with commented that, the Manager is approachable...staff get on well with each other. The Manager told us that staff morale is good. A range of quality assurance measures were in place, including annual satisfaction questionnaires for people living at the Service, relatives and external professionals. We discussed with the Manager the benefit of also surveying staff opinions on the quality of service provided. We examined the summary of completed questionnaires and noted they were generally positive. The Manager told us that the Care Home Care Homes for Older People Page 23 of 28 Evidence: Support Service had sent satisfaction questionnaires to residents, relatives, staff and other professionals. One case tracked person we spoke with told us, Im happy here...staff will do anything for you...Ive been to one or two residents meetings. We saw minutes of the last Residents Meeting held in March 2010. These were kept in the Services Quality Assurance File along with minutes of staff meetings, Monthly Progress Reports, posters of forthcoming events and complimentary letters/cards. We examined the Services comprehensive Quality Assurance Plan for 2010. In the preinspection self assessment we were told that the Service had, gained the Investors in People Award in February 2010. Record sheets of personal monies belonging to two case tracked people were examined. These were found to be satisfactory. Money was being stored securely. The Manager explained that the personal monies system was now foolproof as most was now held in one bank account. The kitchen was clean and good food hygiene practices were noted. The Environmental Health Officer last visited in mid-2009. Weekly environmental checks of each room were being undertaken, the Manager said, and any work needing to be done is then transferred to the Maintenance Sheet. The linen cupboard, next to room 16 in the residential home, was not being kept locked shut as required by the Fire Officer. Cleaning materials were being securely stored and Product Information Sheets were kept in the office. Information provided in the pre-inspection self assessment indicated that equipment was being checked and maintained appropriately. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 2 Contracts should specify fees payable for accommodation, nursing and personal care and, except where a single fee is payable, the services to which each fee relates. Care plan documents would be improved by following a person centred approach, as discussed. Staff should be encouraged to consistently complete care plans to ensure they are holistic and reflect personal needs. The Service should consistently follow its policy of contacting relatives if a GP is called out. Records of medicine administered should be consistently and accurately recorded. Staff should pay attention to the laundry system to ensure people receive back their own clothes and not those of other people. The descriptions of activity undertaken by the Activities Coordinator should be cross-referenced with individuals care plans or daily records. Daily menus should be displayed for people to read. 2 3 4 5 6 7 7 8 9 10 7 12 8 15 Care Homes for Older People Page 26 of 28 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 9 10 11 12 18 18 19 29 Staff should be reminded, at regular intervals, of the Services Whistle Blowing policy. Policies & procedures for safeguarding people should be specific to the Service and to Derbyshire. The privacy lock, on the door to the toilet off the light well, should be repaired. Job applicants should be asked for details of any criminal offences in respect of which the person had been cautioned by a constable and which, at the time the caution was given, they admitted - as stated in the Regulations, Schedule 2.2(b). All staff needing to undertake training on Fire Safety, and First Aid, should be enabled to do this. Linen cupboards, required to be kept locked shut, should be kept locked shut. 13 14 30 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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