Care Home: Pellon Lane Care Home

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What the care home does well The home is run in the best interests of the people living there. People are being consulted about the way the home is managed and their views are taken into account. Anyone thinking of moving into Pellon Lane Care Home can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff from the home will carry out an assessment to make sure that they can meet that persons needs. Each person has an individual care plan that sets out what care and support they require from staff. The plans are detailed and give staff very good information about people`s likes and dislikes. People living in the home told us that their health and personal care needs are being met. Staff are vigilant and care plans are updated as people`s needs change. Staff are also quick to involve doctors or other specialists for advice. There are individual and group activities on offer, including trips out, to keep people stimulated. We saw some good interactions between staff and people living in the home and it was clear that staff know about people`s preferences. People can follow their own routines and relatives and friends are welcome to visit at any time. Meals at the home are good offering choice and variety. The home is clean, tidy and comfortable. In the surveys we asked people what the home does well. These are some of the comments made by people living in the home, relatives, health and social care professionals and staff (where people have made specific comments about one of the units these have been identified below): BRACKENBED VIEW - INTERMEDIATE CARE `Staff check on your physical condition on arrival and immediate action is taken if necessary. Staff make sure the right equipment is available and the manager an `top brass` play an active role.` `In respect of Brackenbed View every care is taken to meet individual needs. Assessments are completed by professionals and care plans are implemented immediately.` `The staff at Brackenbed View work to a very high standard and are always friendly with clients and family. The manager of this unit is professional at all times. I would recommend Brackenbed View for its care, friendly atmosphere and high standard.` PELLON MANOR `Pellon Manor has good communication with residents and families. Staff deliver a high standard of person centered care.` `My relative is very happy at Pellon Manor. The staff have genuine affection for the residents, they are very patient and it is very common to find a resident and member of staff engaged in converstion about the residents life before Pellon Manor. My relative definately considers Pellon Manor to be her home.` `The staff know all of the residents and their many needs extremely well. They are quick and efficient in responding to incidents, such as spilt food or incontinence. All contact from staff is good humoured and completely lacking in any fuss or hint of impatience. My relative has responded positively to the approach and friendliness and is happier and more light hearted than I have seen them in over a decade.` GENERAL COMMENTS `Entertainment.` `They cater for individual needs and personal care. They keep good notes and records.` `Staff are always happy to update you on any queries you may have.` `People living in the home are treated as individuals.` `Home does their best to keep people happy.` `Person centered care for the residents.` `The home is always clean and tidy.` We also asked people what they thought the home could do better. The comments received were all about the company investing more money in the home and improving the physical environment. These issues are clearly being addressed at the moment with the major redecoration and refurbishment programmes for the three homes. What has improved since the last inspection? Complaints are being dealt with properly. People feel able to raise concerns and the manager is making sure issues are fully investigated and resolved. Staff are following the safeguarding procedures and keeping people in their care safe. Staff recruitment procedures are robust and staff are being properly checked to make sure they are suitable and safe to work with older people. Photographs have been added to staff files to make sure each staff member can be easily identified. There is a lot of redecoration and refurbishment in progress at all three of the homes on the site. This is making sure all of the homes are being maintained to a good standard. What the care home could do better: We have not made any requirements following this visit. The manager and staff need time to consolidate the improvements they have already made and to implement the ones they have identified in the AQAA. Key inspection report Care homes for older people Name: Address: Pellon Lane Care Home 200 Pellon Lane Pellon Halifax West Yorkshire HX1 5RD     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: Paula McCloy     Date: 2 5 0 5 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 27 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 27 Information about the care home Name of care home: Address: Pellon Lane Care Home 200 Pellon Lane Pellon Halifax West Yorkshire HX1 5RD 01422342002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): pellon.care.centre@fshc.co.uk Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Mrs Heather McGrath Type of registration: Number of places registered: care home 100 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Birkshall Mews Unit - Care home with nursing. 30 x DE(E). Elderly persons over 55 years of age. Brackenbed View Unit - Care home with nursing. 35 OP. Elderly persons over 60 years of age. Pellon Manor Unit - Personal care only. 34 x DE(E) and 1 x MD. Maximum number 35. Date of last inspection Care Homes for Older People 0 2 1 2 2 0 0 9 0 1 0 Over 65 64 0 35 Page 4 of 27 Brief description of the care home Pellon Lane Care Centre is situated off Pellon Lane in Halifax. There are two retail parks with shopping facilities nearby and Halifax Town Centre is within easy reach by public or private transport. The centre is divided up into three units. Each unit has its own lounges, dining rooms, single bedrooms with en-suite toilet facilities, bathrooms and toilets. There is a central kitchen and laundry. The three units offer the following accommodation and care: Brackenbed View is a 35-bedded unit that provides 24 hour nursing (including intermediate care,) and personal/ social care for older people. Pellon Manor provides care and accommodation for up to 35 older people with mental health needs, in particular people with dementia. Birkshall Mews provides 24 hour nursing and social care for up to 30 older people who have dementia. In addition to the weekly fee, additional charges are made for chiropody, hairdressing and newspapers. 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: The current weekly charges at Pellon Lane Care Home range from £392.50 to £590.00 per week. Additional charges are made for hairdressing, chiropody and newspapers. This inspection was carried out to assess the quality of care provided to people living at the home. We last inspected the home in December 2009 when it was assessed as being a 0* poor service. We asked the home to provide us with an improvement plan to tell us what they were going to do to meet the requirements we made in the inspection report. We received their improvement plan and this told us that they had or were in the process of meeting those requirements. The manager completed an annual quality assurance assessment (AQAA) prior to our inspection, which provided us with information about the service. We have used some Care Homes for Older People Page 6 of 27 of that information in this report. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home by two inspectors, which lasted approximately 4 hours. During the visit we spoke to 6 people living in the home, 8 members of staff and the manager. We also observed staff delivering care, looked at various records and looked around the home. Surveys were sent to 10 people living in the home, 10 relatives, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Two people using the service, four relatives, two health and social care professionals and six members of staff wrote to us with their comments. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 27 What the care home does well: The home is run in the best interests of the people living there. People are being consulted about the way the home is managed and their views are taken into account. Anyone thinking of moving into Pellon Lane Care Home can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff from the home will carry out an assessment to make sure that they can meet that persons needs. Each person has an individual care plan that sets out what care and support they require from staff. The plans are detailed and give staff very good information about peoples likes and dislikes. People living in the home told us that their health and personal care needs are being met. Staff are vigilant and care plans are updated as peoples needs change. Staff are also quick to involve doctors or other specialists for advice. There are individual and group activities on offer, including trips out, to keep people stimulated. We saw some good interactions between staff and people living in the home and it was clear that staff know about peoples preferences. People can follow their own routines and relatives and friends are welcome to visit at any time. Meals at the home are good offering choice and variety. The home is clean, tidy and comfortable. In the surveys we asked people what the home does well. These are some of the comments made by people living in the home, relatives, health and social care professionals and staff (where people have made specific comments about one of the units these have been identified below): BRACKENBED VIEW - INTERMEDIATE CARE Staff check on your physical condition on arrival and immediate action is taken if necessary. Staff make sure the right equipment is available and the manager an top brass play an active role. In respect of Brackenbed View every care is taken to meet individual needs. Assessments are completed by professionals and care plans are implemented immediately. The staff at Brackenbed View work to a very high standard and are always friendly with clients and family. The manager of this unit is professional at all times. I would Care Homes for Older People Page 8 of 27 recommend Brackenbed View for its care, friendly atmosphere and high standard. PELLON MANOR Pellon Manor has good communication with residents and families. Staff deliver a high standard of person centered care. My relative is very happy at Pellon Manor. The staff have genuine affection for the residents, they are very patient and it is very common to find a resident and member of staff engaged in converstion about the residents life before Pellon Manor. My relative definately considers Pellon Manor to be her home. The staff know all of the residents and their many needs extremely well. They are quick and efficient in responding to incidents, such as spilt food or incontinence. All contact from staff is good humoured and completely lacking in any fuss or hint of impatience. My relative has responded positively to the approach and friendliness and is happier and more light hearted than I have seen them in over a decade. GENERAL COMMENTS Entertainment. They cater for individual needs and personal care. They keep good notes and records. Staff are always happy to update you on any queries you may have. People living in the home are treated as individuals. Home does their best to keep people happy. Person centered care for the residents. The home is always clean and tidy. We also asked people what they thought the home could do better. The comments received were all about the company investing more money in the home and improving the physical environment. These issues are clearly being addressed at the moment with the major redecoration and refurbishment programmes for the three homes. What has improved since the last inspection? Complaints are being dealt with properly. People feel able to raise concerns and the manager is making sure issues are fully investigated and resolved. Staff are following the safeguarding procedures and keeping people in their care safe. Staff recruitment procedures are robust and staff are being properly checked to make sure they are suitable and safe to work with older people. Photographs have been added to staff files to make sure each staff member can be easily identified. Care Homes for Older People Page 9 of 27 There is a lot of redecoration and refurbishment in progress at all three of the homes on the site. This is making sure all of the homes are being maintained to a good standard. 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 10 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 11 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 can visit the home to see for themselves if they think it is suitable. No one moves into the home unless staff are sure they can meet their needs. Evidence: A member of staff from Pellon Lane Care Home will go and assess anyone thinking of moving into the home. There is an assessment document that staff complete, which means that peoples needs are identified and that staff are sure they can meet those needs before people move in. We looked at the files for four people and found all of the assessment information we would expect, together with a care plan for each. People can visit the home themselves to look around so that they can see for themselves if they think the home is suitable. There are designated nurses and care staff running the intermediate care unit. This service is used by people who want to live in their own homes, but need specific, short Care Homes for Older People Page 12 of 27 Evidence: term support in order to achieve this. Health and local authority staff provide additional support. For example physiotherapists, occupational therapists and rehabilitation staff to work with people to get them back home. We received two surveys from health and social care professionals who told us that the intermediate care service is well managed and people receive the care and support they need. Care Homes for Older People Page 13 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. Peoples health and personal care needs are being met. Evidence: We looked at four care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. The information in the care plans is important because a lot of people living in the home have dementia and may not be able to tell staff what they need or about their personal preferences. We found that the care plans were detailed, up to date and contained good information. All of the necessary risk assessments have been completed and staff are writing down the action they need to take to reduce or eliminate that risk. For example one person had been identified as being at risk of malnutrition. There was a clear plan in place to monitor their food and fluid intake. We saw that this person had also been weighed regularly and was putting on weight. Peoples health care needs are being identified and met. Staff are vigilant and GPs and Care Homes for Older People Page 14 of 27 Evidence: other health care professionals are being involved as necessary. Details of any visits by health care professionals are clearly documented in the residents care plan, together with the advice that has been given. In the surveys people told us that their health care needs are met and that they get the care and support they need. Generally people looked well cared for. The care plans contain information about the clothing people like to wear and how often they like to go to the hairdresser. This means that peoples appearance is how they like it. The medication system is well managed. People are receiving their medication at the prescribed times and records are well maintained. Care Homes for Older People Page 15 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. There are activities available to keep people stimulated. The meals at the home are good offering choice and variety. Evidence: There was some detailed information in the care plans about peoples preferences and their likes and dislikes. There were no life histories in any of the care plans we looked at. It is important that this information is written down to make sure staff know about peoples past lives and experiences. There is a dedicated activities co-ordinators on Brackenbed View and Birkshall Mews who arranges a variety of activities and outings. The acting manager has recruited activities staff for Pellon Manor but they have left and she is still trying to fill this post. In the interim staff provide individual and group activities for people. This means that people are kept mentally active and stimulated. We found some information in the care plans about peoples interests and activities that they enjoy, although we did not always find a specific plan about how staff were going to meet these needs. Care Homes for Older People Page 16 of 27 Evidence: We saw some good interactions between people living in the home and staff. There were some good humored exchanges, laughter and we could see people responding well to different staff. Meals at the home are good and that there is a choice available for every meal. People choose where they eat and staff made sure that the people who needed assistance got the help that they required. The care plans contained details of peoples likes and dislikes and other information that was relevant to individuals. Staff are observant and use the information they gain from watching mealtimes to work out what people do and dont like. For example staff had noted in one persons plan that they didnt like potato skins. This means that staff are using their day to day observations to inform peoples care. Care Homes for Older People Page 17 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. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. Evidence: The homes complaints procedure is on display and copies have been put in every bedroom so that people can refer to the procedure if they need to. We looked at the complaints file and could see that complaints that have been received have been taken seriously and have been dealt with properly. This means that people feel able to raise concerns and know that issues will be dealt with appropriately. Staff at the home understand the safeguarding procedures and the different types of abuse that can occur. The home report any safeguarding issues both to us and the Local Authority safeguarding team and have taken appropriate action in order to keep people in their care safe. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable and tidy. It has benefited from the recent redecoration and refurbishment programme. Evidence: Pellon Lane Care Home is situated on Pellon Lane in Halifax. It is close to two retail parks with a range of shopping facilities. Halifax Town center is easily accessible by public transport. There are three homes on the site, each has its own car park and garden. The kitchen has been awarded 4* for hygiene by environmental health. this means that standard of hygiene is good. At the time of our visit all three of the homes were having major refurbishment work completed. Communal areas have been redecorated, new lighting has been installed and most areas have new carpets. Dining rooms have also had new flooring and bathrooms are in the process of being redecorated and refurbished. New furniture for the lounges and dining rooms has been ordered together with new pictures for the walls. The delivery of these items will take place when the decorators and carpet fitters have finished. The refurbishment programme is making sure that the accommodation is maintained Care Homes for Older People Page 19 of 27 Evidence: to a good standard. People living in the home and staff are pleased with the results. We spent some time on Pellon Manor and found the unit to be overly warm. The outside temperature was only 12 degrees centigrade, but the temperature in the lounge upstairs was 27 degrees (we would expect a comfortable temperature to be around 21 degrees centigrade). Staff told us that over the last weekend when the weather was good the lounge and corridor were even warmer. We discussed this with the area manager, who arranged for an air conditioning unit to be purchased immediately. Staff need to continue to monitor the temperature to make sure people living in the home are not having to endure accommodation that is overly hot. 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. Recruitment procedures are robust and staff are fully check to make sure they are suitable and safe to work with older people. Evidence: Pellon Manor, Birkshall Mews and Brackenbed View all have their own staff teams. The acting manager is aware that she needs to keep staffing levels under review as peoples needs change and when new people are admitted. When we looked at the duty rotas we saw that there a number of staff working across the three homes who are related. The acting manager told us that family members do not work together. The acting manager needs to keep the rotas under review to make sure that neither staff or people living in the home are left in a vulnerable position because of these relationships. All of the recruitment files have been audited and checked to make sure they have all the information that is required. We looked at the files for four staff who have been recruited recently. We found that all of the necessary checks had been completed before they started working at the home. Each file also contained a recent photograph of that member of staff. The recruitment procedures have been improved and following their probationary Care Homes for Older People Page 21 of 27 Evidence: period new staff members are either confirmed in their post permanently or if there are any concerns about their performance the manager extends their probationary period. This means that people are only being confirmed in post if they are suitable to continue in that role. When we visited in December there were only 15 of the care staff team who were qualified. On this visit we found that 29 of the care staff team have completed their National Vocational Training (NVQ) at level 2 or 3 in caring for older people. This means that they have been assessed as being competent to do their job. There are also some staff in the process of completing this training. We expect that 50 of the care staff team have an NVQ qualification. The home are working towards this and are confident they will achieve this. We spoke to the area manager and she told us that recent changes within the organisation should make it easier to get more staff through this training. In the surveys staff told us that their induction into the job was good and provided them with the skills to do the job. They also told us that they are also given training that is relevant to their role and keeps them up to date with good practice. All staff are offered training; one of the administration team makes sure that peoples training is kept up to date and courses are arranged as necessary. 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 home is being managed in the best interests of the people living there. Evidence: The acting manager has been in post for about 6 months. She is a nurse who has 12 years experience of managing a home and has achieved her registered managers award, which means she has been assessed as competent to manage a home. She has applied to be registered with us and is waiting for a date for her interview. Staff are confident in the manager and told us that any issues they raise are dealt with properly. Four Seasons have quality monitoring systems in place and surveys have been sent out to get peoples views about the service. These have been collated and there is a report on the findings. People living in the home and/or their relatives have been sent a letter about the findings of the surveys and have been invited to residents and relatives meetings as well to discuss any issues. This means that people are able to have their say about how the home is managed and tell the home about any Care Homes for Older People Page 23 of 27 Evidence: improvements or changes they might like to see. Staff are receiving supervision and no new staff members are being confirmed into a permanent post unless they have fully completed their induction and are competent in their role. The manager is looking at all of the accident reports and analysing them on a regular basis. This will make sure any trends or patterns can be spotted and measures put in place to try and reduce the number of accidents. The home does hold money on behalf of people living in the home. Records are maintained with receipts available for any purchases made. This means that people are protected from any financial abuse. There is a rolling programme of training to make sure staff are kept up to date with safe working practices. 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 13 Peoples life histories should be added to their care plan. This will help staff to learn about peoples past lives and experiences. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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