Care Home: Pembroke Hotel For The Retired

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What the care home does well The home provides residents with a homely, relaxed and caring environment. Residents are enabled where possible to exercise choice and control over their lives whilst resident in the home. Residents spoke positively about their experiences at the home. Residents who completed the residents survey when asked, what the home does well comments received were, `the home does well in the cooking of the meals served to us`, `pleasant atmosphere`, `cooking`, `cleaning, care`, and `cares for me, that covers everything`. The staff was observed to deliver care with dignity and respect. Three residents spoken with felt the care provided respected their privacy and dignity. Residents live in a clean and homely environment, with their private accommodation personalised to suit their taste. A hundred percent of the care workers has achieved a National Vocational Qualification (NVQ) Level 2 in care. What has improved since the last inspection? The Manager stated that further guidance has been sought from Environmental Health and acted upon as to the controls in place in relation to the unguarded radiators, to protect residents. The homes Statement of Purpose and Service User`s Guide has been updated to reflect all changes within the home. The Mental Capacity Act is now incorporated into the care plans, with regular reviews. Staff have attended refresher courses on safeguarding vulnerable adults. The staff cloakroom has been refurbished and carpets replaced, new ornate railings have been fitted at the front of the house for residents safety, bedrooms have been redecorated when they become vacant,, and a staff library has been developed in the training room. Staff has undertaken training in nutrition and health, and all care workers are trained in first aid and a number of staff have gained a certificate in dementia awareness training. The Manager and the senior care worker are now infection control champions. Most of the systems in the home have been computerised. What the care home could do better: No Requirements and Recommendations have been made following this inspection. Where shortfalls have been identified the Manager was able to demonstrate or stated work would be completed to address the issues. Risk assessments for daily living skills should be developed and where residents go out independently to protect residents. Key inspection report Care homes for older people Name: Address: Pembroke Hotel For The Retired 2 Third Avenue Hove East Sussex BN3 2PD     The quality rating for this care home is:   three star excellent 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: Judy Gossedge     Date: 1 0 1 1 2 0 0 9 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Pembroke Hotel For The Retired 2 Third Avenue Hove East Sussex BN3 2PD 01273326942 01273323900 pembrokegroup@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Susan Brand care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home Pembroke Hotel is a care home registered to provide services for 18 people over the age of 65. The home does not provide nursing care. The property is a detached Grade 2 listed building situated in a conservation area close to the seafront and the main shopping centre of Hove. All local amenities and transport routes are close at hand. Accommodation is on four floors accessed by a passenger lift. All rooms are en-suite and have an intercom system. There is a comfortable lounge, an activities room and a spacious dining room. The garden is accessed by via a flight of steps or a path around the side of the building. Paid parking is available in the street. The home has achieved the Investors in People Award, the Residential Domiciliary Benchmark Star Rating Care Homes for Older People Page 4 of 27 Over 65 18 0 Brief description of the care home Award and also holds the Clean Food Award. Pembroke Hotel aims to offer freedom and independence with discreet care to retired people who wish to maintain an independent lifestyle. The fees at the time of the inspection range from £525.00 to £650.00 a week for a single en suite room. Additional fees are charged for hairdressing, chiropody, private phone line and newspapers. A Statement of Purpose and Service Users Guide is available to reference. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 uses the term service users to describe those living in care home settings. For the purpose of this report, those living at Pembroke Hotel will be referred to as residents. This unannounced key inspection took place over five hours between 10:50 and 15:50 on 10 November 2009. The last key inspection was undertaken on 15 November 2006. Since the last key inspection an annual service review has been completed. It does not involve a visit to the service but is a summary of new information given to the CQC, or collected by us. No concerns were raised. Care Homes for Older People Page 6 of 27 The Manager had been asked to complete an Annual Quality Assurance Assessment (AQAA), which was detailed and information from which is quoted in this report. The AQAA would benefit from continued development to fully detail the operation of the home. Communal areas and a selection of residents bedrooms were viewed during the inspection. A sample of care records, staff records and health and safety records were viewed and are detailed in the report. Eleven people were resident and three were spoken with individually in their bedroom or in the lounge. The care that three of the residents received was reviewed. The opportunity was also taken to observe the interaction between staff and residents in the communal areas. Eight residents surveys were sent out and five came back completed. Information was sought on the day from a senior care worker, a care worker, the cook, the domestic support/care worker, the administrative assistant and the Manager. Three care workers surveys were sent out and two completed surveys were returned. Two relatives were spoken with during the inspection. 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: No Requirements and Recommendations have been made following this inspection. Where shortfalls have been identified the Manager was able to demonstrate or stated work would be completed to address the issues. Risk assessments for daily living skills should be developed and where residents go out independently to protect residents. Care Homes for Older People Page 8 of 27 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information about the home available for residents and their representatives to view. Potential new residents are individually assessed prior to an admission to ensure that their care needs can be met in the home. Intermediate care is not provided in the home. Evidence: The combined Statement of Purpose and Service Users Guide was read during the inspection. The AQAA details a copy of the Statement of Purpose and Service Users Guide is given to prospective residents or their representatives as part of the admission process. A copy of the last inspection report is available to read in the home. Four residents surveys stated they had received enough information prior to moving in, and one did not know. Two residents spoken with and one relative all stated they had had an opportunity to look around the home prior to any admission and had received enough information about the home. Care Homes for Older People Page 11 of 27 Evidence: The Manager stated that she visits new residents prior to any admission or a prospective resident will visit the home to discuss their care needs. This is to ensure individual residents care needs can be met in the home and to provide staff with information on the care to be provided. A detailed pre-admissions format has been put in place, and for three new residents admitted to the home since the last inspection there was detailed pre-admission information viewed, which had been completed. Where one resident had been re-admitted to the home the pre-admission assessment had not been reviewed to ensure that the residents care needs continued to be met in the home. This was discussed with the Manager who stated this would be addressed. So a Requirement has not been made on this occasion. Intermediate care is not provided in the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by a detailed individual plan of care where all their personal, social and health care needs are identified at the start of their stay and which informs staff of the care which needs to be provided. Supporting risk assessments would benefit from further development to protect residents. Medication policies and procedures are in place. Evidence: Four of the residents individual care plans were viewed and are kept in well-structured folders. These were detailed and gave clear guidance to staff of the care to be provided, residents health care requirements, dietary needs, and social and leisure interests. The AQAA details that on arrival to the home residents provide further information to help care workers meet the residents daily living routines, meal choices and times, and food likes and dislikes. Supporting risk assessments were also viewed and where there are any identified risks the recording detailed how these will be managed. Where residents go out independently from the home they did not have a supporting risk assessment in place and risk assessments for daily living tasks would benefit from further development. This was discussed with the Manager who stated Care Homes for Older People Page 13 of 27 Evidence: this would be addressed. So a Requirement has not been made on this occasion. The records viewed detailed that a weekly check of the care plans and a six monthly review. Two care workers surveys stated always given up-to-date information about the residents care needs. The AQAA details that the home maintains and promotes residents health and help them access health care services to meet their needs. Records viewed evidenced residents are registered with a local General Practitioner (GP) and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in care plans that were examined, those appointments with or visits by health care professionals are recorded. Residents spoken with confirmed good access to their GP. Four residents surveys stated that they felt that their medical care needs were always met in the home and one stated usually. The AQAA details the home has a policy for the handling of medication which includes receiving, recording, storage, handling, administration and disposal of medicine. The storage of control drugs has been reviewed and changes have been made to ensure that current storage meets current requirements. The Manager agreed to seek advice as to the recording to ensure that this also meets current requirements. Residents are able to self medicate under the management risk assessment framework. Two of the residents whose care plans were viewed self medicated at the time of the inspection. One had a risk assessment in place and the other did not. The risk assessments would also benefit from further development. This was discussed with the Manager who stated the risk assessment would be addressed on the day and the risk assessments would continue to be developed. So a Requirement has not been made on this occasion. Medication is stored in lockable facilities in the home and a sample of the recording of medication administered was viewed. Information and advice is sought from a pharmacist who visits the home and a copy of the pharmacists last visit to the home was viewed. The Manager and the care workers spoken with confirmed they had received medication training. Two of the residents spoken with who had their medication administered stated that the system in place worked well. The staff was observed to deliver care with dignity and respect. The residents spoken with felt the care provided respected their privacy and dignity. The five residents surveys stated they usually received the care and support they needed. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Where possible residents are enabled to exercise choice in their lives whist resident in the home, there are some opportunities to participate in social and recreational activities provided and which continue to be developed, residents are encouraged to maintain contact with family and friends as they wish and a varied diet is provided. Evidence: Residents social interests are recorded on their individual care plans. The AQAA details that there is a varied stimulating social activities programme. That residents views are actively canvassed about the social activities programme content and residents are free to take part or decline as they wish. Regular minibus trips are organised out of the home. On the day of the inspection there were no activities arranged in the home. The sample of records viewed detailed the activities facilitated include quizzes, board games, music hours, videos, and reminiscence sessions. There is a social activities function room with wide screen television and DVD Player for all residents use. It is also made available to residents for celebrations, special birthdays and anniversaries etc with their families and is regularly used by residents who attend the Tai Chi group. The residents surveys were varied and stated that activities were always, usually or sometimes arranged. The residents spoken confirmed activities were facilitated. The AQAA details that this is an area which it is planned to continue Care Homes for Older People Page 15 of 27 Evidence: to develop over the next twelve months by developing new relationships with external organisations and individuals, to look at ways to provide additional social activities and encourage residents and their families to contribute to the development of the social programme. The Manager confirmed that there is a monthly religious service in the home provided by a local church, but that staff will discuss and help facilitate any other requirements to meet individual residents spiritual needs. The AQAA details that residents are free to have visitors at any reasonable time. Residents and visitors spoken with confirmed there was flexible visiting that staff is very welcoming and they could see their relatives and friends in private if they wished. The care and support provided was observed to enable residents where possible to exercise choice whilst at Pembroke Hotel. The four residents files viewed, staff, visitors and the residents spoken with confirmed this. The cook was spoken with who works one day a week. She stated she holds a basic food hygiene certificate. A further cook works six days a week. A rotating menu is place. It does not identify that choices available at all meals, but staff and residents all confirmed if they do not like what is on the menu there are always a range of alternatives. Lunch on the day was shepherds pie, carrots and cabbage and rice pudding and peaches. Special diets are catered for. Fresh fruit was available in the home. On the day some residents were observed eating their lunch in the dining room and others had their lunch in their bedroom. It was a relaxed environment taking into account the different length of time that individual residents would need to finish their meal. The five residents surveys stated they always liked the meals. All the residents spoken with stated they had enjoyed their meal. Records are kept of food consumed individually by each resident to ensure they are receiving an adequate diet. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place to enable residents or their representatives to raise any concerns about the care being provided and to ensure that residents are protected from abuse. Evidence: The AQAA details that there is a clear and accessible complaints policy and procedure in place, and that a copy of the procedure is given to new residents. Two complaints have been received at the home during the last year. The CQC have not been made aware of any concerns in relation to the care provided at Pembroke Hotel. The three residents and two visitors spoken with had not had to raise any concerns and felt it was an environment where they could raise concerns and they would be listened to. The five residents surveys stated they were aware who to talk to if they were not happy and four knew how to make a complaint and one stated they did not know. The two staff surveys stated they knew what to do with any concerns raised. The AQAA detailed that there are policies and procedures in place in relation to the safeguarding of vulnerable adults and evidenced that a copy of the East and West Sussex County Council, Brighton and Hove safeguarding adults procedures is available to reference in the home. The Manager and the care workers spoken with confirmed they had attended this training and demonstrated an awareness of the policies and procedures. 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 residents with a pleasant and well-maintained environment. The home is clean and tidy. Evidence: The AQAA detailed there is an ongoing external and internal maintenance programme serviced by the homes maintenance person or external contractors. That over the last twelve months the staff cloakroom has been refurbished and carpets replaced, new ornate railings have been fitted at the front of the house for residents safety, bedrooms have been decorated when they become vacant, and a staff library has been developed in the training room. A selection of communal areas and residents bedrooms were viewed during the inspection. The home is decorated and furnished in a homely style. There are sixteen bedrooms on all floors in the home; all but one were being used as single bedrooms at the time of the inspection. A number of bedrooms were viewed and displayed residents individual styles and interests. All bedrooms have an intercom system. All of the bedrooms have en-suite facilities of a toilet and wash-hand-basin. Residents are able to control the temperature in their own bedrooms. The residents spoken with confirmed there is adequate heating and hot water in the home. Care Homes for Older People Page 18 of 27 Evidence: A passenger lift is available in the home accessing all floors. There is a lounge and a dining room on the ground floor and a smaller activity room on the lower ground floor. Residents have access to a private and well-stocked garden at the rear of the home. The AQAA details that there is a policy in place for managing infection control and an action plan is in place to deliver best practice in the prevention and control of infection. The home was clean and free from offensive odours at the time of the inspection. Feedback from the residents surveys was that the home was always or usually fresh and clean. A care worker who was covering the domestic assistant post was spoken with who stated she had received training and guidance in infection control and the control of substances hazardous to health regulations (COSHH). The AQAA detailed that infection control training has been facilitated for three members of staff and it is planned more staff will be able to attend this training. The Manager and senior care worker have become a champion of infection control. Staff confirmed that there was good access to protective clothing, liquid soap and paper towels. Recording was viewed of routine fire checks that had been carried out in the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are recruitment policies and procedures in place, care workers receive an induction and are provided with opportunities for training to develop their skills and ensure the individual care needs of residents can be met. Evidence: Staff spoken with and rotas viewed confirmed the staffing in place. On the day a senior care worker and the Manager were on duty during the morning and two care workers during the afternoon. One domestic staff was on duty during the morning of the inspection and a cook covering the ancillary tasks in the home. A part-time administrator was also on duty. At night the home deploys one sleeping in member of staff. The AQAA details that the Manager carries out regular assessments to ensure that there is enough appropriately skilled staff for the assessed needs of the current residents. Three of the residents surveys stated staff always listen and act on what residents say and two usually. All stated they usually receive the care and support needed and four stated staff are always available when you need them and one usually. Care Homes for Older People Page 20 of 27 Evidence: The two care workers surveys stated there is always or usually enough staff to meet residents needs. When asked what the home does well, provides expert discreet care for all residents in a relaxed and friendly environment, with an excellent standard of cuisine, and Pembroke Hotel always offers excellent training. Offers a high level of care. The AQAA detailed that all of the care workers hold an NVQ Level 2 in care and a number have NVQ Level 3. The AQAA detailed that new staff working in the home had satisfactory preemployment checks. There is a stable staff team and agency staff are not used to cover shifts in the home. The documentation was viewed for one new care worker, who had been recruited since the last inspection. The records demonstrated the completion of an application form, two written references were in place, a record of verbal references which had been sought, a completed Criminal Records Bureau check (CRB)/and a Protection of Vulnerable Adults (POVA) First check, which recorded had been received prior to staff commencing work in the home. The home offers a very good level of training and one of the top floor rooms has been refurbished and is a dedicated staff training room and another is available for staff to use with a range of reference books available to reference. The Manager stated that the induction training for new members of staff in place meets the requirements of the General Skills for Care induction standards. The documentation viewed for the new care worker recorded that this induction had been completed. The two care workers surveys stated recruitment was done fairly, the induction covered everything very well, that training is provided, and the Manager regularly gives support. One comment received was, working here is an extremely rewarding and enjoyable experience 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team have strived to create an atmosphere within the home, which is open, relaxed, homely and caring. Quality assurance systems enable ongoing feedback about the care provided in the home and systems are in place to ensure a safe environment for staff and residents Evidence: The Registered Manager for the home is Elaine Darby, who has completed the Registered Managers Award and NVQ Level 4 in care. The Manager stated she has attended training on the Mental Capacity Act and the Deprivation of Liberty, and that no applications have been made under the Deprivation of Liberty. The Manager is usually supported by a deputy manager but who left recently and the post is currently being recruited to. A quality assurance system is in place. It was evidenced that feedback about the service provided has recently been sought from residents through six monthly residents surveys. The Manager stated that the proprietor has collated outcome of the Care Homes for Older People Page 22 of 27 Evidence: recent residents surveys, but this was not available to view during the inspection. This should be available to any interested parties to view and reference. The AQAA detailed that policies and procedures are in place and that these had been reviewed. The Manager stated that there is a monthly visit being carried out by the proprietor of the home to meet Regulation 26 , and a sample of these records were viewed. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible person external to the home. The Manager stated that they do sometimes hold small amounts of money for a few residents, and records and receipts for money being held for two residents was viewed. The AQAA detailed , records viewed and care workers feedback evidenced that supervision for care staff is in place Care workers spoken with stated they have received the required training and updates in moving and handling, basic food hygiene, first aid and infection control within the required timescales. The Manager stated that an audit of staff training needs had been completed by an external company and training matrix was viewed which recorded staff had completed the required training. A detailed check of the environment had been completed and the AQAA detailed that the maintenance of equipment and services has been carried out. Risk assessments are in place for the building. There were records of regular testing of the hot water temperatures at outlets accessed by residents to ensure these are being maintained at close to the recommended safe temperature of 43 degrees centigrade. None of the radiators within the home are guarded. This matter has been discussed before at previous inspections and the Manager has stated that they have installed a specific valve, which does not allow the radiator temperatures to go above 43 degrees centigrade. It was also stated that radiator temperatures were checked on a weekly basis by staff. A sample of records viewed during the inspection evidenced these checks had been maintained since the heating had been switched on following the summer weather. The Manager also stated that further guidance has sought from Environmental Health and acted upon to ensure current controls in place are adequate to protect residents. A fire risk assessment in place undertaken by an external agency in 2005. This was discussed with the Manager who stated she would seek further guidance from the East Sussex Fire and Rescue Service as to the frequency the fire risk assessment should be Care Homes for Older People Page 23 of 27 Evidence: reviewed. So a Requirement has not been on this occasion. Records evidenced that fire drills had been maintained in the home and the Manager stated that fire training was also provided with the fire drill. A sample of recording was viewed of incidents and accidents. 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 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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