Care Home: Pilgrim Homes

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What the care home does well The admission process ensures that only residents whose needs can be met are admitted to the home. Care staff demonstrated an understanding of the individual needs of residents and was attentive to them on the day of the site visit. Residents make decisions about their lives and are consulted on aspects of life in the home to ensure choice and preferences are accounted for. In keeping with the ethos of the home devotions are carried out each morning and again after supper, ensuring religious needs are met. Residents have access to health professionals when the need arises. Residents are provided with opportunities to involve themselves in activities if they wish and their routines are to their own choice and preference. Visitors are welcomed at the home and there are no restrictions imposed. The home has a relaxed and welcoming atmosphere. There are systems in place to ensure residents feel free to air their views and know that action will be taken where needed. The physical environment of the home fulfils the home`s stated purpose and the location facilitates freedom for the people who live there and the opportunity for residents to be involved in the local community. The home is managed by an experienced manager who ensures the home is run in the best interest of residents. What has improved since the last inspection? An Annual Service Review was undertaken in June 2008 that showed that the previous requirement relating to care plans had been addressed. This site visit identified that the home is continuing to ensure that there is a clear paper trail for the care of residents with information complimenting each other. The AQAA identifies areas that they have improved in the last 12 months. Examples given were: make the garden more wheel chair friendly and made changes to the menu. These changes were made as a result of listening to people. Other improvements identified in the AQAA have been implemented to assist in improving outcomes for residents. This included: senior staff undertaking customer care training, providing additional training to staff and introducing an activities manual. What the care home could do better: Any minor shortfalls noted at the site visit, of which no requirement or recommendation has been made have been highlighted throughout the report. Some areas of improvements are: to ensure clear information is available for the use of prescribed creams/lotions, to ensure staff double sign any hand written prescriptions and to provide clear information for those residents who self medicate. All staff must have Protection of Vulnerable Adults clearance prior to commencing work. The shortfalls noted were not consistently observed throughout the site visit. The service has previously demonstrated the commitment to ensuring compliance and improving outcomes for residents. The AQAA identifies that they are committed to making further improvements and ensures the views of residents are included in future plans. We are confident that they have mechanisms in place that are sufficiently robust within the home to identify its own areas for improvement. When asked what the home could do better, staff could not think of any changes they would want to make. Key inspection report Care homes for older people Name: Address: Pilgrim Homes 35/36 Egremont Place Brighton East Sussex BN2 0GB     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: Jennie Williams     Date: 1 7 0 7 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 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) 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 28 Information about the care home Name of care home: Address: Pilgrim Homes 35/36 Egremont Place Brighton East Sussex BN2 0GB 01273606940 01273692640 anne.gower@wfcsmail.com www.pilgrimhomes.org.uk Pilgrim Homes care home 21 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 21 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 Dementia - DE Date of last inspection Brief description of the care home Pilgrim Homes is registered as a care home providing services for up to twenty one (21) older people in receipt of personal care. The home is located on the border of Brighton and Kemptown and is within walking distance to local amenities and the seafront. The home is part of a national charity organisation. Accommodation and care is provided to older people who follow the Protestant Christian religion. The establishment also has accommodation for 17 tenants that reside in the sheltered Care Homes for Older People Page 4 of 28 Over 65 0 0 21 21 21 0 Brief description of the care home housing part of the home. The tenants within the sheltered housing area are independent and staff employed at the home do not assist with any of their care needs. Residents of the care home and tenants of the sheltered housing mix well together. The manager is responsible for the entire complex. The care home is located over three floors, with two floors being used for residents accommodation. There is a passenger shaft lift to assist residents to access all areas of the home. The home has one undesignated room that is used for emergencies. The rest of the accommodation consists of 16 single rooms, of which two have en suite facilities and two double rooms that do not have en suite facilities. There are two assisted bathing facilities, one assisted shower room and nine communal toilets located throughout the home. There is a good sized dining area and a good sized lounge room. There is a smaller lounge room used as a library and can be used by residents when they have visitors/parties. Areas are colour co-ordinated to assist people in orientating themselves. There is a large garden area at the rear of the home. The home has car parking facilities for up to eight to nine cars, otherwise there is restricted paid parking in adjacent areas. Current weekly fees range from £544 to £650. Information regarding additional costs is available from the home. This information was provided to us on the 17 July 2009. 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: 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: It has been identified that service users prefer to be called people who use services. For the purpose of this report, people who use the service will be referred to as residents. This site visit was facilitated by the Registered Manger. The last inspection was undertaken on the 03 August 2007 and an Annual Service Review (ASR) was undertaken on 23 June 2008. This unannounced site visit took place over six and quarter hours on the 17 July 2009. Evidence obtained at this site visit, previous information regarding this service and information that we have received since the last inspection forms this key inspection report. An annual quality assurance assessment (AQAA) was sent to us by the service, completed on the 19 May 2009. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The AQAA was completed by the Registered Manager and returned when we asked for it. Fourteen residents (people from the sheltered housing are included in this number) Care Homes for Older People Page 6 of 28 were involved in the inspection process via discussions with us or through observation. Two care plans were viewed and specific areas of care looked at in a further six care plans. Five staff were involved in the inspection process via discussion or through observation. Four staff files were inspected. A training matrix and training records were viewed. Medication procedures were looked at and the procedures and records for handling residents finances were inspected. Some individual rooms were viewed, along with communal areas. The quality assurance system, complaint records and quality monitoring checks in place were viewed/discussed. There were 15 residents residing at the home at the time of this site visit. 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: Any minor shortfalls noted at the site visit, of which no requirement or recommendation has been made have been highlighted throughout the report. Some areas of improvements are: to ensure clear information is available for the use of prescribed creams/lotions, to ensure staff double sign any hand written prescriptions and to provide clear information for those residents who self medicate. All staff must have Protection of Vulnerable Adults clearance prior to commencing work. The shortfalls noted were not consistently observed throughout the site visit. The service has previously demonstrated the commitment to ensuring compliance and improving outcomes for residents. The AQAA identifies that they are committed to making further improvements and ensures the views of residents are included in future plans. We are confident that they have mechanisms in place that are sufficiently robust Care Homes for Older People Page 8 of 28 within the home to identify its own areas for improvement. When asked what the home could do better, staff could not think of any changes they would want to make. 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 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 10 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. The pre admission process ensures that only residents whose needs can be met at the home are admitted. Evidence: It was confirmed that the Statement of Purpose and Service Users Guide were currently being amended. The home has previously notified us of changes made to these documents as required by legislation. These documents provide prospective residents/representative with information about the home so they can make an informed decision if the home can meet their needs and expectations. There was evidence that residents are assessed by the home prior to admission. Information from social services or other health professionals is obtained wherever possible. The Registered Manager confirmed that written confirmation is provided to prospective residents following their assessment that the home can meet their needs within their contract, which is given prior to admission. Care Homes for Older People Page 11 of 28 Evidence: Staff spoken with confirmed that management takes appropriate action should someones needs become too much for them to continue to be met within the home. Prospective residents are encouraged to visit the home for a day prior to admission to test drive the service and meet staff and other residents. An eight week trial period is offered. Intermediate care is not provided at the home. Respite care is available if there is a spare place available. Care Homes for Older People Page 12 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. Residents needs are being met with the information provided in the care plans on the assessed needs of individuals. Residents privacy and dignity are respected. Evidence: Care plans were observed to be in place and provided staff with guidance on how to meet the needs of residents. The Registered Manager confirmed that work has been done since the last key inspection to ensure that care plans are consistent with the daily notes and the information in risk assessments. Some minor shortfalls in relation to the information within the care plans were discussed with the home. The Registered Manager took the comments on board and will review the information. Care plans are reviewed on a monthly basis with residents/advocates. Risk assessments are reviewed on an annual basis or if the needs of an individual changes. Six specific areas of care were noted to have clear guidelines in place for staff on how to meet these needs. Feedback from staff identified that there is a key worker system Care Homes for Older People Page 13 of 28 Evidence: in place and they find care plans user friendly. There is a profile in each bedroom providing the resident with information about their key workers role. Whilst residents dont initially have a choice in who their key worker is, changes are able to be made where needed. There was evidence that professional advice is sought from other health professionals when the need arises. There was evidence that medication procedures in practice safeguard residents. Staff administering medicines have received training for this. Medication Administration Records (MAR) charts identified that medicines are signed for when administered. It is recommended that hand written prescriptions on MAR charts are double signed by staff who are medicine trained. This will further safeguard staff and residents from errors being made. For one MAR chart where the information identified that medicines were not being signed for, there was no information to identify that this person was self-medicating, as confirmed by a staff member. Whilst there is information regarding use of prescribed creams, there was no information to identify of these were being administered or not. This needs to be addressed. There was evidence that accurate records are being maintained of controlled drugs. Staff were observed to have a good professional rapport with residents and were heard to be calling them by their preferred term. Of the residents asked, all confirmed that they felt their privacy and dignity are respected. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lifestyle within the home is their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Choices and preferences are catered for at meal times. Evidence: There is a varied activities programme provided at the home. In keeping with the ethos of the home devotions are carried out each morning and again after supper, ensuring religious needs are met. Residents were observed to move freely within the home on the day of the site visit. There is an activity manual at the home that gives staff suggestions for activities and contains guidelines on how to make these activities successful. Residents have enjoyed having musical afternoons and outside entertainers also visit the home. The AQAA identifies some other activities provided at the home are: card making sessions, painting, exercises and musical movement, word games and reminiscence. Staff spoken with confirmed that residents choose their own lifestyle and some residents choose not to involve themselves in activities. Care Homes for Older People Page 15 of 28 Evidence: Visitors are encouraged to visit the home and there are no visiting restrictions imposed. Residents are able to receive visitors in private if they wish. The home has a winter and summer menu and ensure individual choices and preferences are catered for. Suggestions boxes are placed within the home a month prior to menu changes asking resident for suggestions on what they would like to see on the menu. Residents were observed to be enjoying their lunch time meal at the time of the site visit and residents were complimentary about the food provided at the home. Staff were observed to be available to offer discreet assistance to those requiring help with meals. Care Homes for Older People Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know how to make a complaint, reassuring those involved that they are being listened to and that action will be taken, if necessary. Evidence: There is a complaints procedure available at the home and there was evidence on the day of the site visit the people within the service feel comfortable to air their views. Six residents asked confirmed that they know who to speak to if they are not happy and would feel comfortable to raise a complaint. The AQAA identifies that there have been two complaints made to the service in the last 12 months of which none were upheld. One complaint was related to an individuals care and some aspects of this were upheld. Records viewed identified that the home keeps copies of correspondence relating to complaints and identifies that the home investigates complaints in a non biased manner. Staff spoken with confirmed that they knew what action to take should someone raise a complaint with the. It was recommended to the Registered Manager that a summary of complaints be kept. This will assist her in accumulating information and outcomes for the AQAA when we next ask for it. Staff receive in house training from the Registered Manager in Safeguarding Adults. Staff spoken with confirmed that they were familiar with Safeguarding Adults Care Homes for Older People Page 17 of 28 Evidence: procedures. The training they receive includes information regarding whistle blowing and stated that they would feel happy to whistle blow within the service. The AQAA identifies that there has been no Safeguarding Adults referrals or investigations made within the last 12 months. Care Homes for Older People Page 18 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. Residents live in a homely environment and are provided with comfortable indoor communal facilities and their private accommodation personalised to suit their taste. Evidence: The last inspection report identified that the outcome for residents within the environment was good. The AQAA identified that there have not been any major changes made to the environment since the last inspection. Whilst walking around the home, it was noted that the home continues to be well maintained. The AQAA identifies that some improvements they have made in the last 12 months are: upgraded and redecorated two care rooms and have upgraded and refurbished the main kitchen. They have identified in what they could do better is to improve the garden area and car park. The Registered Manager confirmed that the garden is currently being landscaped and made secure. Some residents were happy for us to visit their individual rooms and these were seen to be personalised to reflect the individuals choice and character. The AQAA identifies that staff receive training in prevention and control of infection and they have an action plan to deliver best practice in prevention and control of infection. The home appeared clean and free from offensive odours on the day of the Care Homes for Older People Page 19 of 28 Evidence: site visit. 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. Residents needs are being met with the skill mix of staff on duty. Residents are generally safeguarded by recruitment procedures. Evidence: The last inspection report identified that the outcome for residents was good in relation to staffing. The AQAA identifies that six care staff/registered nurses have left employment in the home in the last 12 months. We observed a relaxed atmosphere within the home when visiting. Six residents spoken with were complimentary about the staff working at the home and felt that there were sufficient numbers of staff on duty to meet their needs. Staff spoken with confirmed that they felt there was enough staff on duty and enjoyed working within the home. They stated that there is good team work. The AQAA identifies that 55 care shifts have been covered by temporary staff or staff from an agency in the past three months. Four staff files were viewed. Ensuring applications are fully completed will assist the home in addressing shortfalls in recruitment procedures such as ensuring gaps in employment are explained. There were no references in one staff file viewed. The Registered Manager assured us that she will address this immediately. There was one Care Homes for Older People Page 21 of 28 Evidence: incident where an employee commenced employment prior to a POVA check or CRB having been returned. The Registered Manager advised that this person worked with another carer. Staff must not commence employment without all relevant checks being in place. There was evidence in staff files of training being provided and staff spoken with also confirmed that they are kept up to date with mandatory training. The home has a training schedule in place that shows staff are provided with opportunities to attend additional training relevant to their roles. The AQAA identifies that there are 19 permanent care workers of which all have undertaken induction training as recommended by Skills for Care. Five permanent care staff have National Vocation Qualification level 2 or above, three are currently undertaking these studies and two additional staff will be registering to undertake this course. 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. Residents benefit from the home being run by an experienced and dedicated Registered Manager who ensures that the home is run safely and in the best interest of residents. Evidence: The Registered Manager is suitably experienced and qualified and provides good leadership, in an open and approachable manner. Staff spoken with confirmed that the manager is fair, supportive, approachable and knowledgeable. A comment received was she has her finger on the pulse. The Registered Manager confirmed that she keeps herself up to date with current good practice guidelines/legislation by attending training sessions, care/nursing manuals, via the internet and confirmed she also receives good support from the organisation. Staff confirmed that they felt there were clear roles and responsibilities within the home. There is information available at the home regarding Deprivation of Liberty Safeguard (DOLS) to ensure staff are familiar with new legislation. The Registered Manager Care Homes for Older People Page 23 of 28 Evidence: attends training and cascades the information to staff. There was currently no application for authorisation being processed. The AQAA identified that there a numerous procedures implemented within the home to provide an opportunity for residents to have their say about the service. Some examples of changes made as a result of listening to people who use their service are: improved the summer house, changed the menu and made a selection of magazines available in the hairdressing room. Surveys are given to residents, relatives and staff twice a year to obtain their feedback on the services and care the home is providing. Health professionals are given a survey when they visit the home to complete. Resident and staff meetings are held every three months. The home has various internal monitoring systems in place and monthly visits are undertaken by a representative within the organisation. Survey results are analysed and results shared with residents. Action is taken to resolve any shortfalls wherever possible. The AQAA contained the information we needed. It identifies areas in what they could do better, how they have improved in the last 12 months and their plans for improvements in the next 12 months. It was discussed with the Registered Manger that the summary provided was very brief. There was no information included in equality and diversity regarding how they meet religious needs, despite this being the main ethos of the service. Shortfalls were discussed with the Registered Manger who will ensure additional information is included the next time we ask for it. Some areas had limited information on their plans for improvement in the next 12 months. The Registered Manger confirmed that they are restricted on some improvements due to finances and restrictions imposed by their head office. She did not wish to include information in case they were unable to fulfill the identified improvements. The AQAA identifies there are some policies and procedures that have not been reviewed for up to four years. Some of these are related to equality and diversity issues. The Registered Manager confirmed these are developed by head office of the organisation. The registered providers must be pro active and ensure policies and procedures are reviewed regularly and reflective of up to date good practice guidance. It was confirmed they were currently in the process of doing this. The home holds personal allowance securely for those individuals who wish to use this service. Records viewed and monies counted evidenced that the procedures in place Care Homes for Older People Page 24 of 28 Evidence: safeguard residents and staff. It was confirmed that regular health and safety checks are undertaken and the AQAA identifies that equipment in use has been serviced or tested as recommended by the manufacturer or other regulatory body. The homes fire risk assessment has recently been reviewed. The AQAA identifies that they have written assessments on hazardous substances, Control of Substances Hazardous to Health (COSHH). Care Homes for Older People Page 25 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 26 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 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. 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. 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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