Care Home: Porte Rouge

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What the care home does well People who use the service and their relatives have the information they need to decide whether Porte Rouge is the right home for them to move into. The admission procedure shows that staff make sure they can meet the persons needs before they are admitted. People receive a good standard of personal care and support, and communication with healthcare professionals in the local community is good. The medicines are well managed and people are asked about whether they would like to be self medicating, if they would then a risk assessment is carried out to assess their suitability. The staff ensure that people see appropriate healthcare professionals when they need to. The residents are being included in decisions about their care and the running of the home as it develops the service. The new support plans being introduced and other documentation and record keeping at the home is good and means that staff know how to care for somebody in a safe and consistent way that meets their individual needs and preferences. The choices people make about how they would like to spend their time is added into the support plans to ensure their whole wellbeing is being considered. People have access to a variety of activities, both in house and within the local community and are encouraged to maintain contact with their family and friends. People are supported to maintain their spiritual beliefs and take part in the civic process if they wish. A cat has just been introduced into the home and this was done in discussion with the residents. Some chickens are about to be purchased and the residents spoken to were looking forward to the prospect. Mealtimes are more of a social occasion and are not rushed so people can spend time chatting if they wish. Each person has individual teapots and mugs and can add their own milk and sugar as required, this helps people to maintain their independence. Staff are available to provide discreet support and assistance if required. Although there are routine mealtimes people can eat their meals when and where they wish. People who use the service and their relatives can be confident that if they complain, their concerns will be listened to and acted on. Complaints received are used by the company as a way of helping to improve standards. The refurbishment and reorganisation of Porte Rouge is nearly complete and is of a high standard. The individual rooms and communal areas are bright and airy and have all of the required adaptations to help people to maintain their safety and independence, where possible. The care manager and support staff have suitable qualifications and experience to care for the people they currently look after. The recent recruitment process has involved a resident who helped with the planning and was included in the interview process. What has improved since the last inspection? The new support plans include all relevant information to enable support staff to provide help and support as required. They are updated regularly and accessible to staff at all times. They have details of peoples social history and hobbies and interests in order that support staff can ensure individualised care and support can be delivered. They include individual risk assessments and self medicating risk assessments if a person decides they would like to administer their own medication. The complaints procedure is up to date and displayed in 2 places in the reception area. The care manager said that all new people also have a copy given to them, whilst the Service Users Guide that includes one, is being updated. The care manager has been on the local authority Safeguarding training and feels confident that the senior staff would be able to follow the local procedures and ensure people are protected at all times. Water in empty rooms is run once a week to ensure the risk of Legionella is reduced. The time and date is recorded as evidence. The health and safety procedures in place whilst the building and refurbishment is ongoing are good and ensure that people are not placed at risk. Risk assessments are recorded, reviewed and updated as the work progresses. Infection control training is ongoing and soap dispensers and liquid soap are available in all en suite and communal facilities, this helps to reduce the risk of cross infection. What the care home could do better: The care manager should ensure that everybody who visits the home signs in so that it is clear who is in the home at all times. Key inspection report Care homes for older people Name: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW     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: Mandy Norton     Date: 2 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 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 24 Information about the care home Name of care home: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW 01752814469 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Torcare Limited Name of registered manager (if applicable) Mrs Ellen Patricia Knell Type of registration: Number of places registered: care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is 33. The registered person may provide the following category of service only: Care home only - Code PC, to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia (Code DE) Date of last inspection Brief description of the care home Porte Rouge is sited in an Victorian style building and is currently nearing the end of a modernisation and refurbishment programme. It sits in large mature gardens and is near the centre of Torpoint, Cornwall where local ammenities and public transport can be accessed. The home has recently been registred to take people with dementia (DE) or mental disorder (MD) who require personal care and support and the service is being developed around these categories. Accommodation is provided on 2 floors, with communal space consisting of 2 lounges, Care Homes for Older People Page 4 of 24 Over 65 0 33 0 7 0 8 2 0 0 9 Brief description of the care home a conservatory and a dining room, all on the ground floor. Access between both floors is via the stairs or the shaft lift. Porte Rouge is part of the Torcare Ltd. group of homes. Torpoint Nursing Centre is next door to Porte Rouge and residents financial records and staff files are kept in the administrators office there. The company has 3 homes and 1 domiciliary care agency, all local to the Torpoint area. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out by one inspector on 28th April 2010 between 10am and 3.30 pm. It was conducted with the care manager, with the training officer, general manager and the provider available as required. During the inspection a tour of the building was carried out, a mealtime observed and a variety of records and documents were reviewed. Staff and residents were spoken to informally throughout the day. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? The new support plans include all relevant information to enable support staff to provide help and support as required. They are updated regularly and accessible to staff at all times. They have details of peoples social history and hobbies and interests in order that support staff can ensure individualised care and support can be delivered. They include individual risk assessments and self medicating risk assessments if a Care Homes for Older People Page 7 of 24 person decides they would like to administer their own medication. The complaints procedure is up to date and displayed in 2 places in the reception area. The care manager said that all new people also have a copy given to them, whilst the Service Users Guide that includes one, is being updated. The care manager has been on the local authority Safeguarding training and feels confident that the senior staff would be able to follow the local procedures and ensure people are protected at all times. Water in empty rooms is run once a week to ensure the risk of Legionella is reduced. The time and date is recorded as evidence. The health and safety procedures in place whilst the building and refurbishment is ongoing are good and ensure that people are not placed at risk. Risk assessments are recorded, reviewed and updated as the work progresses. Infection control training is ongoing and soap dispensers and liquid soap are available in all en suite and communal facilities, this helps to reduce the risk of cross infection. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 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 current needs assessment in use means that peoples diverse needs are identified and planned for before they move to the home. Evidence: The care manager said that people are always assessed prior to moving into the home to ensure their needs can be met. He will be able to develop the current pre admission assessment form to meet the needs of the service now they have been registered for dementia and mental disorder. He also said that the Service Users Guide has been reviewed and found not to be representative of the service now able to be offered so it is being re written. However people (and their representatives) are given as much information about what the service offers as possible and are given a copy of the current complaints procedure when admitted. Care Homes for Older People Page 10 of 24 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. The practice regarding the planning and delivery of care means that people can be sure that their health, personal and social care needs will be met. Evidence: The care manager said he is introducing new care plans. He has started using them with the last 3 people who have been admitted to the home. Following discussion with the staff group and any residents that may be interested about how they are being used and any changes that are required they will be introduced to all residents. The completed ones were reviewed during the inspection. They included a support plan, individual risk assessments, an authority to share information sheet (signed by the resident or their representative where possible), social history and details of hobbies and interests. The care plans and daily diary show that people have access to community health services, GPs and therapeutic services as appropriate. During the inspection it was clear that staff support peoples own capacity for self care and provide support and care where necessary. The excellent approach to in house and outside activities and Care Homes for Older People Page 11 of 24 Evidence: supporting people to spend time constructively (see section on daily life and social activities) also adds to peoples general wellbeing and is noted as good practice to consider the impact of lifestyle in peoples health and wellbeing. On admission the staff ask people if they want to self administer their own medication. If they do a risk assessment is completed and relevant records kept. However the majority of people have their medicines dispensed by support staff. They come in blister packs, are properly dispensed, stored and disposed of in line with laid down legislation. The home has no controlled drugs cupboard (they do not have any controlled drugs currently in use) the care manager said one is on order and will be installed in line with pharmaceutical guidelines when it arrives. Throughout the day of the inspection people were being treated with dignity and their privacy was being maintained where necessary. People are called by their preferred form of address and were dressed appropriately. The care manager was reminded to put signs on bathrooms and toilet doors to ensure people know where they are situated. Care Homes for Older People Page 12 of 24 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. A range of activities within the home and the local community mean that people have opportunities to participate in stimulating and motivating activities that meet their individual needs.. Meals and mealtimes are not rushed and staff are available to help make them an enjoyable and social occasion for people. Evidence: The new care plans reviewed had evidence that information about peoples social history and hobbies and interests is starting to be recorded and used to inform the staff about how people want to spend their time whilst at Porte Rouge. One of the support workers as part of her role is the activities officer and will be seeking new activities and encouraging people to get involved in activities. The care manager added that they have a small number of volunteers who are involved in activities. A cat has been introduced into the home, this was done in consultation with the residents and it was considered a good idea. A number of chickens are being bought and the residents spoken to were looking forward to the prospect of helping the support staff care for them. We were told that people go out into the community for a variety of activities and that some activities take place in house. A n area of rough Care Homes for Older People Page 13 of 24 Evidence: ground in the courtyard is in the process of being transformed for use as a garden and seating area. Current residents are being encouraged to take part in the process. A herb garden has been planted and a greenhouse is in place and it is hoped that the produce can be used in the kitchen. The catering staff are keen to involve the residents in cooking and preparation if they wish and they think using their own produce would be a great experience. On the week of the inspection staff and any residents who want to are having a weeding session to prepare some more ground for use. Raised beds have been ordered and it is envisaged that the area will be full of colour, smell and activity. There are also large grounds for the residents to use, there was evidence that people had been sitting out in the grounds during recent good weather. The care manager said he hoping to have an internet connection for residents to use and a community mapping exercise is ongoing to ensure all local services/activities etc. are known about and people can then be offered a range of things to do whilst resident in the home both in and out of the home. A tour of the home showed that people can arrange their rooms how they wish and bring in personal possessions to make their room homely. A meal time was observed and we saw that most people have their meal in the dining room, making it a social occasion. However people can have their meal where they like and when they like, especially if they are engaged in other activities at the routine mealtime. It was noted as good practice that people had individual teapots and mugs so that could pour their own drink and add milk and sugar as required, this helps to stimulate independence and motivation. Staff were available to provide support and assistance as required but were not intrusive. Care Homes for Older People Page 14 of 24 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. Formal complaints and safeguarding policies and procedures are in place and are available to staff at all times. All staff undertake safeguarding training. This means that people who live at the home are adequately safeguarded. Evidence: The care manager said that a complaints procedure given to each person who moves in whilst the Service Users Guide is being updated to reflect the new categories within the home. Two copies of the up to date complaints procedure were also seen displayed in the home. The Commission has not received any complaints about the service since the last inspection and the home have not received any complaints either.. The care manager told us that all residents are on electoral register and postal votes for the upcoming general election have been arranged. Some people are going to the poll station in person and will be facilitated to do so. The care manager said he has been on the local authority 2 day safeguarding course and feels that he, the general manager and provider (one of which is always on call) know the local reporting procedures should an incident occur. Care Homes for Older People Page 15 of 24 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. Nearly completed refurbishment, redecoration and ongoing maintenance means that people have a comfortable, homely and safe environment in which to live. This will continue to improve as the refurbishment is completed. Evidence: The home is nearing the end of an extensive rebuilding and refurbishment programme that has seen total refurbishment of all rooms to include en suite facilities, upgrading of the communal areas, entrance hall and offices and addition of communal bath, toilet and shower facilities. The building complies with the local fire service and environmental health department. The grounds are extensive to the front and side of the house and are accessible to the current residents. A courtyard area in the centre of the building is currently being redesigned and reorganised, this area can be secured so that people who are at risk of wandering can do so safely. Communal space within the home consists of 2 lounges, a conservatory and a dining room. All of which have recently been refurbished. The conservatory cannot be used in very hot weather and the provider is looking at ways of making sure it can be used throughout the year. There are toilet facilities, bathrooms and shower rooms throughout the home. They are finished to a high standard and have a variety of grab rails and hoists to aid Care Homes for Older People Page 16 of 24 Evidence: mobility. The doors throughout the home are wide enough to allow access for people who use a wheelchair. There is sufficient space for storage of equipment if required. The home has a call bell system fitted throughout. All doors to individual rooms are fitted with locks and there is lockable space within each room. They all have the required furniture and fittings and the occupied rooms seen were personalised to peoples own taste. The heating, lighting, water supply and ventilation meet the relevant environmental health and safety standards. The water in empty rooms is run weekly to ensure reduced risk of Legionella. On the day of the inspection the house was clean, tidy and hygienic. Domestic staff were seen working throughout the inspection. The laundry is of sufficient size and has washing machines with the specified programming ability to meet disinfection standards. Infection control training is offered by the in house trainer and up to date policies and procedures around control, of infection are available to staff at all times. Care Homes for Older People Page 17 of 24 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. The current staffing levels and skill mix are satisfactory meaning peoples needs are being met. The Torcare Ltd. recruitment procedure means that people who live at the home are being looked after by appropriate staff and their welfare is not at risk. Evidence: There is currently a registered manager in place. A care manager has been appointed and is currently in the process of applying to be the registered manager. He has experience of supporting people with mental health issues in a variety of settings. He will have the support of the general manager and provider as the service is developed. He is keen that support staff have a career pathway so one is also the activities officer and another is the volunteer co-ordinator, he feels this keeps staff motivated. He includes staff in proposed changes, to support plans for example, asking them for their advice on any changes required as they are the people using them on a day to day basis. This is all noted a good practice. There have been no staff members who have left in the last 9 months. Each resident is allocated a key worker who updates the support plans (with the resident if possible) ensures that social and personal histories are up to date and that there ongoing welfare is being maintained. It also gives the resident a point of contact Care Homes for Older People Page 18 of 24 Evidence: within the staff group with whom they can discuss any issues at all. We saw sufficient staff on duty on the day of the in section. Overnight there are 2 waking night staff and additional staff at peak times of activity during the daytime. There are also administrative, catering, domestic, laundry, training and maintenance staff to support care staff. Over half the staff have a qualification at least NVQ level 2. The training officer ensures that staff are encouraged to undertake their NVQ training and have full support during the process. Torcare Ltd. have a standard recruitment procedure that includes a CRB check, 2 written references and asking for previous employment history. Staff files were not examined during this inspection but previous staff files seen (at Torcares other homes) have always had the required information in them and are stored securely at Torcares main office at Torpoint Nursing Centre, the home adjacent to Porte Rouge. The care manager said that following the inspection they need to recruit 2 new staff members. he said that he had been able to develop the interview plan and carry out the interviews with a resident and this had proved successful, he will continue to ask residents if they would like to be involved in the recruitment process and as the service grows they will be several more opportunities for this. This was noted as good practice. The company has its own training officer, based at Porte Rouge, she ensures staff induction is carried out and ongoing statutory training is completed. She keeps detailed records of who has received what training. She also offers training on dementia care, safeguarding and any other subjects that the staff group need. The care manager said that support staff have had some training on care plan writing as they are introducing new care plans. Outside training is accessed if it cannot be offered by the training officer. The care manager said that senior support staff have had in house training to enable them to provide ongoing supervision for support staff and he does the ongoing supervision of the senior support staff. He added that all staff including domestic and catering staff have supervision sessions. Care Homes for Older People Page 19 of 24 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 systems and procedures in place are designed to meet the needs of the service as they strive to continually improve the service the home offers to the people that live there. The responsible attitude to health and safety shown by the providers, care and ancillary staff during the ongoing building and renovation means that people live in a safe environment. Evidence: The current Registered Manager is qualified and experienced she is currently also the training manager for Torcare Ltd., a care manager has recently been appointed and he is applying to be the registered manager. He has the skills required to develop the service as it now has dementia (DE) and mental disorder (MD) categories. There are clear lines of accountability within Torcare Ltd. and the general manager and provider are available for support and guidance. Care Homes for Older People Page 20 of 24 Evidence: Torcare Ltd. have an internal formal quality assurance (QA) system. Porte Rouge has not undergone a formal QA process whilst it has been undergoing such significant change and introduction of new categories of care. The care manager said that once the building work is complete a formal QA will take place. The general manager, provider and care manager are always available to people who may want to make comments about quality or have any suggestions. The care manager is trying to involve staff and residents in ongoing changes as the service develops and appreciates their input to ensure the service is providing what people expect of it. Policies and procedures and practice are reviewed and updated as necessary in light if changing legislation and good practice advice. The records for residents money were not examined at this inspection but have been before and found to be satisfactory. Any money that is managed for residents is done so by the administrator and secure records are kept at Torpoint Nursing Centre office. Residents have access to their money at any time. The training manager confirmed that all fire safety, lifting and handling and food hygiene training for the current staff group is up to date. During the ongoing building and redecoration work health and safety issues have been dealt with and the responsible attitude of all of the staff has ensured people have not been unduly put at risk. Risk assessments have been developed and reviewed throughout the work. All of the residents are asked how they would leave the building in the event of a fire, this is documented in a book available to all staff, information about who is in which room is displayed at the reception area to ensure staff know where to find people in the event the home has to be evacuated. The care manager looks at all reported incidences and accidents and as a result is able to see if there is a training need, the need for any equipment or if a risk assessment needs to be reviewed. The support plans have individual risk assessments included in them which are updated with the resident (where possible) and the keyworker and adapted as required. During the inspection it was noted that some people entered the building without signing in or making it clear who they were. The care manager was reminded that the staff need to know who is in the building at all times for security and fire purposes. Care Homes for Older People Page 21 of 24 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 22 of 24 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 37 The staff should ensure that all visitors sign in when visiting the home whether they are relatives, visiting professionals or in the home in another capacity. This is for security and fire purposes. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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