Care Home: Roseberry Court

What the care home does well Roseberry Court is a new, purpose built facility that was registered in July 2009. The home is spacious with wide corridors and is beautifully decorated. Good quality furniture has been purchased for both bedroom and communal areas. The home has a welcoming atmosphere and visitors are made to feel welcome at any time. The home has an activity co-ordinator to plan, arrange and take part in activities for people that use the service. The activity co-ordinator works twenty hours a week over five days. The activity co-ordinator works weekdays and on occasions weekends. Activities taking place on a daily basis include dominoes, flower arranging, quizzes, and crafts. On the morning of the inspection people that use the service were flower arranging. Flowers were being arranged in small bud vases which were later displayed on all dining room tables. Some afternoons people that use the service and staff play bowling and other activities on a games console. Menus offer choice and food provided is varied and enjoyed. Visitors are welcome to stay for a meal, however there is a charge made for this. Staff are well trained. Twenty out of twenty one care staff employed at the home have achieved a minimum qualification of NVQ level 2 in Care. Housekeeping staff are working towards achieving an NVQ level 2. The home`s food menu is varied and offers choice at each meal time. Food provided is enjoyed. People that use the service are happy with the care that they receive. Comments made by people spoken to during the inspection and surveys received included, "My mother and I are very happy with everything at Roseberry Court. All the staff are very friendly and helpful" "The home is first class and the staff are great" "I am always made to feel welcome on my visits. I regularly stay for lunch, which is always tasty and well presented" "My room is lovely. I have brought lots of ornaments and pictures in to make it feel like home" What has improved since the last inspection? This is the first inspection of the service since registration. What the care home could do better: Some care plans for people that use the service need to be developed further to ensure that they are individual and specific to the person. This will help to promote Independence, ensure that care needs are met and that care is delivered in such a way that is acceptable to the person. Care plans for those people identified with agitation or aggression should include any triggers to the agitation/ aggression and action that should be taken by staff to reduce or deal with the agitation/aggression. Unused medication carried over from one month to another should be recorded on the Medication Administration Record to enable auditing. Water temperatures should be taken and recorded on a weekly basis to ensure that they are within safe limits for people that use the service. Key inspection report Care homes for older people Name: Address: Roseberry Court Roseberry Court Low Farm Drive Redcar Cleveland TS10 4DZ     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: Katherine Acheson     Date: 0 7 0 1 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 29 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 29 Information about the care home Name of care home: Address: Roseberry Court Roseberry Court Low Farm Drive Redcar Cleveland TS10 4DZ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gaynor Mallaby Type of registration: Number of places registered: care home 63 Helen McArdle Care Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1. The maximum number of service users who can be accommodated is: 63 2. The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 63 Dementia - Code DE, maximum number of places 63 Date of last inspection Brief description of the care home Roseberry Court is registered to provide personal and nursing care to sixty three people. The home is situated on Low Farm Drive in Redcar and is close to pubs, shops, a library and churches. Care Homes for Older People Page 4 of 29 Over 65 63 63 63 0 Brief description of the care home The home is a three story, modern, purpose built facility that opened in 2009. The home has been divided into three units. The ground floor of the home is being used to accommodate a maximum number of eighteen older people. The ground floor has two lounge areas and a dining room. The first floor of the home was not open at the time of the inspection visit, however, is intended to be used to accommodate twenty four older people. The first floor has two lounge areas and a dining room. The second floor of the home is being used to accommodate a maximum number of twenty one older people with dementia. This floor has one lounge and a dining room. All bedrooms have ensuite facilities, which includes a toilet and hand wash basin. Some of the ensuites have a shower. All bedrooms meet the required amount of space. The home has a beauty/hairdressing salon and direct dial telephone to every room. There is a passenger lift to enable access to the first and second floor of the home. The home has an enclosed garden area for people to use. The cost of care at the time of the inspection ranged from £477 to £590 per a week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is two star. This means that people who use the service experience good quality outcomes. This unannounced key inspection took place on 7th January 2010. This is a first inspection of a newly registered service. The manager completed and returned an Annual Quality Assurance Assessment, (AQAA). The AQAA is the services self assessment on how they think that they are meeting National Minimum Standards. This information was received before the inspection and was used as part of the inspection process. Before this inspection visit we looked at all of the information that we have received since registration of the service in July 2009. Care Homes for Older People Page 6 of 29 The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the Government for care homes. Numerous records were examined including care records of people living at the home, medication records, risk assessments, complaints and staff records. People living at the home, relatives and staff working there were also spoken to. Discussion also took place with the registered manager and senior managers of the service. Before the inspection surveys for people that use the service, relatives and staff were sent out to the home for the manager to distribute . Surveys for people that use the service and relatives asked for comments on care received. Surveys for staff asked for comments on what it was like working at the home and training received. We received six surveys from people that use the service, five from relatives and one from a staff member. Comments in surveys received can be read in the main body of the report. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Some care plans for people that use the service need to be developed further to ensure that they are individual and specific to the person. This will help to promote Independence, ensure that care needs are met and that care is delivered in such a way that is acceptable to the person. Care plans for those people identified with agitation or aggression should include any triggers to the agitation/ aggression and action that should be taken by staff to reduce or deal with the agitation/aggression. Care Homes for Older People Page 8 of 29 Unused medication carried over from one month to another should be recorded on the Medication Administration Record to enable auditing. Water temperatures should be taken and recorded on a weekly basis to ensure that they are within safe limits for people that use the service. 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 29 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 29 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. Assessments of people who are to use the service take place before they move into the home to ensure all needs can be met. Evidence: The home has a statement of purpose and service user guide both of which were available for inspection. An easy read service user guide has been developed and includes pictures to help those people with dementia understand the services provided by the home. The manager said that people who are to use the service are assessed before coming into the home. They firstly receive an assessment from a social worker and/or health care professional. This assessment is sent to the home for the manager to look at. Once this assessment has been reviewed the manager then visits the person at home or in hospital to do a further assessment. The manager uses these assessments to decide whether the home can meet their needs. Care Homes for Older People Page 11 of 29 Evidence: If a person is funding their own care an assessment is usually only undertaken by the manager of Roseberry Court. People are encouraged to visit the home before they move in. On the day of the inspection two people who were looking for a home for their relative came to the look round. People who are to use this service are offered a trial period of up to six weeks. At the end of the trial period a review takes place to make sure that the placement is both successful for the person using the service and the home. One person spoken to during the visit said, We came to look round and were made to feel very welcome. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service receive good support and are happy with the care that they receive. Medication systems and practice are good. Senior care staff responsible for the administration of medication are appropriately trained, which helps to ensure that safe practice is followed. Evidence: The files of four people that use the service were looked at during the visit, two from the dementia unit and two from the older persons unit. Files examined contained a detailed assessment, risk assessments, evidence of nutritional screening and care plans. Care plans are records used by care services to show what sort of help each person needs and how staff will provide that care. Two of the four care files looked at contained care plans that provided clear guidance to staff about how to meet the needs of the person and included evidence of personal choice. One plan of care detailed how a person preferred a bath to a shower and how they liked to have a wet shave. Another plan of care gave good information on how to promote independence with eating. The other two care files looked at would benefit Care Homes for Older People Page 13 of 29 Evidence: from the care plans being developed to include more information. One plan of care for a person who needed help with washing and dressing stated, Able to do some tasks but requires one carer to assist. This plan of care should detail what the person can do for themself and what help is needed. Another plan of care looked at during the visit highlighted that the person can become agitated and aggressive, however, did not detail any triggers to the agitation and aggression and action that should be taken by staff to reduce or deal with the agitation/aggression. Files looked at during the visit contained a detailed history of the person including place of birth, childhood, marriage, children, work life and other important information. This is particularly important when caring for a person with dementia. There was clear evidence of the involvement of GPs, District Nurses and other healthcare professionals such as chiropodists. People living at the home confirmed that if they were feeling unwell, the GP would be called. During the inspection visit the manager and staff were observed to interact well with people that use the service and visitors. Staff approached people in a supportive and respectful way. People spoken to during the visit and surveys received were complimentary about life in the home and care received. Comments made included, Roseberry Court is a lovely home and the staff are really nice Roseberry Court provides warm, clean accommodation with a happy atmosphere and happy staff Its first class. The staff are lovely Im quite happy During the inspection arrangements for receiving, storing, administering, recording and disposing of medication were observed and examined on the older persons unit. Systems and practice were good and medicines were appropriately stored. Record keeping could improve by documenting the amount of unused medication carried over from one month to another on the Medication Administration Record to enable auditing. The manager said that senior care staff are responsible for giving out medication. She said that before staff give out medication they do safe handling of medication training and have their practice observed to make sure that they are Care Homes for Older People Page 14 of 29 Evidence: competent. The manager said that senior managers of the service do monthly medication audits. Care Homes for Older People Page 15 of 29 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. People that use the service lead fulfilling lifestyles through exercising choice and control over how they spend their day. Food provided is enjoyed by people that use the service. Evidence: The manager said that the home has an activity co-ordinator to plan, arrange and take part in activities for people that use the service. The activity co-ordinator works twenty hours a week over five days. The activity co-ordinator works weekdays and on occasions weekends. Activities taking place on a daily basis include dominoes, flower arranging, quizzes, and crafts. On the morning of the inspection people that use the service were flower arranging. Flowers were being arranged in small bud vases which were later placed on all dining room tables. Some afternoons people that use the service and staff play bowling and other activities on a games console. The activity co-ordinator is to be trained so that she can safely do chair exercises with people that use the service. People visit the library which is next door to the home on a regular basis. Care Homes for Older People Page 16 of 29 Evidence: Reminiscent scrap books are used in activities for people on the dementia unit. The manager said that there are regular visits from representatives of the local Church of England, Methodist and Roman Catholic Churches. On the day of the inspection a representative from the local Church of England Church visited to give a number of people communion. The hairdresser visits the home on a weekly basis. A charge is made for this service. Visitors are welcome at any time. There was a plentiful supply of visitors on the day of the inspection. Food provided by the home is enjoyed by people who use the service. The lunch time of people on the dementia unit was observed. The lunch time menu of the day was beef and mushroom casserole or chicken and sweetcorn pie, creamed potato, sweetcorn and peas. For desert it was prunes and custard. The home has a four week menu plan which offers a choice at each meal time. At the time of the inspection people had their main meal on a lunch time. The manager is consulting with people that use the service to change the main meal to tea time. The lunchtime of people on the dementia unit was relaxed with people enjoying the food that was provided. Staff were assisting those people that needed help. People spoken to during the inspection and surveys received spoke highly of the food provided comments made included, The food is beautiful and plenty of it The food is excellent The food is really good and nicely presented Families and friends are able to stay for a meal at the home. Prior notice needs to be given to the cook and a charge is made for the meal. A number of relatives spoken to during the visit said how they liked to stay for a meal and how much they enjoyed the food. Comments made included, I regularly stay for Sunday lunch. The food is beautiful it only costs me £3.50 for a lunch and pudding Care Homes for Older People Page 17 of 29 Evidence: We all came for Christmas lunch. We had three courses, soup, turkey dinner and trifle and Christmas pudding. There was also wine, tea, coffee and Orange juice. It was well worth the £7.50 a person I can stay for a meal and it is worth eating Care Homes for Older People Page 18 of 29 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. People that use the service are confident that their complaints would be listened to, taken seriously and acted upon. Staff working at the home receive adult protection training, which will help to ensure the safety of people living at the home. Evidence: The home has a complaints procedure, which details how to make a complaint, who to contact and timescales for action. This procedure also informs people of their rights to contact Funding Authorities. People spoken to during the visit said that they would feel comfortable and confident in raising any concern that they may have with the manager of the home. There have not been any complaints since registration of the service. The home has an adult protection procedure, which advises staff of action to follow if abuse is suspected. The manager said that all staff working at the home have regular adult protection training. People living at the home said that they felt safe. Care Homes for Older People Page 19 of 29 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 standard of the environment is good providing people that live there with an attractive, homely and comfortable place to live. Evidence: Roseberry Court is registered to provide personal and nursing care to sixty three people. The home is situated on Low Farm Drive in Redcar, and is close to pubs, shops, a library and churches. The home is a three story, modern, purpose built facility that opened in 2009. The home has been divided into three units. The ground floor of the home is being used to accommodate a maximum number of eighteen older people. The ground floor has two lounge areas and a dining room. The first floor of the home was not open at the time of the inspection visit, however, is intended to be used to accommodate twenty four older people. The first floor has two lounge areas and a dining room. The second floor of the home is being used to accommodate a maximum number of twenty one older people with dementia. This floor has one lounge and a dining room. All bedrooms are single and have ensuite facilities, which includes a toilet and hand wash basin. Some of the ensuites have a shower. All bedrooms meet the required amount of space. Care Homes for Older People Page 20 of 29 Evidence: The home has a beauty/hairdressing salon and direct dial telephone to every room. There is a passenger lift to enable access to the first and second floor of the home. The home has an enclosed garden area for people to use. The Inspector walked around the home with the Manager. Communal areas were beautifully decorated with good quality furniture. Bedrooms of people that use the service were nicely decorated, had appropriate furniture and were personalised. Memory boxes filled with familiar items were on the walls outside bedroom doors on the dementia unit to help people to identify their bedroom. People have lots to see out of the homes windows ie shops, houses, traffic and pedestrians. Appropriate laundry facilities were in place. The standard of cleanliness around all of the home was very good. It is clear that housekeeping staff work extremely hard to keep the home clean, tidy and odour free. Care Homes for Older People Page 21 of 29 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. Staff are trained and skilled to meet the needs of people living at the home. The homes recruitment procedure could improve by ensuring that references for prospective staff are obtained from the management or HR department of the previous employer to ensure good recruitment procedures are followed and people are safe. Evidence: At the time of the inspection there were thirty eight people using the service, The older persons unit on the ground floor of the home was fully occupied with eighteen people. Duty rotas looked at during the visit informed that there are two care staff on duty during the day and night one of which is a senior carer. The first floor of the home, which is intended to accommodate twenty four older people is due to open in the next couple of weeks. The manager is in the process of recruiting staff to work on this unit. The dementia unit on the second floor of the home had one vacancy and at the time of the visit twenty people were using the service. Duty rotas looked at during the visit informed that there are three care staff on duty during the day and two staff during the night, one of which is a senior carer. Care Homes for Older People Page 22 of 29 Evidence: Although the home is registered to provide nursing care the manager said that a decision had been made to only accommodate those people requiring personal care for the foreseeable future. The manager of the home works full time and is supernumerary. People spoken to during the visit thought that there were enough staff on duty, Two surveys from people that use the service thought that the home could do with more staff on duty and that on occasions they had needed to wait for staff to help them. The manager said that twenty out of twenty one care staff employed at the home have achieved a minimum qualification of NVQ level 2 in Care. She said that other housekeeping staff are working towards achieving an NVQ level 2. Records were examined to confirm that the home in general follows good recruitment procedures. Three files of newly recruited staff were looked at during the visit. Files looked at contained evidence that references and Criminal Record Bureau Checks had been obtained prior to commencement of employment. It was observed that references on two of the staff files looked at during the visit were from the last employment, however, were from work colleagues and not the management. This was pointed out to the manager at the time of the inspection who said that in future she would ensure that references were obtained from the management or HR department of the previous employer. The manager said that new staff receive induction training that meets with the required standard. Records were available to confirm that staff had attended training in Moving and handling, fire, and health and safety. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the interest of people that use the service. The health safety and welfare of people that use the service is promoted. Evidence: The manager is a Registered Mental Nurse who has achieved a management qualification. The manager has many years of experience of working in social care and managing a care home. People spoken to during the inspection spoke highly of the manager and staff team. Comments made included, The manager is good, very approachable and easy to talk to and, I am really happy here. The manager and staff are great, nothing is too much trouble. Appropriate quality assurance monitoring systems are in place to make sure that the home is run in the best interest of people that use the service. In house meetings for people that use the service and relatives are held every six weeks. The manager Care Homes for Older People Page 24 of 29 Evidence: advised that surveys are to be sent out twice yearly to people to make sure that they are happy with the care received. Surveys were last sent out in November 2009. A report of the findings was available for inspection that indicated people were happy. Regular monthly audits take place by senior managers of the service to make sure people are happy and good practice is being followed. The home looks after small amounts of money belonging to some people that use the service. Appropriate records of transactions are kept. A sample of health and safety records were examined and in general found to be in order. Records were available to confirm that the fire alarm had been tested in November and that staff were on average doing weekly checks of the fire alarm system. Two fire drills involving staff had taken place in August and October 2009. Records were available to confirm that monthly testing of water temperatures takes place. It is recommended that water temperatures are taken and recorded on a weekly basis to ensure that they are within safe limits. Care Homes for Older People Page 25 of 29 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 29 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 7 Care plans for those people identified as being agitated and aggressive should detail any triggers to the agitation/ aggression and action that should be taken by staff to reduce or deal with the agitation/aggression. Care plans should be individual and specific to the person. Care plans should be developed to include what the person can do for themself, assistance needed, likes, dislikes, evidence of personal choice and preferences. This will help to promote Independence, ensure that care needs are met and that care is delivered in such a way that is acceptable to the person. Unused medication carried over from one month to another should be recorded on the Medication Administration Record to enable auditing. The manager should ensure that references for prospective staff are obtained from the management or HR department of the previous employer to ensure good recruitment procedures are followed and people are safe. Water temperatures should be taken and recorded on a Page 27 of 29 2 7 3 9 4 29 5 38 Care Homes for Older People 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 weekly basis to ensure that it is within a safe limit for people to use. Care Homes for Older People Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!