Care Home: Rosemont

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What the care home does well People said they felt well cared for and were assisted promptly when they needed help. The majority of care staff were described as kind and caring. People said they had a good relationship with the owner and staff team and felt they could raise concerns with them. The home is spacious and comfortable, with many of the rooms having pleasant views. Meals were described as excellent. What has improved since the last inspection? Several requirements were made at the previous inspection relating to trip hazards throughout the home and these have been addressed. The glass in the door leading from the dining room has been covered with a protective film to reduce the risk of injury should it be broken. Medication practices have been reviewed to ensure only when medicines have been given to a person are the records signed and out of date medicines are returned to the pharmacy immediately. Anyone who wishes to retain responsibility for their medicines is assessed as safe to do so. The care staff rota is properly maintained to identify who is on duty at any one time and who is the "on-call" person at night. What the care home could do better: Care plans still do not contain sufficient detail to ensure people`s care needs are fully documented and there is little information for staff about what people can do for themselves and how they should offer assistance. Leisure and social activities are not well planned and people have little opportunity to become involved in meaningful activities during the day. People`s religious and cultural beliefs are not always identified and where they are, there is little information about how the person can continue with these once they move into the home. Although the meals were described as excellent, there is little choice as people are unaware of the meal until they come to the dining room. People are not always offered something to eat at supper time. The home has four bathroom or shower rooms however only two are suitable to be used by people with restricted mobility and the home owner should consider altering the layout of the other two to make them more accessible. The clean linen stored in the laundry room should be removed to prevent the risk of cross-infection contamination. Staff training records are poorly maintained and it is not possible to identify if staff have received the necessary training to ensure they have a good understanding of the care needs of older people or have received training in health and safety matters. There is no evidence that staff receive formal induction training or individual supervision to discuss their work performance and training and development needs, although staff said they have a good relationship with the deputy care manager and feel they could raise any concerns. The home`s adult protection policy should be updated to reflect the local authority`s guidance about who should undertake any investigation should it be suspected someone it at risk of abuse. People are formally consulted about the quality of the care and services they receive. The home owner was advised to summarise the results and make these known to people. Servicing records for the stair-lift and hoists were not available and the home owner has been asked to provide copies if these to provide evidence that these are maintained in good working order. Key inspection report Care homes for older people Name: Address: Rosemont Yealm Road Newton Ferrers Plymouth Devon PL8 1BX     The quality rating for this care home is:   one star adequate 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: Jane Gurnell     Date: 0 9 0 2 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: Rosemont Yealm Road Newton Ferrers Plymouth Devon PL8 1BX 01752872445 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr D M Beckhurst care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Rosemont is registered to provide care for 19 people in the category of old age only. At the time of our visit, 13 people were living in the home. It is owned and managed by Mr Beckhurst, who is assisted by another staff member who is known as the Care Manager. Two rooms have en-suite facilities. The premises comprise a large, older property that stands in its own grounds overlooking the picturesque creek of Newton Ferrers. There are a dining room, two lounges and a conservatory. The home has two stair lifts to the upper floor and ramps to provide access in and out of the building. Adjoining the property are two privately owned flats that are not connected to the care home. The proprietor and his family live in one flat and the second is used as staff accommodation. Mr Beckhust told us that current weekly fees range between £350 and £450 per week. This does not include chiropody, hairdressing or magazines and newspapers. Information about the service provided at Rosemont can be obtained Care Homes for Older People Page 4 of 29 Over 65 19 0 2 3 0 4 2 0 0 9 Brief description of the care home directly from the home. 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: one star adequate 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 unannounced inspection was undertaken on Tuesday 9th February 2009. Mr Beckhurst, the home owner and Registered Manager, was present as was the deputy care manager who supports Mr Beckhurst in the day-to-day running of the home. We spoke with the majority of the people living in the home and the staff on duty. We looked at the care plans and assessments for three people, the medication records and observed medication being administered over the lunchtime period. We also looked at staff recruitment and training files and documents relating to health and safety issues in the home. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care plans still do not contain sufficient detail to ensure peoples care needs are fully documented and there is little information for staff about what people can do for themselves and how they should offer assistance. Leisure and social activities are not well planned and people have little opportunity to become involved in meaningful activities during the day. Peoples religious and cultural beliefs are not always identified and where they are, there is little information about how the person can continue with these once they move into the home. Although the meals were described as excellent, there is little choice as people are unaware of the meal until they come to the dining room. People are not always offered something to eat at supper time. The home has four bathroom or shower rooms however only two are suitable to be used by people with restricted mobility and the home owner should consider altering the layout of the other two to make them more accessible. The clean linen stored in the laundry room should be removed to prevent the risk of cross-infection contamination. Staff training records are poorly maintained and it is not possible to identify if staff have received the necessary training to ensure they have a good understanding of the care needs of older people or have received training in health and safety matters. There is no evidence that staff receive formal induction training or individual supervision to discuss their work performance and training and development needs, although staff said they have a good relationship with the deputy care manager and Care Homes for Older People Page 7 of 29 feel they could raise any concerns. The homes adult protection policy should be updated to reflect the local authoritys guidance about who should undertake any investigation should it be suspected someone it at risk of abuse. People are formally consulted about the quality of the care and services they receive. The home owner was advised to summarise the results and make these known to people. Servicing records for the stair-lift and hoists were not available and the home owner has been asked to provide copies if these to provide evidence that these are maintained in good working order. 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 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 9 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. People considering moving into Rosemont are provided with sufficient information to make a decision about the suitability of the home. Pre-admission assessments are undertaken to ensure peoples needs can be met at the home. Evidence: The deputy care manager confirmed that either she or the care manager visit people prior to their admission to provide them with information about the home and to undertake an assessment of their care needs: this assessment was evident in the three care plans we looked at. Following the assessment the home owner writes to each person summarising their care needs and confirming whether the home is able to meet these. One person newly admitted to the home confirmed that she had been visited prior to her admission but said that she had not wished to have the homes brochure as she knew the home well having lived in the village for many years. She said she had Care Homes for Older People Page 10 of 29 Evidence: settled in and felt well cared for. She confirmed that she had been offered a larger room shortly after her admission and she was very pleased with this as this room had a beautiful view over the valley. Rosemont does not provide intermediate care. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are insufficiently well organised and detailed to provide staff with the information they need to provide care and support in a consistent manner. Medication practices are now safe. Evidence: The majority of people living at Rosemont said they had lived in Newton Ferris or the surrounding villages and knew the home well. Many people had come to the home for respite care following short illnesses and knew the home owner, care manager and staff well. Most people living in the home were spoken with and all were generally satisfied with the care they received. However, some people raised concerns over the inconsistencies in staff performance and attitude, saying that some staff were much more caring and attentive than others: this was discussed with the deputy care manager and the home owner who were both aware of this and were taking steps to resolve this matter. We looked at the care plans for three people, one newly admitted to the home and two for people who had lived in the home for a longer period of time, Care Homes for Older People Page 12 of 29 Evidence: one of whom had complex care needs. Records about each person comprised of an assessment of care needs, a summary of these needs, daily notes and risk assessments relating to matters such as mobility and the risk of falls. The assessment document was of a tick chart format with little room to describe someones care needs in detail and the care plans were insufficiently detailed to provide clear information to staff. For example, one care plan indicated that the person needed help with washing and dressing from one member of staff but there was no description about what this person could do for themselves or how staff should offer assistance. Another care plan indicated that the person was at risk from recurrent falls however there was no information in the care plan about how far the person could walk, whether she required any aids, or what assistance should be given to reduce the risk of falls. This lack of detail places people at risk from not having their care needs met in full and in a consistent manner and, with regard to the risk of falling, places the person concerned and the member of staff at risk from injury. There was evidence that these care plans had been reviewed every 2 to 3 months however any changes identified at the time of review had not been transferred to be assessment or care plan documentation, meaning that staff how to read each review to identify esch persons current needs. There was no evidence that the person whom the care plan had been written about had been involved in its development or review and those people spoken with did not know the home held a care plan about them. We looked at the way medicines were used in the home. A padlocked box is used to carry medicines around the home. We saw that when it was not in use, the box was kept in the locked office. Other medicines were stored in a locked cabinet in the office. The recording of medicine administration has been reviewed since the previous inspection and medicines are only signed for when given to the person and not before. A member of staff was observed giving medicines at lunchtime and this was done safely and unhurriedly. Medication records were neat and accurate and each person was identified with a photograph to reduce the risk of medication errors. One person had chosen to retain responsibility for their medication and a risk assessment relating to their safety to do this was seen in their care plan. We heard staff speaking supportively and kindly to people living in the home and saw them offering support when this was needed. Staff knocked on doors before entering and closed doors when providing personal support. Care Homes for Older People Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rosemont offers a satisfactory lifestyle for people who are more independent. However, social opportunities and choices are too limited for people who are less able. Meals are nutritious and of good quality but choice is limited. Evidence: People spoken with said that they were free to come and go from the home as they pleased and that family and friends could visit at any time. When asked about how they spend their day, people said they mainly stay in their rooms reading, listening to music or watching television. They said that very rarely are social and leisure activities arranged by the home. Two people described that the home had in the past offered a variety of day-to-day activities, including quizzes and slide shows, but this had reduced due to peoples lack of interest. The deputy care manager said that this was something she was keen to reintroduce and had started to organise a timetable of events and that she was planning to speak with each person to identify whether they would like to see daily activities again. She confirmed that people would be supported to go to the shops in the village or for a car ride round the local area if they asked however those people spoken with were unaware of this. Care Homes for Older People Page 14 of 29 Evidence: The three care plans looked at only made a brief reference to peoples preferred social and leisure activities, or their religious and cultural beliefs. For example, one entry referred to the person being a regular church goer however, there was no indication of the denomination or whether the person was still able to attend church. From the information recorded in the daily care notes it was clear that some staff spent time with people in their own rooms in conversation or offering a hand massage, although this information was not included in the persons care plan nor was it seen as a regular event to be undertaken by all the staff. Some people living in the home said that they were able to follow their own routines and were happy with the lifestyle provided by the home. We saw that people who were able could choose whether to take their meals in the dining room or in their own room. Those who were able, spent time in the homes two lounges or in the conservatory while others chose to remain private. People said they enjoyed the meals and they were of an excellent quality. However, when asked during the morning no one was aware of what the lunchtime meal would be. People said that they werent consulted about whether they wish to have the planned meal at lunchtime and were only aware of what the meal was when they entered the dining room and saw the menu written on the notice board. People said they thought they could have an alternative if they didnt want the main meal but as that would mean waiting they usually went ahead and had what was on offer. People said there was more choice with the evening meal as the meal was written on the notice board and people could make a choice at lunchtime. We observed the lunch time meal which was mostly taken in silence while staff served. When asked about this people said that they did not mix often with the other people living in the home and only came down to the communal areas the lunch. Two people said they had formed a friendship and would take their morning coffee together. The meal offered at lunchtime was homemade beef and mushroom pie with fresh vegetables followed by sponge and custard. People said the evening meal was always a choice of a warm meal and was served about 5 pm: that evenings meal was homemade onion quiche. Menus showed that a varied traditional menu of all home cooked meals was provided. People said they were offered a milky drink in the evenings but only a few staff offered Care Homes for Older People Page 15 of 29 Evidence: something to eat such as biscuits. The home owner was advised that staff must offer people something to eat in the evenings as it was over 12 hours between the evening meal and breakfast, and although people said they thought they could ask for something if they were hungry, they didnt like to as staff were busy and they didnt want to make a fuss. Care Homes for Older People Page 16 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 living at Rosemont can be confident any concerns or complaints they may have will be listened to and taken seriously. Evidence: All the people we spoke with said that they would feel able to raise concerns with the staff or the home owner. A copy of the complaints procedure was displayed in the hallway of the home. The deputy care manager confirmed that a book was available to record peoples concerns and that the home had not received any complaints since the previous inspection in April 2009. The home had received numerous letters and cards of thanks over the past year from family members of people who would previously lived in the home or who were still living in the home. We interviewed three members of staff, all of whom had received at least in-house training on safeguarding vulnerable adults from abuse. Each was able to identify different forms of abuse and describe who they would alert if it was witnessed or suspected. The homes policy on safeguarding adults does not conform to current guidance as it suggests that staff should conduct an investigation into suspected abuse in the first instance: the deputy manager was aware that this needed to be changed and also Care Homes for Older People Page 17 of 29 Evidence: aware that it was social services responsibility to investigate any safeguarding concerns, not the homes. Care Homes for Older People Page 18 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. Rosemont offers a spacious and comfortable home to the people who live there. There are sufficient facilities to meet the needs of those currently living in the home, although the layout of some of the bathrooms could be improved for ease of access by people with restricted mobility. Evidence: People we spoke with told us that the home was usually kept clean and that they found the accommodation very comfortable. During our tour we noted that cleaning was taking place and that there were no unpleasant odours in individual rooms or public areas. The home employs a part-time cleaner, and the home owner confirmed that he is looking to appoint one other member of staff to assist her and to cover days off and annual leave. Rooms are provided over both the ground and first floors with a stair lift proving access. Many of the room are spacious and provided pleasant views over the garden and the valley. The home owner has addressed the requirements made at the previous inspection with regards to potential hazards, such as the trip hazards at the threshold to the kitchen and at the top of the stairs, as well as the risk of the glass breaking in the door leading from the dining room. The home has a number of toilets and bathrooms available over both floors: some of Care Homes for Older People Page 19 of 29 Evidence: the toilets do not have a wash hand basin, however hand cleaning gel was available in each of these. The home had three bathrooms and a shower room: two of the bathrooms had a layout that would be difficult for people with restricted mobility to use, meaning that for the majority of people only one bathroom and a shower room was suitable. We found that the laundry room was being used as a store for clean linen and other items:the home owner was advised to remove these clean items from this room to reduce the risk of cross infection should the home suffer an outbreak of an infectious illness such as Norovirus. Care Homes for Older People Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers to meet the needs of those currently living in the home. Poor recording and administration of staffing records made it difficult to establish whether staff had received the necessary training to ensure their safety and that of the people living in the home. Evidence: People said that the staff were respectful and supportive and they were assisted promptly, indicating that there were sufficient staff on duty. We looked at the staff rotas which indicated the number of staff working in the home each day: there were usually three staff available during the morning, two staff in the afternoon and three staff during the early evening. One member of staff is available during the night with another member of staff on-call. The staff explained that the on-call person was identified on the staff rota, and that all the staff carried a mobile phone with their telephone number should they need to contact them in an emergency. The on-call person stays in a flat adjacent to the care home and is available immediately. We spoke with three care staff, the deputy care manager and the home owner. All demonstrated a thorough understanding of the care needs of people living in the home, and the staff confirmed they had received training fire safety, first aid and moving and handling, however due to poor record-keeping there was no evidence of this in the staff files examined. We examined the staffing records for three staff Care Homes for Older People Page 21 of 29 Evidence: members, one of whom had been recently employed by the home. All three files contained the necessary pre-employment checks, including a Criminal Record Bureau check and two written references, to ensure, as far as possible, only suitable people are employed at the home. Staffing records were not well organised and were held together in a single file which was not sub-divided. There was some evidence of training certificates but this did not represent a complete record of the training for each staff member, nor was there any evidence of planned training for the forthcoming year. The deputy care manager said that the home owner had asked her to review each member of staffs training and identify what training need to be organised. Many of the staff had obtained a National Vocational Qualification in care, or were in training. Newly recruited staff are provided with an in-house induction working alongside an experienced member of staff until they feel confident and are judged as competent to work unsupervised. There was no evidence that staff had been offered a formal induction training programme, such as that available from Skills for Care, a nationally recognised programme for staff new to the care profession. Care Homes for Older People Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements within the home have not been formalised and as such the home owner cannot be sure that care practices within the home provide a safe and consistent service to people. Evidence: Mr Beckhurst, the homeowner, is registered with the Commission as both provider and manager of the service. He is assisted in the management of the home by a member of staff known as the deputy care manager: the care manager identified at the previous inspection is temporarily not available at the home. The deputy care manager is experienced in caring for older people and has worked in the home for many year; she holds a National Vocational Qualification at level IV in Care and the Registered Managers Award: Mr Beckhurst does not hold these qualifications. People living in the home said they felt the home was well run and they had a good relationship with the deputy care manager. Staff also said they had a good relationship with the home owner and the deputy care manager, who works alongside Care Homes for Older People Page 23 of 29 Evidence: staff on a daily basis. There was no evidence, however that staff had been provided with the opportunity to have individual supervision meetings to discuss their work performance and personal development. The deputy care manager explained that people living in the home are consulted from time to time using a questionnaire to ask them their views of the quality of the service. There was evidence that these questionnaires had been sent out in January and August 2009 and results of these were favourable. The deputy care manager was advised to summarise the results and to let people living in the home and their relatives know the results and any actions taken in response. The deputy care manager stated that the home is not involved in any way with peoples finances other than to hold small amounts of cash for safe keeping. Individual finances are managed either by the person concerned, their relatives or other representatives. The records of the money held for each person were examined and found to be accurate. We looked at health and safety issues in the home, including a record of the servicing and testing for the fire alarm system. We saw that this had been routinely undertaken to ensure the system is maintained in good working order. The servicing records for the stair-lift and the hoists were not available at the time of the inspection and the deputy care manager said that she would send copies to be commission following the inspection. Staff training in health and safety issues was not clear. It was not clear during the inspection whether there was a trained first-aider on duty at all times. This was not indicated on the staffing rota. Neither could we establish whether all staff who handle food had received training in food hygiene. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 The Registered Person must 05/06/2009 ensure that each person has a care plan that provides a detailed description of the persons needs and how they are to be met. This is so that staff are clear about the care required and how to provide it. Care Homes for Older People Page 25 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 1 7 15 The Registered Person must 31/03/2010 ensure that each person has a care plan that provides a detailed description of the persons needs and how they are to be met. This care plan must be developed and reviewed with the person it is written about. This is so that staff are clear about the care required and how to provide it. This requirement was made at the previous inspection and the timescale of 05/06/9 has not been met. The timescale has been extended. 2 12 16 The Registered Person must consult with people living in the home about their social interests and make arrangements to enable them to engage in local, social and community activities. 15/03/2010 Care Homes for Older People Page 26 of 29 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 This is to ensure people have the opportunity to participate in meaningful activities of their choice during the day. 3 15 16 The Registered Person must provide meals at times as may be reasonably required by the people living in the home. Due to the length of time between the evening meal and breakfast, people must be offered something to eat in the evenings. 4 30 18 The Registered Person must ensure that care staff receive training appropriate to the work they perform. This is to ensure staff have the knowledge and skills to care for older people. 5 38 13 The Registered Person must 31/03/2010 ensure that all equipment used in the care of the people living in the home is maintained in a safe working order. This relates to the stair-list and hoists. The Registered Provider has been asked to sent copies of the servicing records to the commission. 31/05/2010 19/02/2010 Care Homes for Older People Page 27 of 29 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 12 The Registered Provider should consult with the people living in the home with regard to their religious and cultural beliefs and identify how the home will support people to continue to practice these. The homes policy on safeguarding vulnerable adults from abuse should be updated to conform to current local and national guidance. The Registered Person should reconsider the layout of the bathrooms to make them more accessible for people with restricted mobility. The clean linen stored in the laundry room should be removed to prevent the risk of cross infection from soiled linen. The Registered provider should ensure each member of staff has a training and development assessment and profile. The Registered Provider should ensure care staff new to the home are provided with a formal induction training programme. The Registered Person should formalise the management arrangements in the home to ensure senior staff have a clear understanding of their areas of resposibility to ensure the smooth running of the home and to provide a quality service to the people living at Rosemont. The Registered Person should summarise the results of the quality assurance consultation and provide people living in the home and their families with the results and the actions taken as a result. The Registered Provider should ensure care staff are provided with formal supervision at least 6 times a year, covering all aspects of practice, philosophy of care in the home and career development needs. The Registered Person should ensure that all staff who handle food have been trained in safe food hygiene practices. 2 18 3 21 4 26 5 30 6 30 7 32 8 33 9 36 10 38 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. 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