Care Home: Rowlandson House

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What the care home does well The manager continues to ensure that people have their needs assessed before moving into the home. This helps to make sure that the home can meet people`s needs and no one is admitted inappropriately. A good range of activities are organised in order to provide stimulation for people. Appropriate staffing levels are maintained that ensures there are always sufficient staff on duty to meet peoples needs. The home ensure that requirements and recommendations from previous inspection reports are addressed. A varied menu of meals and snacks continue to be provided, with different choices available. The building is well maintained and kept in good decorative order. What has improved since the last inspection? Individual written care plans are more clearer and continue to be developed within the home. A daily monitoring document has been implemented and this gives more in depth information as to how somebody spends their day. An activities coordinator has been appointed and the activities plan is more person centred on residents hobbies and preferences. In order to ensure that the residents have a range of interesting activities they can take part in. Photographic menus have been implemented and this assists people in choosing their meals from the varied menu that is in place. The home have responded positively to any complaints that have been made and have also revised their complaints policies and procedures. Refurbishment work has been carried out throughout the home. The homes manager is continuing to access training for staff to ensure that they are kept up to date with good practice. And the manager has gained more knowledge in how to access appropriate training providers. What the care home could do better: The written care plans must continue to be developed in order to ensure that staff are following consistent practices particularly when dealing with behaviours that challenge. When completing the annual quality assurance assessment that has to be submitted to the commission. More detail should be included in the appropriate sections. Staffing files must always contain evidence that full recruitment checks have been carried out when employing people who have been recruited via employment schemes. Key inspection report Care homes for older people Name: Address: Rowlandson House 1 Rowlandson Terrace Ryhope Road Sunderland SR2 7SU     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: Clifford Renwick     Date: 1 1 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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: Rowlandson House 1 Rowlandson Terrace Ryhope Road Sunderland SR2 7SU 01915144125 01915144125 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rowlandson House Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 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 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: 33 Dementia - Code DE, maximum number of places 10 Date of last inspection Brief description of the care home Rowlandson House is a residential care home. It is registered with CSCI to accomodate up to 33 older people. Up to 10 of these people may have specialist care needs due to dementia. It can not provide nursing care. The home has been taken over by a new owner, Rowlandson House Limited, who registered with CSCI in May 2008. The registered manager is Elizabeth Doreen Milner. The home is close by the junction of Villette Road and Ryhope Road, near the city of Care Homes for Older People Page 4 of 29 Over 65 0 33 10 0 1 8 1 2 2 0 0 8 Brief description of the care home Sunderland. It is a victorian terraced property that has been converted for use as a care home. The communal facilities and bedrooms are located over three main floors, accessible by passenger lift and stairs. A small number of bedrooms can only be accessed by stairs, so they can only be used by people who can mange this independantly. Communal facilities on the ground floor include two dining areas and two good sized lounges. There is a small paved parking area at the rear of the property and small garden area to the front. Up to date information about the homes fees and terms and conditions should be sought directly from the homes manager. 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: he quality rating for this service is 2 stars. This means that the people who use this service experience Good quality outcomes. The last inspection of this service was carried out in December 2008. Before the Visit. We looked at. Information we have received since our last visit. How the service has dealt with any complaints or concerns. Any changes to how the service is run. The providers view of how well they care for people from information they provided in the annual quality assurance document (AQQA) that they sent to us. The Visit. An unannounced visit was made on the 11th November 2009. During the visits we. Met with the people who live in the home. Spoke with the staff who were on duty. Held Care Homes for Older People Page 6 of 29 discussion with the manager who was present during our visits. Spoke with relatives who were present during our visit. Had lunch with the residents. Observed staff working practices. Looked at information about the people who are receiving support and how well their needs are met. Looked at other records which must be kept in relation to health and safety and staffing. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it was accessible, well maintained, safe and free of any hazards. We also gathered information from looking at, care records to assess how staff supports people with their assessed needs. We also focused upon looking at the records for the 3 people who are currently receiving a service we refer to this as case tracking. And this involves looking at all of the records for a named individual. We told the manager and the owner what we had found. The people who live in this home prefer to be known as residents therefore this term of reference is used throughout 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: The written care plans must continue to be developed in order to ensure that staff are following consistent practices particularly when dealing with behaviours that challenge. When completing the annual quality assurance assessment that has to be submitted to the commission. More detail should be included in the appropriate sections. Staffing files must always contain evidence that full recruitment checks have been Care Homes for Older People Page 8 of 29 carried out when employing people who have been recruited via employment schemes. 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. The home ensures that people are only admitted after a full assessment of their needs has been completed and they are confident the persons needs can be met in the home. Evidence: In discussion with the manager it was confirmed that a full assessment of needs is completed before anyone is offered a place in the home. The home also ensure that if the placement is being arranged through a care manager then a copy of their assessment is also obtained. The manager stated that the assessment document in use by the home had now been modified due to some previous problems with one person. Whereby full information had not been available during the assessment process. And as a result of this a number of issues had arisen around behaviours that challenge Care Homes for Older People Page 11 of 29 Evidence: and had put staff in a position where they found it extremely difficult to work with this person. The manager stated that they now include as part of their assessment a section that relates to challenging behaviour and whether there are safeguarding issues to consider before offering someone a place in the home. Once a person moves into the home the staff then use the assessment document to formulate an individual plan of care that sets out how a person is to be supported with their assessed needs. The assessments are kept under review and any changes in needs are addressed by staff. The manager also confirmed that recently care managers have started to review and update the initial assessments that they provided to the home. And this is to assess whether peoples needs have changed. And if so to ensure that the manager of the home receives additional support. We looked at three peoples assessment records and found that these contained assessments by the homes manager and information that had been gathered from other professionals involved in the persons care. As noted in previous inspection reports anyone who expresses an interest in wishing to move into the home has the opportunity to visit the home to see what it is like. 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. Though individual plans of care require further development people receive the health and personal care they need from caring staff and medication is managed safely. Evidence: As part of this visit we looked at the care files for three people and we refer to this process as case tracking. This involves us looking at all records that relate to health and care and this assists us in assessing how peoples individual needs are being met by staff. Each person has an individual plan of care that is divided into nine sections and this supported by a risk assessment if any risks have been identified. The care plans and files have been reformatted since our last visit and in their current format are much clearer and easy to follow. Discussion held with the manager confirmed that the care plans are continuing to be developed. Care Homes for Older People Page 13 of 29 Evidence: This is necessary as some work that is being carried out by staff and which relates to assisting people with nutrition and weight management is not as fully detailed as it could be.Amd also where staff are working with people who have behaviours that challenge morde detail is needed. The risk assessments have been colour coded by the staff as a way of identifying any high risks and where action may need to be taken quickly by staff to minimise these risks. For one person who wishes to retain some independence and bathe themselves staff have implemented a risk assessment to support this. And for another person who presents behaviours that challenge staff have implemented comprehensive recording systems and strategies to deal with this. The style of the care plans and how they are written has ensured that the plans are personal centred and unique to each individual. This is continuing to be developed for each resident. To support the care plans and to give staff additional information to assist them with their work. Personal information about a persons previous lifestyle and background history has been updated for each person. This information is used to assist in planning some aspects of the care and also how people wish to be supported on a daily basis. Records are available are to confirm that residents have the opportunity to access all NHS services. And this confirmed when a resident sees the G.P. or other health professional. Anyone who is prone to falls is monitored on a daily basis and staff complete an assessment tool. If someone is then deemed to be at high risk then an appropriate referral is made to the falls assessment team. We looked at records that relate to receipt, disposal and administration of prescribed medicines and these were being managed satisfactorily. Each persons medicines administration records had a photograph of the resident on Care Homes for Older People Page 14 of 29 Evidence: them and having photographs on these charts is important. As it helps staff identify people and reduces the risk of medication being given to the wrong person. Discussion with the manager confirmed that people who are responsible for administering medicines have all received training in the safe handling of medicines. Two people are currently prescribed medicines that are termed as controlled drugs and the records that are used to record this are in good order. The controlled drugs register accurately reflected the stock of controlled drugs that are used. At the time of our visit none of the residents were responsible for administering their own medicines. 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. The residents are supported to exercise choice and control over the lives and maintain contact with relatives and friends. A well balanced and wholesome diet ensures that the residents receive food that is both nutritious and which they enjoy. Evidence: The home have recruited a person in the role of activities coordinator and they are responsible for organising activities and outings for the residents. A double bedroom on the ground floor has been converted to a memorabilia room and is furnished and equipped with a range of items from bygone years. This included war time identity papers, old tins, household implements such as irons and a range of other items. In discussion with the manager it was confirmed that that this room is used by residents when they take part in craft sessions and also for holding informal discussions with residents. All of the residents have free access to this room and able to spend time in the room Care Homes for Older People Page 16 of 29 Evidence: whenever they wish. Some of the recent craft sessions that residents have taken part in included making small wooden trains and money boxes from kits. The residents then painted these so that they could be used as decorative items. A list of the activities that were planned for the week were on display in the main entrance lobby. And these confirmed that an activity was available for each day of the week. At the time of our visit here was a musical session carried out in the morning and in the afternoon a game of bingo took place in the main lounge. The residents have the option of whether to partake in activities or not. Arrangements were also in place for a number of the residents to go to the theatre to see Scrooge. And two Christmas parties had been booked as well as arranging for a school to come into the home to carry out a Christmas Carol service. There have been some outside excursions to Mowbray Park and also to take part in ten pin bowling. In discussion with the manager it was confirmed that the home are able to access appropriate transport for outings and this ensures that people who may have a physical disability also have the opportunity to go out. The manager stated that the home had recently formed an activities committee which is attended by two residents family members. And plans are in place to improve upon the activities programme and develop more fund raising events. It was good to see that staff have procedures in place to support people with their choices. For example one person always likes to have an alcoholic drink at lunchtime and this is arranged. In addition to this the person likes to retire to their room after lunch to have a lie on their bed and listen to radio 2 and this again is supported by staff. There are no restrictions on visiting the home and the residents are able to maintain Care Homes for Older People Page 17 of 29 Evidence: contact with their friends and relatives. A four week menu plan is in place and this is developed on a seasonal basis. A variety of meals are offered and residents choices are incorporated into the menu. Lunch was taken in the dining room with the residents and this was a pleasant experience. Tables were nicely set with tablecloths and cloth napkins, the main dish of meat was served on the plate and the vegetables were served in tureens so that residents could choose the amount they wanted. Each table was also provided with their own jug of gravy. Drinks were available throughout the meal and as previously stated for those who wished an alcoholic drink was available with the meal. The home have photographic menus which depict the meals offered in the home and these are used by staff when sitting with people who have a cognitive impairment to establish what they would like to eat. For those persons who required some assistance with eating their meal this was provided by staff in a discrete and professional manner. The mealtimes was unhurried and relaxed and enabled the residents to take part in conversation whilst having their meals. And the food itself was well presented, hot and tasty with additional portions being available if people wanted extra food. 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. Robust policies and procedures are in place that ensure residents are protected from abuse and an effective complaints procedure ensures that their legal rights are protected. Evidence: The home have appropriate policies and procedures in place that deal with complaints and staff have been instructed in how to address any concerns that are raised. In discussion with the residents they confirmed that they had no complaints but if they did they would inform the staff. Records are kept of any complaints made and evidence is available to demonstrate that these are dealt with promptly. There has been one formal complaint since our last visit and this was dealt with by the home and the social services in order to reach a satisfactory outcome. There are policies and procedures in place that deal with safeguarding adults and since our last visit there has been one safeguarding alert. This was dealt with by the home and other agencies and resulted in an action plan being issued by social services to the home. Care Homes for Older People Page 19 of 29 Evidence: Most of the points covered in the action plan have now been addressed and the manager has organised appropriate training for staff in safeguarding adults. All staff in the home are currently enrolled on a 12 week distance learning course on safeguarding adults and additional training has been sourced from the Local Authority and this will take place in March 2010. In terms of ensuring the safety of one resident and minimising risks a Deprivation of Liberty Order has had to be obtained and implemented for this person. This involves placing restrictions on the person in terms of going out of the home. The records confirmed that all of the necessary steps had been followed and the manager had involved other professionals in applying for this order. Care Homes for Older People Page 20 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 home is maintainted to a good standard making Rowlandson House a homely, pleasant and comfortable place for residents to live in. Evidence: During our visit we looked at all communal areas and some of the residents bedrooms. The home was clean and tidy, free of any noticeable hazards and there were no unpleasant odours. Good housekeeping standards are in place. Refurbishment of all areas of the home have been taking place since our last visit and this has included decorating residents bedrooms and renewing some of the furnishings. The entrance hall stairwells and hallways have been decorated. Work is currently being carried out in preparing a safe seating area to the front of the home in what was once a garden area. Work has still to be completed in this area. In discussion with the manager it was confirmed that refurbishment will continue to be carried out in the home as part of an ongoing rolling programmer of maintenance. 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. Staffing levels were satisfactory ensuring consistency of care for people living at the home. A staff development and training programme is in place to ensure that staff are equipped with the skills and knowledge required for their roles. However not all staff files contain all required pieces of information to help protect the people living at the home. Evidence: Since our last visit there has been a large turnover of staff with many of the current staff being newly employed. The manager confirmed that this had not had a negative effect on the home and recruiting new care staff had had a positive impact on the home. It had also enabled the manager to recruit people with a variety of skills and experiences that would assist in developing the services in the home. Staffing rotas confirmed that there were sufficient care staff on duty on each shift to meet the needs of the residents. Care Homes for Older People Page 22 of 29 Evidence: There are also sufficient housekeeping and catering staff on duty on each shift. We looked at staff files for all new people who had been recruited in the home since our last visit. Robust records are in place to confirm that when the home recruit staff all of the required information is obtained and this includes a criminal record check. This is done to prevent unsuitable people being employed. The records were in good order with the exception of one person who had been recruited via an employment back to work scheme. Though it was assumed by the manager that the agency who provided the worker had completed all of the necessary employment checks. There was no information on the persons file to confirm this. This was discussed with the manager who was advised by us that the employment record for this person needed to include sufficient information to confirm that all of the necessary checks had been completed. In discussion with the manager we spoke about staff training and the manager confirmed that most staff have achieved NVQ training at various levels. The manager and 11 of the staff as well as kitchen staff have undergone a 12 week distance learning course on dementia. And a 12 week distance learning course on safeguarding adults has also been accessed for staff. As previously stated in section 16 - 18 of this report a safeguarding adults training course has been sourced from the Local Authority and will take place in March 2010. 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 managed by an experienced and qualified person who ensures that appropriate systems are in place to ensure the health and safety of the people who live and work in the home. Evidence: Discussion took place with the manager throughout our visit and also the owner who was present during most the visit. The manager is experienced and qualified and is in receipt of the NVQ Level 4 in care and also the Registered Managers Award. It was positive to note that when arranging training courses for the staff team the manager has also undergone the same training in order to keep updated with best practice. Care Homes for Older People Page 24 of 29 Evidence: The owner confirmed that he visits the home at least 4 times weekly to offer support to the manager. And as part of building upon the management team in the home the manager has appointed a person to fulfill the role of deputy manager. As well as having some shifts whereby the deputy manager and manager overlap, the deputy manager also is in charge of the home in the absence of the manager. Staff described the manager as being approachable and operating an inclusive style of management whereby everyones ideas on how the service could be developed were taken into account. The deputy manager stated that though she was new in post she had settled in well and was enjoying her work. As part of the ongoing quality assurance within the home the manager has met with all of the senior staff to ensure that they are aware of the polices and procedures and follow the correct guidance in the absence of the manager. The manager is carrying out formal supervisions of all staff and at least one supervision session solely focuses upon safeguarding adults to ensure that staff are kept up to date with their practices. The owner and the manager are carrying out regular audits to ensure that standards continue to be developed in the home. As well as visiting the home on a weekly basis the owner also compiles a report each month on how the home is performing and sets objectives with the manager. Where required the home holds small amounts of money on behalf of the residents and records are kept that confirm that this is dealt with appropriately. In addition to this secure and safe facilities are in place for the storing of monies and valuables. We looked at accident records and these are well maintained and contain good detail of how staff deal with any accidents in the home. Five staff have received updated training on first aid and this has assisted them in maintaining their skills and updating their knowledge. We also looked at the fire log book and the records that are kept in relation to fire drill and fire instruction training. These confirmed that staff take part in appropriate fire Care Homes for Older People Page 25 of 29 Evidence: drills and receive fire instruction training. An external company checks the fire alarms systems and doors and records are available to confirm when this has happened. And appropriate contracts are in place for the servicing of the lift and other equipment that is in use within the home. Care Homes for Older People Page 26 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 27 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 1 7 15 The care plans must continue 31/01/2010 to be developed so that they contain more detailed information about staff are offering support. This will ensure that staff are following consistent practices when supporting people. 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 29 The manager should ensure that when staff have been recruited from any employment agency schemes that confirmation is received that all of the necessary documentation has been obtained to confirm that they are suitable to work in the home. Steps should be taken to ensure that staff receive ongoing training in dealing with behaviours that challenge. 2 30 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. 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