Care Home: Russettings

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What the care home does well The home is well maintained, clean and well furnished with homely comfortable furniture, fixtures and fittings. Residents are cared for by a well trained team of staff and the interaction between the staff and the residents is good. Residents praised the staff and said they were kind and caring. The medication policies and procedures are safe and regular auditing takes place. Prospective residents are able to visit for the day or have a trial stay to enable them to decide if the home will be right for them. A good range of activities are arranged for residents. What has improved since the last inspection? The home has had more support form regional office including increased visits and support for staff. All residents now have full risk assessments carried out including nutrition and the care plans are regularly updated. The medication procedures have been improved with regular auditing taking place. A new system has been introduced to ensure staff are kept up to date with mandatory training and general record keeping in the home has improved. The home has purchased more profiling beds and pressure relieving mattresses to benefit residents and some new furniture and furnishings have been purchased. A newsletter has been produced which gives information about the home, what is going on and what is planned. Monthly health and safety meetings are held, more audits undertaken and timely action plans developed. What the care home could do better: The provider does need to address the frequent management changes that have happened in the home and try to bring some stability. The home has had numerous managers none of whom have stayed at the home long enough to be registered with the Commission. The AQAA tell us that future plans for the home include: Provide more training for staff, especially qualified nurses and provide appropriate training for the activity coordinator. To recruit more bank staff to reduce the use of agency staff. Arrange more meetings at night for night staff and to increase the number of staff trained to NVQ level. To arrange more outings for residents. Key inspection report Care homes for older people Name: Address: Russettings Mill Lane Balcombe West Sussex RH17 6NP     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: Ann Peace     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Russettings Mill Lane Balcombe West Sussex RH17 6NP 01444811630 01444811932 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.alphacarehomes.com Alpha Care Homes Name of registered manager (if applicable) Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 45. The registered person may provide the following category/ies of service only: Care home with nursing - (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 (OP) Date of last inspection Brief description of the care home Russettings is a care home with nursing registered to provide accommodation for forty-five service users within the category OP (Old age, not falling within any other category). The home is located in Balcombe village, close to local shops. The village is situated between Haywards Heath and Crawley town centres. The home consists of three floors, two of which provide service user accommodation and communal space. Both floors are accessible by passenger lift. The establishment was registered with Care Homes for Older People Page 4 of 28 Over 65 45 0 0 2 0 4 2 0 0 9 Brief description of the care home the current provider in January 2003. Alpha Health Care owns Russettings and the Responsible Individual is Mrs Sian Sobti. The home does not have a registered manager. The current fees range from 775 pounds-780 pounds per week. Extra services, which include hairdressing, chiropody are not included in the fee. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: An unannounced visit was made to the home on 1st December 2009 and lasted five hours. The home does not have a registered manager and the person in charge on the day told us he was an interim manager until a new manager for the home starts in the New Year. Before the visit to the home we looked at all of the information we have received from the home. This included the Annual Quality Assurance Assessment (AQAA) which is a document completed by the home. The AQAA gives the home the opportunity to say what it does well and provide evidence of this. It also gives them the opportunity to say what they feel they could do better and what the future plans for the home are. It tells us how they have dealt with complaints and concerns, any changes to how the home is run and how well they care for people. The AQAA also gives us some numerical information about the service. The AQAA had been completed in good time Care Homes for Older People Page 6 of 28 for the visit and was clear and concise, some of the information has been used in the report. We talked to ten residents and asked them what it was like to live in the home, they were all complimentary about the home and told us the staff were kind, caring and attentive. We also spoke to six staff who work in the home and they told us they were well supported and had enough training to be able to carry out their roles. We looked at information about the residents who live there and how well their needs are met. We looked at other records that must be kept and checked that staff had the skills, knowledge and training to meet the needs of the residents they support and care for. We also looked around the building to make sure it was clean, safe and comfortable. Our last visit to the home was in April 2009, during that visit we made eight Statutory Requirements relating to risk assessments, medication, staff training and record keeping. We checked these requirements during this visit and found they had been met. No requirements were made during this visit. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The provider does need to address the frequent management changes that have happened in the home and try to bring some stability. The home has had numerous managers none of whom have stayed at the home long enough to be registered with the Commission. The AQAA tell us that future plans for the home include: Provide more training for staff, especially qualified nurses and provide appropriate training for the activity coordinator. To recruit more bank staff to reduce the use of agency staff. Arrange more meetings at night for night staff and to increase the number of staff trained to NVQ level. To arrange more outings for residents. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good pre admission procedures and assessments are carried out before admission to ensure identified needs can be met in the home. Full risk assessments are in place to keep residents safe. Trial visits are offered. Intermediate care is not offered at Russettings but respite care is available. Evidence: The Statement of Purpose and Service User Guide for the home was available in the foyer and most residents spoken to said they had seen it at some point. The documents give a clear description of the home and what residents can expect, although they do need updating with the current situation regarding the absence of a registered manager. We looked at the pre admission assessments, assessments and care plans for four residents. The records confirmed that the relevant information had been gathered and Care Homes for Older People Page 11 of 28 Evidence: the assessments carried out before the residents were admitted to the home. All residents have preference charts completed and at the front of their notes these noted the likes, dislikes and personal preferences regarding rising times, bedtimes and whether they would like a male or female carer. When we asked residents about this they told us that the majority of time this is respected. All residents had appropriate risk assessments carried out if a risk had been identified including nutritional risk assessment which were a requirement from the last inspection. Where the need for specialised equipment had been identified such as pressure relief mattresses these were provided. Intermediate care is not offered at Russettings but respite care is available. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have up to date care plans which staff follow to meet identified needs. Residents health is monitored and changes in health and welfare acted on. Medication polices and procedures are safe and robust. Residents are treated with dignity and respect and their privacy is protected. At the time of their death they and their families would be treated with care, sensitivity and respect. Evidence: During our visit we noted that the atmosphere in the home was calm and relaxed and the staff friendly but respectful towards residents. Up to date care plans were in place for all residents, we looked at assessments and tracked them to care plans to see if the needs identified were being met by the staff and the equipment identified as being needed was provided. We could confirm this for the records we saw. Care Homes for Older People Page 13 of 28 Evidence: We could see that the health of the residents is monitored, records made and other professionals involved when necessary. The GP visits the home at a specific time every week and sees all of the residents that need to be seen although they do visit at other times if the need arises. At the front of all records there was a personal preference chart to say what likes and dislikes the resident has, what time they like to get up and go to bed, whether they like a female or male carer, what activities they like, how they like to spend their time during the day, where they like to go on outings and what food they like and dont like. When we asked residents if their preferences were respected they said in the majority of cases they were and if not there was usually a good reason. They were very complimentary about the staff and the way they care for them and told us the home had improved since the new manager had been in place. Records confirmed that audits on care practices and care plans are carried out on a regular basis and action plans compiled where necessary. The staff have a short weekly meeting where any issues that need attention are discussed and an action plan is made with a member of staff being made responsible for carry out whatever task needs to be done, this is checked by the manager. We were told that this had made a difference in the home with staff taking ownership therefore benefiting residents. At the last inspection requirements were made regarding the medication practices in the home. We could see that since then new procedures have been put in place and staff have had extra training. Regular medication audits are undertaken, if any discrepancies or issues are identified an action plan is put into place we saw evidence of this as a recent audit had been carried out some minor issues identified and a timed action plan had already been put into place. The Pharmacist who last inspected the home made a recommendation that the providers check out the legality of the drug cabinet. Since then the home has taken delivery of a new drugs cupboard and is waiting for it to be fitted. Through observation of the staff in their interaction with the residents and by talking to the residents and staff we concluded that if a residents was dying the staff would treat them and their family with care sensitivity and respect. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good activity programme in the home. Residents are encouraged to maintain contact with their family and friends. Residents are offered well balanced home cooked food. Evidence: When we spoke to residents they told us that the routines in the home are flexible they can get up and go to bed when they want to and although mealtimes are set they could eat at other times if they wish. They told us that the preferences they had told the home about are respected. The lounge and the dining room were festive with a decorated Christmas tree in each room. An activity co-ordinator is employed at the home and has arranged an activity programme to try to meet the majority of residents needs. She also carries out one to one activities for those who stay in their rooms either through choice or ill health. Individual records are kept and we could see they are updated on a regular basis. The activity co-ordinator works 5 days a week and arranges activities in the morning and afternoons, sometimes she carries out activities on a Saturday. Regular activities include: one to ones, exercises, quiz, music, arts and crafts, knitting and stories. Care Homes for Older People Page 15 of 28 Evidence: There were many photographs on the notice boards of recent activities including birthday parties to which relatives and friends were invited. Cream tea, Halloween party, Guy Fawkes competition and a fireworks display. There had been a visit from a local nursery who bought cakes for residents. A PAT dog visits regularly and residents told us they enjoyed this. A recent visit from an Elvis impersonator was very successful and the photographs showed that the majority of residents had taken part. Residents also told us that they enjoyed a visit from a Pearly King and Queen who entertained them. Some of the activities for December included presentation of long service awards for staff, a Christmas Pantomime, Christmas Carols sung by some school children and a Nativity Play. The home has produced a newsletter telling residents and relatives about things happening in the home including introducing new staff, forthcoming events, church services etc. At the last inspection we made a requirement that the chef had specific training in nutrition for the elderly residents and residents suffering from dementia. This chef has now left the home and a new one has been recruited who is still going through the induction process. The new chef has the qualifications and previous experience. It will for the home to decide through supervision if any further nutritional training is required. The menus were seen and looked varied and well balanced, residents told us they enjoyed the food and they could always have an alternative meal if they wanted. Snacks are available throughout the day and night, the Chef told us that he had now started stocking Marmite as some residents like a sandwich before going to bed. This does show that residents preferences are being taken seriously. Residents can eat in their rooms or in the dining room. At lunchtime on the day we visited the choice of main meals was turkey with potatoes and vegetables or meatballs followed by sponge pudding and custard. Residents told us they enjoyed it. Staff were noted to help those who needed it with patience and sensitivity. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints procedure enables residents and other people using the service to know that any complaints will be taken seriously and responded to. The homes safeguarding adults procedure and training for staff safeguards residents living in the home. Evidence: The home has a complaint procedure, which is outlined in the statement of purpose and displayed in the home. We could see that complaints are taken seriously and acted on in a timely fashion. When we asked residents they did say they knew how to complain and would feel able to. We looked at the homes procedures for safeguarding residents and from records we could see that all staff have training in what constitutes abuse and are aware of how to raise an alert. Recruitment records also confirmed that appropriate checks and references are carried out before staff work in the home to ensure residents are safeguarded. During the visit we asked staff what they would do if they suspected abuse and they could tell us the correct procedure and said they would not hesitate to report it. The home has two safeguarding alerts open at present both were substantiated, but we were told that they had been completed and that the home was awaiting Care Homes for Older People Page 17 of 28 Evidence: confirmation of this from Social Services. Following the alerts the home put in an action plan to address issues raised. Some of the issues raised were to do with the use of agency staff in the home, we were told that the home was not presently using agency staff. While the safeguarding investigations were going on West Sussex Social Services suspended admissions to the home. The manager told us this had now been lifted. Information on advocacy services is displayed and is accessed if needed. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well maintained and clean environment with their personal possessions around them. They have access to safe and comfortable communal facilities and there are sufficient toilet and washing facilities. Staff have access to specialist equipment to maximise residents independence and to meet health and safety risks that have been identified. Evidence: The home is pleasant, bright has a nice atmosphere and is a safe place to live. The standard of decoration is good and the furnishings including supportive chairs are good quality and homely in nature. We walked around the home and visited residents bedrooms with their permission. All areas were warm, clean and tidy. Bedrooms have been personalised and they looked homely. Residents are able to lock their rooms following a risk assessments. There are kitchenettes on each floor where hot drinks can be made either by able residents or their visitors. The lounge and the dining room had large nicely decorated Christmas trees in them which added to the warm atmosphere. The lounge and dining room are well decorated and had flowers, ornaments and pictures around. There is a large television in the lounge and there is also a music centre with a good supply of CDs. Some of the furniture in the lounge had been arranged to make little separate seating areas rather than one big one although most of the residents who are able to choose Care Homes for Older People Page 19 of 28 Evidence: sit together in the larger seating area. There is a pleasant dining room with plenty of seating for residents there is also a large conservatory off the dining room which some residents like to use. Assisted bathrooms and toilets are easily accessible for residents. The home has a full time handyman who is keeping the home in good order, maintenance records were available and are kept to a good standard, he told us that if he needed equipment or supplies these are available. Policies and procedures are in place for infection control and staff have training for infection control and health and safety. Records in the bathrooms indicated that staff test the temperature of the water before bathing residents to prevent the risk of scalding. A call bell system is in all areas of the home so staff can attend to residents who need help. We asked residents how long they have to wait for the bells to be answered and they told us that they are usually answered promptly. There are well kept gardens which overlook open countryside surrounding the home these are accessible to residents. There is also a large patio area which the conservatory opens on to. The home is suitable for wheelchairs and a passenger lift is provided. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living at Russettings are protected by the recruitment procedures in the home and staff receive appropriate training and supervision so they can meet the needs of the residents living at the home. Evidence: Recruitment policies and procedures are in place to ensure staff employed by the home have the necessary skills and experience to carry out their roles. Criminal record bureau checks and references were seen on file for three members of staff. These checks ensure residents are protected. All new staff have a basic induction and this was confirmed when speaking to a new member of staff who was booked to go on a more intensive induction program in the near future. There is a staff training program in place and a training matrix displayed on the wall showed that when staff are due to have training updates and we saw flyers that had the individual names of staff who were to attend. The staff had 2 days Equality and Diversity training in October 09. We also saw that a staff supervision and appraisal system is in place. The AQAA records that over 50 of the care staff have achieved a National Vocational Qualification of Level 2 and above. Care Homes for Older People Page 21 of 28 Evidence: We asked residents about the staff and they were all complimentary about them all. Some comments were Staff are very kind to me. We are looked after very well here. The staff are wonderful. When we asked residents and staff if they thought there was enough staff on duty to meet needs and we were told they did. Although a number of residents and staff did say they did not like the frequent changes in management although they all said they thought the present manager was very good and were sad that he was not permanent. We were told that there is presently a vacancy for a full time registered nurse, and the deputy managers post is vacant, however when the new manager starts in January the present interim manager will step into that post. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is presently being well managed by an interim manager until a new manager arrives in the New Year. The home is being run in the best interests of the residents and they are kept safe by staff following correct health and safety practices. Record keeping in the home is maintained to a good standard. Evidence: The home has had a number of different people managing the home in the recent past this has led to a number of concerns and problems including a breakdown in communication with other visiting health professionals. This was in the process of being sorted out when we last visited the home in April when a different manager was in place, on that visit we saw an action plan that was being put into place. We were pleased to note that this action plan has continued and the home now has an arrangement with the local GP practice which we were told is working well. Care Homes for Older People Page 23 of 28 Evidence: The present interim manager is a very experienced nurse and manager and staff and residents told us that there had been great improvements in the way the home was run, they said the home and the staff were better organised and residents were kept informed what was going on in the home. Staff said they felt more supported than in the past and we noted that they all looked happy to be working in the home. Unfortunately the manager we met when we visited is only carrying out an interim role until a new manager starts work in the New Year. The Commission hopes that the improvements that have recently been made are sustained during yet another management change. The AQAA was completed in good time and gave us clear information about the home, what improvements they had made and what their plans were for the future. We could see from records that audits are undertaken in all areas of the running of the home including health and safety, fire safety, medication and care plans. This indicates that a robust quality assurance is in place. Some are internal audits and some external. Monthly unannounced visits under Regulation 26 are carried out and reports are made on how the home is operating, these were available for us to see and we noted that where issues are identified these are acted on in a timely manner. Regular residents and staff meetings are held and we saw minutes of these also any action that needed to be taken. We were told that regional managers attend some of the meetings and that they were more high profile in the home than in the past. Staff told us that they thought this was good because someone was overseeing the home, also the area manager does get involved in the supervision of some of the staff. The manager also has weekly meetings where tasks are compiled to make sure all areas of the home are kept clean, tidy and that procedures are followed. We examined records of the administrative systems in the home such as records of systems to keep residents and staff safe and these were in order. The home does not manage the financial affairs of residents and does not handle large Care Homes for Older People Page 24 of 28 Evidence: sums of money. Where small amounts of money is held there are safe systems in place to ensure residents finances are protected, these are audited on a regular basis. The home through the head office has access to professional, business and financial advice and has the necessary insurance cover to enable it to fulfill any loss or liabilities. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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