Care Home: Rutland Residential Care Home

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What the care home does well It was evident from the questionnaires received and from speaking to the people who live in the home, that they were comfortable living in the home, they said they were well cared for, that the facilities the home provided were very good, that their rooms were decorated, furnished and maintained to a good standard; they also praised the quality and portions of food they enjoyed and said they we always asked what they would like to eat. The home provides a comfortable, homely, safe and protected environment for the people who live there. The owners of the home, the designated home manager and staff members clearly understand the personal, health and social care needs of the people in their care and are experienced, skilled and competent in the care of the elderly. The home is to be commended on the good standard of care it provides to the people who live there who expressed their appreciation of the care they receive and the environment in which they live. What has improved since the last inspection? The owners of the home have decided to employ a home manager for the day to day operation of the home, they will still be involved in the day to day running of the service but the home manager will have overall responsibility of the service provision. The designated home manager has applied to the CQC to become the registered manager of the service, has enrolled on a courses for the registered Managers Award and the NVQ 4 in Social Care. The designated manager has made considerable improvements in the documentation used in the home particularly in the care plans, risk assessments, recruitment and selection, supervision and appraisal of staff, staff induction and training, Statement of Purpose, Service User Guide and Health and Safety . Policies and Procedures have been revised and updated including quality assurance and Safeguarding Vulnerable Adults and the Safe Administration of Medication. A review of all fire procedures has been undertaken, a fire risk assessment is in place and all fire alarm, emergency lighting, fire fighting equipment test are undertaken regularly and recorded appropriately. Fire training and fire drills have been implemented and are recorded. What the care home could do better: The service is to continue with the improvements it is making relating to the registration of the designated home manager relating to registration and qualifications. The service is to continue with the review and updating of all documentation and policies and procedures. The service is to recruit permanent members of staff instead of using agency staff. Key inspection report Care homes for older people Name: Address: Rutland Residential Care Home Rutland Residential Care Home 51 Marlings Park Avenue Chislehurst Kent BR7 6RD     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: Susan Meaker     Date: 1 0 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 26 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 26 Information about the care home Name of care home: Address: Rutland Residential Care Home Rutland Residential Care Home 51 Marlings Park Avenue Chislehurst Kent BR7 6RD 01689821560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: mavand@ntlworld.com Mrs Mavis Fleming,Mr Andrew Albert Fleming care home 4 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 who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (CRH - 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 Date of last inspection Brief description of the care home Rutland Residential Care Home is a large, well- maintained, detached house that is sited on a corner plot in a quiet residential area in Chislehurst, close to shops, leisure facilities and has good access to public transport. The interior of the home provides accommodation for four elderly residents in well decorated and furnished en-suite bedrooms; there is also a well-equipped separate bath and toilet facilities on the ground floor. The home has a stair lift to the first floor giving easy access for the residents. The home has a spacious sitting room, a dining room and a well-equipped Care Homes for Older People Page 4 of 26 Over 65 4 0 1 6 1 2 2 0 0 8 Brief description of the care home domestic style, kitchen. The home has a secluded garden to the rear, with a variety of shrubs and plants and a lawn area; there is also a patio with garden furniture easily accessible to the residents and their visitors. There is ample car parking space to the front of the property with an in and out driveway. Care Homes for Older People Page 5 of 26 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 to the home was made on the 10th December 2009. Before the visit we looked at:- Information we have received since the last visit on the 9th December 2008. The Annual Quality Assurance Assessment (AQAA). The AQAA gives the CQC evidence to support what the home says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for the people who live in the home. The views of the people who use the service, their relatives, staff and other professionals who visit the service. During the visit we:Talked with the people who use the service, staff member, the owners of the home and the designated home manager. Looked at information about the people who use the service and how well their Care Homes for Older People Page 6 of 26 assessed care needs are met by the service. Looked at records that must be kept in the home. Checked that the management and staff of the home had the knowledge, skills and training to meet the needs of the people in their care. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements have been made since the last visit. Before the inspection we sent out questionnaires to the service. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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 gives the people who wish to live there good information about the service so they are able to make an informed choice. All the people living in the home have a thorough assessment by a qualified and experienced person from the home, making sure that their assessed personal, health and social care needs can be met by the service. All the people living in the home receive a Statement of Terms and Conditions, a contract, making sure that they understand their rights and obligations. Evidence: Rutland Residential Care Home has a detailed Statement of Purpose and a Service User Guide, that gives clear and concise information about the services they can provide to the individual seeking admission to the service. The Statement of Purpose Care Homes for Older People Page 10 of 26 Evidence: is specific to the home and the resident group they care for, setting out their philosophy, aims, and objectives for the service. The guide details what the prospective resident can expect from the service and gives a clear account of the services it can offer to the people who wish to live in the home. Currently there are four ladies living in Rutland Residential Care Home, all of whom had been referred to the home by local social services. All the ladies living in the home had been assessed by social services as needing residential care and the appropriate documentation had been received and documented in the personal file of each person. Subsequently the designated manager of the home went to the hospitals and assessed the prospective individuals; this was done so that they could be sure that they were able to meet their assessed health, personal and social care needs. The individual, their family and other healthcare professionals were involved in the assessment process; this was confirmed by questionnaires received and from speaking to the people living in the home. Questionnaires received and comments from people spoken to confirmed that they felt that the assessment of need was conducted in a professional and skilled manner, that they felt involved in the decision and that the service could meet their assessed personal. health and social care needs. Prospective residents and their family or representatives are given the opportunity to visit the home prior to making a decision about whether or not they want to live in the home, helping they to understand what it would be like to live there, what their room was like, what facilities the home could offer them and what the food was like. It also gave them an opportunity to meet the management, staff and the other people living in the home. All the people living in the home are provided with a Statement of Terms and Conditions, a contract, this sets out in detail what is included in the fee, the role and responsibility of the provider and the rights and obligations of the individual. This contract is clear and easy to understand and gives a very clear understanding of what people living in the home can expect from the service. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The four care plans seen evidenced that the service could meet their specific assessed personal, health and social care needs. It was also evident that the management and staff of the home treated the people who live there with respect making sure that their privacy, dignity and independence was paramount. The home has good policies and procedures in place for the safe administration of medication, making sure that the people who live in the home receive the correct medication at all times. The people who live in the home and their family can be sure that their last wishes will be respected and undertaken by the home if that is what they have decided. Evidence: Four care plans were, looked at in detail, during the visit to the home, there had been a considerable improvement in the way in which the file was organised. The files Care Homes for Older People Page 12 of 26 Evidence: contained the assessment of need received from Social Services, the assessment conducted by the designated home manager, specific care plans relating to the individuals care needs and how these needs were to be met by staff. One of the people living in the home is deaf and dumb there was a care plan relating to this, mobility was a problem and the care plan reflected how this was to be managed by staff, the care plan also identified that the person enjoyed singing and music. Another person also had mobility problems and there was a care plan and risk assessment appertaining to the use of a zimmer frame. Another person was in a wheelchair, there was a care plan and risk assessment about this issue, also there was one about odeama in the legs and how that was to be managed and that there was a interest in newspapers and doing crosswords. Another person living in the home had care plans and risk assessments relating to panic attacks, anxiousness and confusion and the medication needed to help with these issues. The care plans seen were individualised and were pertinent to the person identifying specific needs, addressing those needs and making sure staff knew how to meet those needs. The service keeps a daily report for each person living in the home, making sure that all their appointments with healthcare professionals are recorded with whatever outcomes, these included visits from or to the GP, District Nurse, optician, podiatrist, dentist and physiotherapist. The personal file of the person living in the home, is a living document with all the information about the person being recorded, signed and dated and complying with the Data Protection Act 1998. The people living in the home said that , they liked living there, that everyone was very kind to them, that they enjoyed their meals and mealtimes and that the food was really lovely. Questionnaires received from relatives also said that the home was a very friendly and that the staff were very kind and that the rooms and food were of a good standard. Another said that they were very please with the way their relative was looked after and that they had no adverse comments to make about the home. There have also been significant improvements in the safe administration of medication, none of the people living in the home self medicate. Prescriptions are taken from the GP to the pharmacy, medication is delivered to the home in weekly dossette boxes with a computer print out of who the medication is for, what the medication is for, the dosage and when to give it, the MAR sheet also states if there are any allergies of if there could be side effects from the medication. The medication and MAR sheets are kept in a locked cupboard and are dispensed by the manager or nurse on duty. The MAR sheets have a photograph of the resident on them thereby avoiding mistakes being made. Care Homes for Older People Page 13 of 26 Evidence: It was evident, during the visit, that the people living in the home were treated respectfully with courtesy, consideration and in a sensitive manner; it was obvious that the management and staff knew the people in their care well. The people living in the home confirmed that any concerns about their personal or health, that they had were listened to and acted upon, but also said they had nothing to complain about as they enjoyed living in the home and that they received a very good standard of care. The personal files of the people living in the home gave information about what was to happen at the time of their death, what arrangements they had made and how the funeral was to be managed, also giving the name of the undertaker. Care Homes for Older People Page 14 of 26 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 service is able to offer, the people who live there, a wide range of appropriate things to do whether it be on a one to one basis or in a group. The people who live in the home are supported and encouraged to keep in touch with family, friends and their local community so that they do not lose touch. The home offers a good choice of meals, snacks and drinks that are healthy and nutritious making sure they have a healthy, balanced diet. Evidence: The four people currently living in the home are supported and encouraged to pursue their interests and hobbies, as identified during the assessment process and recorded on their social care plan. The people living in the home enjoy reading the daily newspaper and discussing topics that interest them. They also enjoy watching television, watching films on DVD and video, reading books from the extensive library in the home, listening to the radio and CDs. The home has a piano in the lounge area and one of the people who lives there likes to play for the enjoyment of the other people living in the home. Care Homes for Older People Page 15 of 26 Evidence: During the nicer weather the people who live in the home like to spend time in the garden, and often have their meals in the garden which is very pleasant and well kept. The home encourages the people who live there to invite their relatives and friends to visit them, making them feel welcome and offering refreshments. The people who live in the home are supported and encouraged to go out to lunch or to go shopping in the local area. The people who live in the home seem to get along with each other and the management and staff very well and this creates a lovely, very friendly atmosphere in the home. The homes management spend time with the people who live in the home, on a one to one basis, talking about the past and discussing general topics relating to their personal, health and social care needs; it was evident that they enjoyed these chats and they felt they could voice any concerns or personal worries knowing such matters are dealt with confidentially. The people who live in the home also felt that any suggestions they made were listened to, discussed and often put into place. The people who live in the home are able to go to the local church if they wish or the local vicar will visit them in the home. They are also able to have some beauty treatments, including hair styling, manicures, as one of the owners of the home is a qualified beauty therapist. The people who live in the home take part in regular armchair exercises these are organised by the manager of the home and the ladies who take part said they really enjoyed these exercises. The home provides a weekly menu that is discussed with the people who live there taking into account their wishes and preferences, light hot and cold snacks and hot and cold drinks, are on offer during the day. The home ensures that the menu is balanced and that they use fresh meat, fish, fruit and vegetables, shopping is done weekly and locally, the service makes sure that the people who live there eat a healthy diet. Mealtimes are a social occasion, and most of the time the owners and the designated manager, eat with the people who live in the home, which maintains the friendly and comfortable ambiance in the home. Care Homes for Older People Page 16 of 26 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 service has protocols in place to protect the people in their care, ensuring that they feel safe and are free from harm. The management and staff are able to access Safeguarding Vulnerable Adults training, and they regularly update this training making sure they are aware of any new guidelines relating to this issue. Evidence: The home has a complaints policy and procedure available to the people who live there, their relatives and representatives, the people spoken to, during the visit, stated that they knew who to go to if they were unhappy about something in the home, they also stated that they have not felt the need to voice any concerns as they were really happy with the care they received, with the staff and management of the home, their accommodation and the meals provided. There have been no complaints at the home since the last inspection, there have been no adult protection investigations and no complaints about this service have been sent to the Care Quality Commission. The people who live in the home, their relatives and friends, their advocates and healthcare professionals have been very complimentary about the services the home provides to the people who live there. The management and staff of the home have a good knowledge of Safeguarding Vulnerable Adults, they have a policy and procedure in place and have access to training for themselves and their staff through the local social services. Care Homes for Older People Page 17 of 26 Evidence: The home has a copy of the local authoritys guidelines relating to the safeguarding of Vulnerable Adults and they are aware of the process they need to follow if an allegation or incident of abuse is made by anyone living in the home. The home also has a policy and procedure relating to Whistle Blowing for the staff, and are aware of what needs to be done when a member of staff finds it necessary to whistle blow. Care Homes for Older People Page 18 of 26 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 provides a clean, comfortable, safe, well maintained, homely place for the people who live there, ensuring that they feel safe and protected at all times. Evidence: This service is in a large family type of house in a quiet, residential area, close to local amenities and services such as the GP, Optician, Dentist and Podiatrist. Currently four people live in the house in single en suite rooms, all of which are decorated and furnished to a good standard, and personalised with photos. ornaments, books, TV and radios. The communal space comprises of two lounges, a kitchen diner, bathroom, laundry and office on the ground floor, these areas are decorated and furnished and equipped to a good standard, these areas are also well maintained by the owners of the house. The house has a lovely garden at the rear of the house and a front garden with parking space for visitors to the home, there is a patio and good quality garden furniture for the people who live in the home and their relatives to use during the nice weather. The home is clean, tidy and free from odours, thereby making sure that the people who live in the home feel safe and comfortable at all times, in a homely and pleasant house. Care Homes for Older People Page 19 of 26 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. The owners of this home, their designated manager and their two agency staff are experiences, competent and skilled in the care of the elderly, and they provide a good quality of care for the people living in their home. The designated home manager is to undertake the Registration process by the CQC, the Registered , experience ans competency to manage the home. Evidence: The home has a written rota, currently the owners live on the premises, they have decided that their son will become the Registered Manager for the service. The designated manager has enrolled for the Registered Manager Award and for NVQ 4 in social care, he has also applied to the CQC for registration. The owners of the home are involved in the day to day running of the home, they are supported by the designated manager and by two agency staff. The owners of the home are very experienced in the care of the elderly as is the designated home manager. The agency staff work as and when required, the home has copies for the agency staff recruitment and selection processes including copies of the application form, two references, proof of identity, POVA and CRB checks and proof of all training undertaken including mandatory training relating to moving and handling, health and safety, first aid and fire training. Supervision and appraisal is to be conducted by the designated home manager and documented on the agency staff personnel file held in the home. Care Homes for Older People Page 20 of 26 Evidence: The designated home manager has reviewed and rewritten the policy and procedure for the recruitment and selection of staff and has set up personnel files for the agency staff employed by the home, there is an intention for the service to recruit there own personal staff in the future. Currently the home does not provide staff training as this is done by the agency, but they are investigating the possibility of setting up a training programme when they begin to recruit staff for the home. The designated home manager will inform the CQC once the registration process is completed and when he has achieved his Registered Managers Award and NVQ 4 in Social Care. Care Homes for Older People Page 21 of 26 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 owners and designated manager of the home demonstrate that they are experienced, have the necessary skills and are competent to effectively manage thieir residential home, thus providing a stable, comfortable home for the people who live there. The designated manager has applied to the CQC for registration , and is undertaking the RMA and NVQ 4 in Social Care, to gain the appropriate qualifications for managing a care home. The financial interest of the people who live in the home are safeguarded in line with regulations. The home complies with health and safety legislation ensuring that everyonr in the home feels safe and protected by the systems that are in place. Care Homes for Older People Page 22 of 26 Evidence: The owners of Rutland Residential care Home have recently appointed a manager. The designated manager is the son of the owners , he has considerable experience of the care industry as he has assisted the owners with the day to day running of the home, the owners will still be involved in the operation of the home but their son will take on the resposibility for the Home. The designated manager has applied to CQC for registration and has enrolled at college for The Registered Managers Award and an NVQ 4 in Social Care. It was evident, during the visit, that the owners, the designated manager and staff member were aware of how the assessed personal, health and social care needs of the people living in the home were to be met. The team are experienced, skilled and competent in the care of the elderly and provide a good service to those living in the home. They have created an open and positve atmosphere within the home making sure that the people who live in their home, their relatives and friends, and staff are comfortable with their aims and objectives and philosophy of the home. The designated manager is to review the homes policies and procedures, the recruitment and selection procedures, quality assurance and the supervision and appraisal of staff. Currently the two members of staff are employed through an agency, all recruitment checks are completed by the agency and copies are given to the home. The designated manager has set up personnel files for both staff members and hias copies of their application form, references, POVA and CRB checks, training records and certificates, employment history and identity check, the designated manager has also set up a supervision and appraisal system and these discussions are recorded on the personnel file. The designated manager is hoping to recruit permanent staff to the home to give a better continuity of care however they have been allocated the same two members of staff by the agency, for the last two months. All financial transactions undertaken on behalf of the people who live in the home, are receipted and recorded in their personal files, the peole who live in the home are encouraged to manage thier own monies and sometimes their family or an advocate will manager their financial affairs. The four people living in the home have a personal pocket money account and all monies and account books are held in a locked filing cabinet in the home. The home complies with current health and safety legislation and provided certificates to show they have the appropriate insurance cover, electrical and gas certificates, fire safety risk assessment and records, the home has insurance with Thames Water to cover the central heating system, plumbing and drains. Accidents and Incidents are recorded correctly and the CQC is informed under regulation 37. The designated home manager has set up a system whereby all fire alarm, emergency lighting, firefighting equipment tests are recorded on a regular basis, in line with health and safety legislation. Fire training is now implemented and fire drills are conducted on a regular basis and are recorded. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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. 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