Care Home: Seacroft Care Home

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What the care home does well Seacroft provides a friendly and caring environment for older people. Care is provided on a one-to-one basis in a family atmosphere. Residents are enabled where possible to exercise choice and control over their lives whilst resident in the home. Residents all spoke very positively about their experiences at the home. The family were observed to deliver care with dignity and respect. Residents spoken with felt the care provided respected their privacy and dignity and were very happy with the overall care provided. Residents live in a clean and homely environment, with their private accommodation personalised to suit their taste. What has improved since the last inspection? A Statement of Purpose and Service User`s Guide have been developed for residents and their representatives to reference. A detailed pre-admission assessment has been developed to record all the residents care needs and ensure that they can be met in the home. A detailed care plan and risk assessment has been developed/introduced and the current residents care needs are now recorded on this new format. The family are undertaking a range of training and all are completing a National Vocational Qualification (NVQ) in Care. A number of the homes policies and procedures have been updated and developed. What the care home could do better: A significant amount of work has been completed to ensure that the National Minimum Standards are met. But there still areas required to be further developed such as care plans and risk assessments, or put in place including a menu for the meals provided. Where Requirements have not been made the Owner/Registered Manager was able to evidence work in progress to address the issue or stated these would be addressed and are detailed in the report. Requirements have been made to seek advice from the Environmental Health Department in relation to infection control procedures in accessing to the laundry room. Also from the East Sussex Fire and Rescue Service as to the fire checks to be made in the home, and fire training required for the family to complete. That risk assessments are put in place in relation to the communal areas where a call bell to summon assistance is not in place to protect residents. Key inspection report Care homes for older people Name: Address: Seacroft Care Home 5 Walesbeech Road Saltdean East Sussex BN2 8EF     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: Judy Gossedge     Date: 0 4 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Seacroft Care Home 5 Walesbeech Road Saltdean East Sussex BN2 8EF 01273306339 01273304571 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Beryl Terry care home 3 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: 3 The registered person may provide the following category/ies of service only: Care home only - 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 - OP Date of last inspection Brief description of the care home Seacroft is a large detached family home situated near the A259 coast road in Saltdean near Brighton. The home is currently registered to care for up to three older people with a low level of need. Bedrooms within the home are located on the ground floor and the first floor. The home has a large lounge with dining area on the ground floor, a pleasant sunroom on the first floor and a spacious rear garden. Local shops, transport and amenities are within a reasonable walking distance. The home would not be suitable for wheelchair users. This home is not considered a typical care home as the owner lives in the house with her family. Staff are not employed in the home with family members carrying out all the tasks. Fees at the time of the inspection are Care Homes for Older People Page 4 of 27 Over 65 3 0 Brief description of the care home between £386.00-£400.00 per week. Guide are available to reference. A Statement of Purpose and Service Users Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 uses the term service users to describe those living in care home settings. For the purpose of this report, those living at Seacroft will be referred to as residents. Following the re-opening of the home in 2009 an announced random inspection took place on 19 November 2009 and was an opportunity for the Owner/Registered Manager to update the CQC on the service being provided. Not all the National Minimum Standards were looked at during this inspection, but a discussion was had about systems and practices currently in place and a sample of documents were viewed. An action plan was requested and received to detail work to be completed to address the shortfalls in the National Minimum Standards. The Owner/Registered Manager and with her husband and daughter provide all the Care Homes for Older People Page 6 of 27 care in the home and do not employ any other staff to work in the home. The Owner/Registered Managers daughter is currently taking the required qualifications with a view to become the Registered Manager for the home and is referred to as Manager in the report. During the random inspection it was discussed with the owner that this particular service is not a typical care home, as the Owner/Registered Manager lives in the home with her family, which has made it difficult to undertake an assessment of all the Standards due to the fact that it is a family dwelling. The Owner/Registered Manager stated they wish the home to remain registered as a care home and are currently working to ensure that all the required National Minimum Standards are being met. The Owner/Registered Manager had been asked to complete an Annual Quality Assurance Assessment (AQAA), for the random inspection and some information from which is quoted in this report. This unannounced key inspection took place between 12.30 pm and 13:30 pm on 29 January 2010, over 10:15 and 13:45 on 4 February 2010. The communal areas and all of the residents bedrooms were viewed and a selection of information for people to reference, care records, medication records and health and safety records were inspected and are detailed in the report. Three people were resident and were all spoken with individually in their bedroom. The Owner/Registered Manager is also caring for her elderly mother in the home. The care that all of the residents received was reviewed. The opportunity was also taken to observe the interaction between the family and residents. No residents surveys were sent out on this occasion. Care Homes for Older People Page 7 of 27 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 27 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 27 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. There is detailed information about the home available for residents and their representative to view. Potential new residents are individually assessed prior to an admission to ensure that their care needs can be met in the home. Intermediate care is not provided in the home. Evidence: A copy of the Statement of Purpose and Service Users Guide are available to be read in the home. The Manager stated two of the residents now have a copy of this information and the third will also receive a copy. The documents were read and are detailed. Both documents were in need of some minor changes which the Manager stated would be addressed. A copy of the last inspection report is also available to read in the home. The AQAA details that over the next twelve months a website for the home will also have been developed. The Owner/Registered Manager has confirmed that potential new residents will have Care Homes for Older People Page 10 of 27 Evidence: an assessment completed prior to any admission, and a new detailed pre-admission and assessment format has been introduced to be completed. This is to ensure individual residents care needs can be highlighted and a decision made if their care needs can be met in the home, and to provide the family with information on the care to be provided. A letter will then go to the resident or their representative to confirm that their care needs can be met in the home. A record that the three residents had received this confirmation was viewed. Where possible a copy of an assessment undertaken by the funding authority is received and two of the residents had a copy of this assessment available to reference. Intermediate care is not provided in the home. Care Homes for Older People Page 11 of 27 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 are protected by a detailed individual plan of care being in place, detailing all their personal, social and health care needs, and with supporting risk assessments completed. Medication policies and procedures are in place to protect residents. Evidence: A new detailed care plan format has been implemented in the home. The three residents individual care plans were viewed. All detailed the care to be provided, residents health care needs, dietary requirements, and social and leisure interests. This information would benefit from further development to personalise the care plans and fully detail individual residents preferences as to how the care is to be provided and provide guidance to the family. Two of the residents had a risk assessment completed in relation to falls. The third did not, and assessment information received detailed this resident had a history of falls. This was discussed with the Manager who stated one would be put in place with immediate effect. So a Requirement has not been made on this occasion. Where any risks are identified guidance should be recorded for the family to follow as to how the risks are to be managed. Two of the residents documents recorded they had been regularly reviewed for the third it was Care Homes for Older People Page 12 of 27 Evidence: not applicable. Daily records had not been maintained and this was discussed with the Owner/Registered Manager who stated this would be addressed with immediate effect . So a Requirement has not been made on this occasion.The residents stated they always received the care and support that they needed. Records detailed that residents are registered with a local General Practitioner (GP) and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in the care plans that appointments with or visits by health care professionals are recorded. The residents confirmed that their health care needs were met in the home. The atmosphere of the home was comfortable, open and relaxed and residents are encouraged to remain independent and to exercise choice over their daily lives. The family were observed to deliver care with dignity and respect. The residents stated the care provided respected their privacy and dignity, and they were very pleased with the overall care provided in the home. The AQAA detailed that medication policies and procedures are in place, which includes receiving, recording, storage, handling, administration and disposal of medicine. Residents are supported to self medicate under the risk management assessment framework and lockable facilities have now been provided in the residents bedrooms which can be used for the storage of medication. One of the residents self medicated at the time of the inspection. A risk assessment was in place, but would benefit from further development. This was discussed with the Manager who stated this would be addressed. So a Requirement has not been made on this occasion. Where medication is administered as required further guidance on the administration of this medication should be put in place for the family to follow. The Owner/Registered Manager stated that a pharmacist was due to visit the following week and introduce a new system for administration of medication in the home. Medication is stored in a locked facility and sample of the recording of medication administered was viewed. A list of signatures of family who administer medication was in place. The Manager stated that a new cupboard to store any control drugs had been ordered to meet current storage requirements for control drugs. The recording of the administration of any control drugs needs to be reviewed to ensure that a control drugs book is in place and double signatures recorded. None of the family have undertaken medication training and are awaiting confirmation of places on training in March, June and July 2010. The residents spoken with stated their medication needs were met in the home. Care Homes for Older People Page 13 of 27 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. Where possible residents are enabled to exercise choice in their lives whist resident in the home, residents would benefit from the development of the frequency that social and recreational activities are provided, and residents are encouraged to maintain contact with family and friends as they wish. A varied diet is provided, but residents would benefit from being aware of the choices available at meal times. Evidence: Residents social interests are recorded on their individual care plans. There are games, books, chess, knitting and jigsaw puzzles in the home for residents use. Residents go out with the family and access local activities in the community. There is not a regular plan of activities provided and one resident spoken with stated they would welcome further activities to participate in. This was discussed with the Manager who stated this is an area it is intended to continue to be developed. So a Requirement has not been made on this occasion. Residents are able to have visitors in private at any reasonable time, either in their own bedroom or in any of the communal areas. The residents spoken with who had visitors confirmed there was flexible visiting, that staff are very welcoming and they could see their relative or friend in private if they wished. Care Homes for Older People Page 14 of 27 Evidence: As part of the new assessment information to be completed residents spiritual needs will be discussed. The Manager stated that it will be ensured that residents are aware they will be assisted to meet their individual religious and spiritual needs if they wish. The care and support provided was observed to enable residents where possible to exercise choice whilst at Seacroft. The three residents documentation viewed, the family and the residents spoken with confirmed this. Residents are able to bring pets into the home on a trial basis with a view to being a permanent arrangement if required. A rotating menu is not in place. Meals provided are based on the residents likes and dislikes. Residents spoken with on the first day of the inspection were not aware in advance of the meal to be provided that day. They stated that they did not always know what was being provided, but that they always liked what was provided and the food was very good and there was plenty of it. This was discussed with the Owner/Registered Manager who stated that it would be ensured that a menu is drawn up and residents informed in advance of the meal and options for an alternative to be provided. So a Requirement has not been made on this occasion. Lunch on the day was poached fish, with new potatoes and broccoli, followed by pancakes. Special diets are catered for and the Owner/Registered Manager and her husband have completed basic food hygiene training and the Manager is waiting to complete this training in February 2010. The Owner/Registered Manager is also due to go on further training which will give guidance on providing special diets and menu planning. One resident was observed eating their lunch in their bedroom. Currently all the residents have chosen to eat their meals in their bedroom and it was a relaxed environment taking into account the different length of time that each individual resident would need to finish their meal. Records are kept of food consumed individually by each resident to ensure they are receiving an adequate diet. The residents all spoke very highly of the meals provided. The Owner/Registered Manager stated she would inform the Environmental Health Department that the home had reopened and seek further advice and guidance as to current requirements and act upon these. So a Requirement has not been made on this occasion. Care Homes for Older People Page 15 of 27 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. Policies and procedures are in place to enable residents or their representatives to raise any concerns about the care being provided and to ensure that residents are protected from abuse. Evidence: There is a complaints policy and procedure in place. No complaints had been received since the home re-opened. The CQC have not been made aware of any concerns in relation to the care provided at Seacroft. A copy of the policy and procedure is detailed in the Service Users Guide and was read. All of the residents stated they knew who to speak to and how to make a complaint. That it was an environment where they would feel comfortable raising any concerns and that they felt they would be listened to. The AQAA detailed that there are policies and procedures in place in relation to the protection of vulnerable adults. It was evidenced that a copy of the East and West Sussex County Council, Brighton and Hove safeguarding adults procedures is available to reference in the home. The Owner/Registered Manager has undertaken safeguarding adults training and stated that all of the family are have booked to attend this training between February and April 2010. Care Homes for Older People Page 16 of 27 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 clean and homely environment, decorated and furnished to a good standard. The home ensures that residents private accommodation is equipped to provide comfort and privacy and to meet the assessed needs of those people residing in the home. Evidence: The home is decorated and furnished in a homely style, with a good standard of the decor, carpeting and furnishings. The AQAA detailed that during the next twelve months further improvements planned to provide more mobility aids for the bathrooms. The Owner/Registered Manager is also looking in to the possibility of providing en-suite facilities in all the the bedrooms. There are three single bedrooms on both floors in the home. All the bedrooms were viewed and displayed residents individual styles and interests. All the residents stated they were happy with their accommodation and the facilities in the home. One of the bedrooms has en-suite facilities of a toilet and wash hand basin. Communal toilet, bathroom and shower facilities are provided in the home. Each bedroom has a doorbell which has been fitted, which enables assistance to be summoned when required. All the residents stated that the bell was answered promptly. Call bells are not in place in the communal areas of the home. This should Care Homes for Older People Page 17 of 27 Evidence: be detailed in the Statement of Purpose and Service Users Guide so that potential residents and their representatives are aware of the facilities provided in the home. Supporting risk assessments should also be put in place to protect the residents. The Manager stated that the family are looking at options to provide a call system in the home, but this is not planned to be provided over the next twelve months. The homes telephone system allows residents to make and receive calls anywhere in the home. Residents are able to control the temperature in their own bedrooms. Currently the hot water temperature is controlled at the boiler and not at the outlets accessed by the residents. Regular testing of the hot water temperatures at outlets accessed by residents to ensure it is maintained close to the recommended safe temperature of 43 degrees centigrade is not being carried out and recorded. This was discussed with the Owner/Registered Manager who stated she would seek further advice from the Environmental Health Department as to the requirements in relation to Legionella and the maintenance of the hot water at the recommended safe temperature. So a Requirement has not been made on this occasion. Not all the radiators in the home are covered. The Owner/Registered Manager stated that it is intended to cover all the radiators and that risk assessments have now been put in place. All the residents spoken with confirmed there is adequate heating and hot water in the home. A stair lift is available from the ground floor providing level access to the first floor. There is one large lounge with a dining area on the ground floor and a conservatory on the first floor. There is a well maintained garden at the rear of the home, which has a patio, barbecue and seating area. The Manager stated that there is a policy and action plan in place for managing infection control and that Control of Substances Hazardous to Health (COSHH) information is now held in the home. The home was clean and free from offensive odours at the time of the inspection. The residents stated home was always fresh and clean. The Manager stated that the family are booked to attend training in the prevention of infection and the management of infection control in February 2010. There is good access to protective clothing, liquid soap and paper towels. Recording of routine fire checks that had been carried out in the home had not been maintained. During the first visit to the home there was wedging open of fire doors in the home. The Manager stated she would seek further guidance from the East Sussex Fire and Rescue Service on the wedging open of doors in the home. On the second visit the wedges had been removed and the Registered Manager stated these would not be used again and would be looking to purchase a suitable devise to hold the Care Homes for Older People Page 18 of 27 Evidence: doors open. There is a separate laundry room which is accessed via the kitchen where food is being prepared and cooked. Further guidance should be sought from the Environmental Health Department and acted upon as to measures to be put in place to meet infection control procedures. Care Homes for Older People Page 19 of 27 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 family are being provided with the required training or updates to ensure they have the skills to meet all the residents care needs. Evidence: The home is staffed by the Owner/Registered Manager, her husband and daughter. The Registered Manager stated that there is always between one to three members of the family on duty in the home at any time. All had completed a Criminal Records Bureau (CRB) and a Pova check. A staff rota to detail who is on duty and when is not in place to evidence the staffing of the home. This was discussed with the Registered Manager who has agreed to address this. So a Requirement has not been made on this occasion. The Registered Manager and husband are currently working towards an NVQ Level 2 in Care. The Manager is working towards NVQ Level 4 in Care. Care Homes for Older People Page 20 of 27 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 family has strived to create an atmosphere within the home, which is open, relaxed, homely and caring. Quality assurance systems have been developed in the home to enable ongoing feedback about the care provided in the home and systems are in place to ensure a safe environment for the family and residents. Evidence: Mrs Beryl Terry is the Owner/Registered Manager for the home. She has not completed the Registered Managers Award or NVQ Level 4 in Care. There is a Manager to support the Owner/Registered Manager, who is in the process of completing NVQ Level 4 in care. The Manager stated she has attended training on the Mental Capacity Act and is due to attend training on the Deprivation of Liberty, and that no applications have been made under the Deprivation of Liberty. The Registration certificate should be displayed in the home for people to reference. The Owner/Registered Manager agreed to address this. So a Requirement has not been made on this occasion. Care Homes for Older People Page 21 of 27 Evidence: A quality assurance system has been developed, which will seek feedback about the care provided at the home from residents, relatives and representatives through surveys. Residents would also benefit from the development of residents meetings as another forum to give feedback on the care provided. This was discussed with the Manager who agreed to address this. Feedback from the outcome of the quality assurance process undertaken in the home should then been collated and be available to read with other documentation in the home. The AQAA detailed that policies and procedures are in place, but not all are in place as required and to protect residents and staff. The Manager stated that the homes policies and procedures are currently being written and or being updated and those not yet in place will be. So a Requirement has not been made on this occasion. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible person external to the home. Lockable facilities have now been provided in each of the residents bedrooms, which can be used for the safekeeping of money and valuables. The Manager stated that if they were to hold small amounts of money for any resident, a receipting and recording system was also available to be in place, but was not currently being used. Formal staff supervision does not occur to meet the requirements. This was discussed with the Owner/Registered Manager who agreed to look into ways of providing supervision for the family to ensure they continue to have the skills required to meet the care needs of the residents. The family members training records was viewed and a training matrix has been developed, which will highlight where refresher training is required. Not all the family have undertaken all the required training such as moving and handling, basic food hygiene, infection control, and medication training. But there was evidence of a plan of training to complete or is due to be provided to ensure that they have all received the required training to protect residents. The training records detail that all the family have attended first aid awareness. A first aid box is in the home and the Manager stated she checks this to replace any items as required and a record will be made of any checks made. The Manager has undertaken environmental risk assessments in the home in 2009. Currently none of the family has undertaken risk assessment training. This was discussed with the Manager who stated she has booked for a risk assessment course in May 2009. A sample of records was viewed of regular environmental checks of the Care Homes for Older People Page 22 of 27 Evidence: environment. The AQAA detailed that some the maintenance of equipment and services has been carried out. There were no records to view. This was discussed with the Owner/Registered Manager who stated this would be addressed. So a Requirement has not been made on this occasion. A check of the homes electrical circuits and a certificate issued is not in place. The Owner/Registered Manager stated further advice and guidance would be sought and acted upon to ensure this requirement has been met. So a Requirement has not been made on this occasion. A fire risk assessment of the building was undertaken of the building in 2009. A sample of records was viewed of fire training and fire drills undertaken by staff in the home. Regular checks of the building do not include checks in relation to fire prevention in the home. Currently fire training has been facilitated in the home by the family. A Requirement has been made for further advice and guidance to be sought from the East Sussex Fire and Rescue Department and acted upon as to the checks to be undertaken and the fire training to be provided. A format to record any incidents and accidents which have occurred in the home is in place if required and a procedure to notify the CQC. Care Homes for Older People Page 23 of 27 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 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 21 13 That risk assessments are 28/02/2010 put in place in relation to the communal areas where a call bell to summon assistance is not in place. To protect residents. 2 25 13 That further advice and guidance is sought from the Environmental Health Department as to the infection control procedures to be put in place and acted upon in relation to the washing of laundry in the home. To protect residents and the family. 28/02/2010 3 38 23 That advice and guidance is 28/02/2010 sought from the East Sussex Fire and Rescue Department as to the checks to be undertaken in the home and fire training to be provided and acted upon. Care Homes for Older People Page 25 of 27 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 To protect the residents and the family. 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 26 of 27 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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