Care Home: Sedlescombe Park Residential Home

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What the care home does well There is a strong feeling of community and sense of belonging among people living in the home. We observed that people living here expressed concern about the well being or feelings of each other and it was evident some friendships had developed. This is evidence of well being in people with dementia care needs. The home has an ethos of building on people`s strengths and abilities. People are supported to retain their skills which promotes their independence. People`s personal care needs are met and their health is promoted. Medicines are managed safely. Mealtimes are celebrated as a social occasion and people benefit from a varied and nutritious choice of food. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. There are sufficient numbers of staff on duty to meet the needs of people living in the home and training is provided to make sure people are cared for by competent staff. Robust recruitment procedures safeguard vulnerable people using the service. The home is effectively managed and is run in the best interests of people using the service. What has improved since the last inspection? People`s needs are assessed before they move into the home, which should mean people can be confident the home can meet their needs. Care plans are reviewed regularly, which should make sure people`s needs continue to be appropriately met. People have their weight monitored and action is taken when weight loss is detected. This should promote people`s health. Arrangements for the safe storage, recording and administration of medicines has improved which should promote people`s health and well being. The manager has attended training in safeguarding adults and is knowledgeable about his role and responsibilities in responding to allegations of abuse. This should safeguard people. The ground floor bathroom has been repaired and redecorated. Checks are carried out on staff before they start working in the home to make sure they are safe to work with vulnerable adults. This should promote people`s safety. What the care home could do better: We have not made any requirements during this inspection. We have made recommendations to improve some practices. These include reviewing the way individual bedrooms are used for communal use and a review of cleaning schedules to make sure all parts of the home are kept clean. Key inspection report Care homes for older people Name: Address: Sedlescombe Park Residential Home 241 Dunchurch Road Rugby Warwickshire CV22 6HP     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: Michelle McCarthy     Date: 0 7 0 7 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) 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 28 Information about the care home Name of care home: Address: Sedlescombe Park Residential Home 241 Dunchurch Road Rugby Warwickshire CV22 6HP 01788813066 01788813066 sedlescombe@pinnaclecare.co.uk wolston@pinnaclecare.co.uk Pinnacle Care Ltd care home 24 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within other category (OP) 2 Dementia (DE) 24 Date of last inspection Brief description of the care home Sedlescombe Park is a large detached dwelling set in its own grounds, off the main Dunchurch Road in Rugby. The home is approximately 1 mile from the town centre. There is a local bus route into the town along Dunchurch Road. A small range of local shops are near by. The Care Home is registered to accommodate up to 24 older persons with dementia. The accommodation is over two floors accessed via a passenger lift. Accommodation is mostly single rooms with some shared rooms. There are 2 lounges and a large conservatory to the rear of the property, which serves as a dining room. The corridors throughout the home are narrow which could make it Care Homes for Older People Page 4 of 28 24 0 Over 65 0 2 Brief description of the care home difficult for wheelchair users. The front entrance to the home is via two steps but there is alternative access for wheelchairs from the side and back of the home. Gardens to the front and rear of the property are landscaped. A drop off and turn area for cars with a small parking area is at the front of the property. The services provided for service users at Sedlescombe Park are on a personal care basis only for people with dementia. Nursing care is not provided in this home, nursing needs are met by the district nurse services. Fee information included in the service users guide states the weekly fees are between £530 and £630 per week. 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: Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. We visited the home on Tuesday 7th July 2009 between 10.40am and 5.30pm. We did not tell the home we were coming on that day. Care Homes for Older People Page 6 of 28 There were 22 people living in the home at the time of our visit. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records relating to staff recruitment and training and the running of the home. We talked to the manager, the deputy manager and two care staff. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. We looked at their records, such as care plans and risk assessments. We talked to people involved in case tracking and chatted informally with other people living in the home. At the end of the visit we discussed our preliminary findings with the home manager. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Peoples needs are assessed before they move into the home, which should mean people can be confident the home can meet their needs. Care plans are reviewed regularly, which should make sure peoples needs continue to be appropriately met. People have their weight monitored and action is taken when weight loss is detected. This should promote peoples health. Arrangements for the safe storage, recording and administration of medicines has improved which should promote peoples health and well being. The manager has attended training in safeguarding adults and is knowledgeable about his role and responsibilities in responding to allegations of abuse. This should safeguard people. The ground floor bathroom has been repaired and redecorated. Checks are carried out on staff before they start working in the home to make sure Care Homes for Older People Page 8 of 28 they are safe to work with vulnerable adults. This should promote peoples safety. 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 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. People who are considering moving into the home are given information to assist them in their choice of home. People benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: The service users guide has been updated since our last inspection. It gives people relevant information about the services the home provides. One person told us they visited the home before they moved in, another person said their family visited the home on their behalf. This demonstrates that people are given the opportunity to visit to help them choose if the home will be suitable for them. The manager said that it was usual practice for him to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. Care Homes for Older People Page 11 of 28 Evidence: We looked at the care files of two people admitted to the home since our last inspection visit. Both files contained a pre admission assessment of each persons needs and abilities. For example, one persons assessment recorded poor vision and a care plan was developed to support their safe mobility. We saw copies of social workers assessments in peoples care files showing that information about peoples needs were also gathered from other professionals. This means that sufficient information was available so that the home could confirm they could meet each persons needs and develop care plans. 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. Peoples personal care needs are met and their health is promoted. Medicines are managed safely. Evidence: We looked at the care files for three people identified for case tracking. Care plans and daily records were available for each person. Each care file contained details of the strengths and abilities of the person and identified some of their needs. These files were stored in the managers office. A separate document describing the action staff have to take to meet peoples needs was in each persons bedroom, along with daily records. Residents care files were standardised, well organised and documented detailed information about each person. This should mean that staff have good access to information about the needs of people living in the home and the actions they need to take to meet those needs. Care plans were available for most of the identified needs of each person and supplied Care Homes for Older People Page 13 of 28 Evidence: staff with the information needed to make sure the persons needs were met safely and appropriately. For example,one persons care plan recorded, requires encouragement from staff to perform washing and dressing. Staff to offer assistance A care plan for another person described how to move them safely using a hoist. We observed staff following the instructions in the care plan when they moved the person from an armchair to a wheelchair. The service uses a range of risk assessment tools to identify whether people were at risk of falls, poor nutrition and developing pressure sores. Evidence was available that action is taken to minimise any risks identified. For example, a care plan developed for one person identified as having a high risk of developing pressure sores documented, ...has an airflow mattress with hospital style bed to aid pressure relief and prevent sores. Will require her position changing at least 2 hourly whilst in bed. People have their weight monitored regularly; records showed people sustaiend their weight. Peoples records show they are supported to access other health and social care professionals such as GP, optician, chiropodist and district nurses. We spoke to three care staff. They were familiar with peoples needs and abilities, and knew what care they needed. We looked at the way the home manages peoples medication. Medicines are only administered by staff who have received training in the safe administration of medicines. A small, locked room is dedicated for the storage of medicines. The staff member responsible for medicines administration holds the keys on their shift to prevent unauthorised access to medicines. Suitable medicine storage cabinets are fitted, to comply with legislation and a medicines fridge is available. A record of room and fridge temperatures is maintained, showing temperatures are within recommended limits. Medicines are ordered monthly from peoples GPs. Staff photocopy and retain written prescriptions from the GP before they are admitted to the pharmacy for dispensing. This should make sure that staff can check that all medication ordered has been correctly prescribed and no new medication has been added by mistake. Care Homes for Older People Page 14 of 28 Evidence: A monitored dosage (blister packed) system is used and medication is delivered to the home on a monthly basis. Accurate records are kept which means peoples medicine can be accounted for. Medicine audits have been introduced since the last inspection, which means senior staff check regularly to make sure people get their medicines as prescribed. All the controlled drug (CD) balances were correct, accurately recorded in the CD register and stored correctly. We audited the medicines of people involved in case tracking by comparing the quantity in stock against the signatures on the medicine administration records (MAR). These were correct, indicating that medicines had been administered correctly. People living in the home were observed to be treated with respect. For example, personal care was provided in private and residents were spoken to respectfully. It was evident from our observations that the personal care needs of people living in the home are met. People looked cared for; their hair had been combed or dressed and nails were trimmed and clean. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. Care Homes for Older People Page 15 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. People living in the home are supported to maintain their independence and enduring interests which enhances their quality of life. Mealtimes are celebrated as a social occasion and people benefit from a varied and nutritious choice of food. Evidence: The home has an ethos of building on peoples strengths and abilities. This is reflected in the case files of each person where a life history, interests, important relationships and personal preferences are recorded to assist staff in providing person centred care. The strong feeling of community and sense of belonging evidenced at our last inspection has been sustained. We observed that people living here expressed concern about the well being or feelings of each other and it was evident some friendships had developed. This is evidence of well being in people with dementia care needs. The home does not have a planned programme of activities, but staff support people living in the home to participate in activities and plan how to spend their time on a day to day basis, depending on their individual preferences for that day. For example, we casetracked one person with an interest in reading and writing letters. The person told us they liked to walk to the post office and post their letters. A risk assessment Care Homes for Older People Page 16 of 28 Evidence: was undertaken and a care plan was developed to support the person to do this independently. This shows that peoples independence is promoted. Staff spoken to were familiar with the peoples preferences and the type of activities that might engage and stimulate each individual. We observed one person leaving the building several times. On each occasion, a staff member followed and spoke with the person, suggesting other activities they could participate in. This encouraged the person to come back in to the home. Staff were sensitive to the persons desire to leave the building and responded appropriately to respect the persons choice, and avoid anxiety. The home has an open visiting policy. People are encouraged to maintain links with their family, friends and local community. People told us their visitors are made welcome. At 12.30pm staff invited people to have their three course midday meal in the bright, pleasant surroundings of the conservatory dining area. Tables were beautifully set with linen tablecloths and slip cloths which lent a restaurant type experience to the social occasion of people coming together to enjoy their meal. The majority of people living in the home attended the dining room for their meal, although a few people chose to remain in their rooms. People were offered a starter of chicken soup followed by a choice from shepherds pie, vegetable bake or sausage accompanied by peas, cabbage, new and mashed potatoes and gravy. Staff offered each person a choice of meal at the table. People who found it difficult to choose were assisted by staff who brought the meal to them as a visual prompt. The most recent Environmental Health Officers inspection of the homes kitchen awarded a Gold Standard for Food Hygiene in August 2008, indicating very good or excellent standards of hygiene. Care Homes for Older People Page 17 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. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: The home has a formal complaints policy which is accessible to people living in the home and their families. People are encouraged to raise their concerns with the manager. People living in the home were observed to be familiar with the senior staff on duty and felt confident to make requests. This suggests residents would be confident in raising concerns with staff. We looked at the record of complaints and concerns received by the home, which included the action taken by the home regarding each issue raised. The service has received two complaints in the last 12 months. Complaints concerned a failure to notify family members that a care review had been rescheduled and a soiled pad found under the bed in a persons room. Evidence was available to confirm the manager makes a timely and objective response to concerns raised and the outcome is recorded. There has been no other information shared with us since the last key inspection that Care Homes for Older People Page 18 of 28 Evidence: raised any concerns about the service. We looked at the homes policy for responding to suspicion or allegations of abuse. The policy has been reviewed since the last inspection to give staff clear direction about how to respond to suspicion, allegations or incidences of abuse. Records show that staff have received training in recognising and responding to signs of abuse. The manager has attended adult safeguarding training in the last 12 months. It was evident through discussion that he is fully aware of his responsibilities in responding to allegations of abuse and discussed with us the procedure for referring allegations for investigation under local Adult Safeguarding Procedures. There has been one safeguarding referral to social services concerning an allegation of neglect. This was ongoing at the time of our visit. Social services requested the manager undertake an internal investigation. We looked at the managers report for this, which demonstrated a comprehensive investigation had been undertaken. Care Homes for Older People Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from homely surroundings but some parts of the home are not kept clean. Evidence: Accommodation is provided over three floors with lots of narrow corridors and nooks and crannies which a person with dementia may find difficult to navigate. Two communal lounges are available on the ground floor along with a bright and inviting conservatory dining area. We observed that one persons bedroom was being used as a hairdressing salon during the morning of our visit. There was no evidence that this was agreed with the person accommodated in the room. The practice of using individual bedrooms for communal use should be reviewed to uphold privacy. The communal lounges of the home are homely and lived in. Information in the AQAA told us that new armchairs for the main lounge have been purchased since our last inspection. A bar has been installed in one area of the lounge. There are lots of items such as games, dolls, magazines, books and soft furnishings available and easily accessible to people. We observed people pottering around the home freely. Care Homes for Older People Page 20 of 28 Evidence: Decoration in corridors is tired and worn in places. We looked at the bedrooms of the people involved in case tracking. These varied in the quality of decoration and furnishings provided. Some contained matching furniture with carpets and soft furnishings to match the decor. Other rooms were more sparse. People are encouraged to personalise their space with some of their own belongings, so their personal accommodation looked as though it belonged to them. In one persons room the skirting boards and furniture were very dusty and the hand basin was dirty. This does not provide a comfortable environment or uphold a persons dignity and well being. The ground floor bathroom has been repaired and redecorated since our last inspection, which should improve infection control and complies with the requirement made at our last inspection. Information in the AQAA told us a new infection control policy has been introduced in the home which includes improved procedures for managing laundry and washing commode pans. Care Homes for Older People Page 21 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. There are sufficient numbers of staff on duty to meet the needs of people living in the home and training is provided to make sure people are cared for by competent staff. Robust recruitment procedures safeguard vulnerable people using the service. Evidence: There were 22 people accomodated in the home on the day of our visit. The manager told us that three care staff are on duty between 7.30am and 9.30pm and two care staff are on duty overnight between 9.30pm and 7.30am. This does not include the managers full time hours which means he is available to supervise and assist care staff. We looked at the staff duty rota between 13th June and 3rd July 2009 which showed that these satff numbers are consistently maintained. There is a member of catering staff in the kitchen between 8am and 2pm each day to prepare breakfast and the main midday meal. Kitchen staff prepare the evening meal but it is heated and served by care staff. The home has one person undertaking cleaning duties between 9am and 2pm during the week; there are no cleaning staff on duty at the weekends. Care staff undertake laundry duties. The home does not employ administrative staff but has support from the organisations head office for training, payroll and wages and recruitment. Care Homes for Older People Page 22 of 28 Evidence: The home does not use agency staff to cover holidays or unplanned absence such as sickness but relies on permanent staff working overtime. This means that people living in the home have some continuity and are cared for by staff that are familiar with their needs. It was evident from the general appearance of people living in the home and observation of working practices that there are sufficient staff on duty to meet their personal care needs. We observed staff spending time with residents during our inspection visit with lots of friendly discussion about their daily lives. We observed that staff were knowledgeable about peoples needs and abilities and offered appropriate support while encouraging people to retain their independence. Seven of the 14 care staff employed in the home have a National Vocational Qualification in Care (NVQ) at level 2 which, at 50 , meets the National Minimum Standard. This should mean that people living in the home are cared for by competent staff. The personnel files of two recently recruited staff were examined and both contained evidence that Criminal Record Bureau (CRB) checks were obtained and satisfactory references received before new staff members started working in the home. These robust recruitment practices should safeguard people living in the home and complies with the requirement made during our last inspection. Staff training records demonstrate that staff receive mandatory training including abuse awareness, fire safety, food hygiene, manual handling and medication. Care Homes for Older People Page 23 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 effectively managed and is run in the best interests of people using the service. Evidence: The registered manager has been in post for 18 months and is registered with us. He has a BA in Health Studies, has achieved the registered managers award (NVQ level 4) and is experienced in the care of older people. The manager completed the Annual Quality Assurance Audit (AQAA) comprehensively and sent it to us within the timescale we requested. The manager sent us an improvement plan following our last inspection, detailing the actions to be taken to make improvements in the home. We saw evidence that the plan is reviewed against the objectives set. The service has complied with all the requirements we made during our last inspection. Care Homes for Older People Page 24 of 28 Evidence: Improved outcomes for people using the service are evident throughout most of the sections in this report. The service does not hold residents personal monies or valuables for safe keeping so standard 35 is not applicable and was not assessed. Residents are invoiced for additional costs such as hairdressing or chiropody. Records relating to the running of the home are maintained, organised and were easily accessible in the managers office. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. A sample of service and maintenance records were examined and found to be up to date; for example, hoists (for lifting people) were serviced in April 2009 and the fire alarm is tested weekly. Incidents and accidents that happen in the home are recorded and were available for examination. 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 1 2 19 26 The practice of using individual bedrooms for communal use should be reviewed. Cleaning schedules should be developed and followed to make sure that all parts of the home are kept clean. 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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