Care Home: Selly Park Care Centre

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What the care home does well People are provided with meals and drinks which are based on their preferences and needs. It is positive that the company took action after our last inspection to look at ways to support the manager in her role and monitor the service more closely. What has improved since the last inspection? People`s health and personal care needs are now being met, although we found that some gaps in written guidance available to staff might prevent some aspects of people`s care needs being met consistently. Possible risks to the health, safety and welfare of people living at the home are now identified and the home is contacting healthcare professionals, such as GPs promptly when there are concerns about people`s health and well being. People are listened to when they make suggestions for improvement, such as with activities. People are provided with some opportunities to enhance their social well-being Staff are checked for their suitability to work with vulnerable adults before they start work at the home and staffing levels are sufficient staff to meet the needs, numbers and dependency of people living at the home. Staff are provided with training so they know how to safeguard adults from harm and abuse. What the care home could do better: The home needs to continue to look at ways to increase opportunities to enhance people`s social well-being and evaluate the effectiveness of activities on an ongoing basis to ensure they are appropriate and meet with people`s expectations and needs. We found that complaints had been recorded but that steps should be taken to ensure staff are effective in their approach in showing the action taken with complaints and concerns. People are provided with an environment which is clean and safe but which needs more attention to ensure it is homely and well-decorated. The company needs to follow through with its plans to refurbish the home so that people are provided with improved living accommodation. Key inspection report Care homes for older people Name: Address: Selly Park Care Centre 95a Oakfield Road Selly Park Birmingham West Midlands B29 7HW     The quality rating for this care home is:   one star adequate 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: Rosalind Dennis     Date: 2 6 0 1 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Selly Park Care Centre 95a Oakfield Road Selly Park Birmingham West Midlands B29 7HW 01214714244 01214711107 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.schealthcare.co.uk Exceler Healthcare Services Limited Name of registered manager (if applicable) Linda Norton Type of registration: Number of places registered: care home 50 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: 50 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 50 Date of last inspection Brief description of the care home Selly Park Care Centre is a converted Victorian building that has been extended to offer 24 hour care for up to 50 older people with nursing needs. The home is located in a residential area in Selly Park and is within easy access to main bus services from the city centre. There is a large car park to the side of the home. Care Homes for Older People Page 4 of 28 Over 65 50 0 2 9 0 9 2 0 0 9 Brief description of the care home The home offers mainly single rooms, eight rooms are for double occupancy and there are three en suite rooms available. There is level access to the reception area on the ground floor and two lifts provide access between the ground and first floor. There are four lounges of varying size and two dining areas available. There are bathrooms and showers which have equipment to assist people who may have mobility difficulties. People can obtain information about this service from the homes Statement of Purpose and Service User Guide, which are available along with a variety of information in the reception area. The guide notes that fees range from £364.00 to £395.83 pounds per week. The reader is advised to contact the home for up to date information on the fees charged. Inspection reports produced by CQC can be obtained direct from the provider or are available on our website at www.cqc.org.uk. The last key inspection was undertaken on 29th September 2009. 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: one star adequate 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: This inspection was carried out over one day by two inspectors. The home did not know we were going to visit. The focus of inspections we, the Commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. The purpose of this inspection was to assess all key standards - that is those areas of service delivery that are considered essential to the running of a care home - and to establish whether the home has complied with requirements we made at our last key inspection on 29th September 2009. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included notifications received from the home and information sent to us from other agencies. We also looked at the written improvement plan from the service which we had asked for after our last key Care Homes for Older People Page 6 of 28 inspection. We case tracked some of the people we met during the inspection. We also looked at the care for people whose care we had looked at during our last inspection. Case tracking involves establishing individual experiences of living in the care home by meeting them, observing the care and support they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Some people were able to tell us about their day to day life at the home and the support they receive from staff. We also observed staff working so we could see how they interacted with people living at the home. We looked around some areas of the home and observed a sample of care, staff and health and safety records. We spoke with staff during the inspection to establish their views of working at the home and if anything needs to be improved. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 8 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We were not able to fully assess this outcome group as there have not been any new admissions to the home. However, systems to help improve peoples experience of moving in are improving. This should reassure people that the home can meet their needs before they are offered a place. Evidence: There have not been any recent new admissions to the home, therefore at this inspection we were unable to establish individual experiences of moving to the home and look at the processes used for those people. However we saw that the company has the supportive documentation to guide staff to ensure people have their needs fully assessed prior to and on admission to the home. We also saw that the home is making improvements with how people, already living at the home, have their care needs assessed and planned by reviewing the care files for all people currently living at the home, so that any gaps with how people want and need to have their care needs met are identified. Care Homes for Older People Page 11 of 28 Evidence: At the last key inspection we were concerned that people were at risk of not having their needs met due to a lack of skilled and competent staff. At this inspection we find that the home is developing the staff team, which means that people should now be reassured that they will be supported and cared for by staff, who have most of the skills and abilities to meet their needs. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are now being met. However some gaps in written guidance available to staff might prevent some aspects of peoples care being met consistently. Evidence: When we last visited the home we were concerned that people were being placed at risk of not receiving the care they need. This inspection finds many improvements in how the home is planning and providing the care people need although we also identified areas where action still needs to be taken. We found that staff are showing improvements with how they communicate and interact with people. We looked at five peoples care records and saw the home has reviewed and updated care plans, so in most instances they focus more on how care should be given based on individual preferences and needs and provide a greater level of information and guidance to staff and. We saw that possible risks to peoples health, safety and welfare have been identified and the management of reducing the risks documented. For example, for a person who needs a specific type of equipment to help them to Care Homes for Older People Page 13 of 28 Evidence: move there was a care plan and risk assessment in place describing the equipment and techniques needed by staff to support them to move safely. The person told us this always happens, which demonstrates staff follow what is documented in the care plan. For another person we saw staff using equipment to support them to stand which corresponded to what was written in their care plan. We saw a care plan on another persons file explaining how staff should support them if they show behaviours of concern. The plan demonstrated that staff had looked to see if there are any possible factors which might trigger the behaviour and gave guidance to staff on how to re-direct them from that behaviour. However for another person their care plan was quite general and staff told us that they do not have any means for supporting this individual during behaviours of concern, apart from talking to them or removing them from the lounge. They told us about changes which had happened with the persons medicine and that the person is waiting for an appointment with a specific healthcare professional however there was nothing on their care plan to reflect this. We also saw from looking at this persons records that a written record had been made describing they recently had a bruised eye, however there was no explanation for this or evidence showing that this triggered staff to look at possible explanations why this injury had been sustained. We spoke with staff about our findings and they could not provide explanation for this recorded injury. This shows that staff and management need to develop a proactive approach to look at why incidents have happened and what can be put in place to reduce the risk of it happening again. We observed that, for people assessed as being at risk of developing pressure sores they had specific mattresses on their beds and cushions on their chairs, which are designed to reduce the risk of pressure sores occurring and care plans described clearly what staff need to do. We also saw that the home had contacted wound care specialists promptly for advice and to request visits when concerns arose. Although written records of one persons wound had not been reported on for five days, generally we found that staff are keeping adequate written records to show how wounds are monitored. We saw from looking at written records that people in bed were being supported by staff to move their position. At the last key inspection we advised the home that it is good practice to obtain written consent from people prior to photographing wounds. We did not see evidence to demonstrate this has happened but received assurances during our feedback at the end of the inspection that this would be looked at as soon as possible. We saw from looking at peoples care records that improvements have occurred with the monitoring of people at risk of not being able to take enough Care Homes for Older People Page 14 of 28 Evidence: nutrition. Care records also show that the home is contacting healthcare professionals, such as GPs, and speech and language therapists promptly for guidance and when there are concerns about peoples health and well being. We observed people whose appearance reflected what was written in their care plan of how they prefer to look and dress. One person told us how staff support them so they can be as independent as possible with their hygiene needs. We saw that the home has taken action to address dignity issues we identified at the last inspection, should people need wheelchairs to move. We observed one incident during our inspection which meant that a persons requests were not attended to and therefore their dignity not fully respected. The person had been asking for sometime to go to the toilet, at a time when most staff were in a meeting. Staff not in the meeting did not take responsibility to request additional help to assist the person to the toilet. We discussed this during feedback to enable better planning in respect of staff meetings and to provide guidance to staff on procedures to follow. We did not see the same issues at this inspection as we had done at the last inspection in respect of end of life care planning. The company representative told is in their improvement plan how the home is liaising with different organisations regarding end of life care and documentation which could be used to support the process. We looked at the medication records for the people we case tracked and saw these records were up to date and properly completed. Medication is stored in locked trolleys and a locked cupboard so that people are not at risk of taking medication they are not prescribed. We saw written records showing that staff monitor the temperature of the medication fridge and the temperature of the room where medication is stored, which were within the correct temperature range. We found improvements have occurred with the storage of medication which needs to be injected to control blood sugar. Peoples care plans and risk assessments gave clear information about the medication people are taking and any known side effects that staff need to know about. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is currently a lack of evidence to show that sufficient activities take place to provide everyone living at the home with opportunities to promote their social wellbeing or to show that activities are based on what people want to do according to their needs and capabilities. However we view that efforts are being made to improve these opportunities. Evidence: At the time of our last inspection we found there was very little in the way of stimulation and specialist activities being arranged to involve, engage and stimulate people. At this inspection we have found some improvements, most notably with how staff speak with and interact with people, although there remains a need to further develop activities. For one person whose care we had looked at during the last inspection their care plan notes that they enjoy being read to and listening to music and we saw that they now have tapes and a working stereo in their room and observed this being used during our inspection. However there was no evidence in their care plan to suggest this happens regularly. Three other peoples care records showed that some activities are taking place, such as Bingo, religious services and music, although the records did not show a particularly creative approach to promote social well-being for people who, because of their illness are not able to take part in Care Homes for Older People Page 16 of 28 Evidence: group activities or who spend most of their time in their bedrooms. Overall we found written entries made into care records were sporadic and did not provide confirmation that all people living at the home are provided with regular activities, suitable for their needs and abilities, although we view that there are efforts being made to improve. We spoke with a member of staff who has some good ideas for further developing the provision of activities within the home. Written minutes from a recent meeting show that some suggestions from people living at the home for activities have been achieved, although other suggestions have yet to be acted upon. We observed staff serving and giving meals out to people at lunchtime and at tea. Meals reflected peoples preferences and specific dietary needs, such as swallowing and chewing difficulties. We saw that staff have improved how they give support to people who need assistance with their eating and drinking and we heard staff speaking with and encouraging people to eat. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure, which provides people with information so they know how to complain although more work is needed to ensure staff are effective in their approach in showing the action taken with complaints and concerns. Staff are provided with training so they know how to safeguard adults from harm and abuse. Evidence: The complaints procedure is on display in the reception and is also available within the service user guide. The procedure provides people with clear information on the process to follow and who to contact if people want to complain. We looked at the processes used by the home to respond and act on complaints which shows that the process is currently not consistent. For example when the company representative responded to a complaint we saw that there was a good process in place, with the complaint and the action taken recorded. However for two other complaints there was no record of either the outcome or whether the issues raised in the complaint had been resolved. The company representative acknowledged that action needs to be taken to improve on how complaints are dealt with by the home so that all complaints are dealt with appropriately. We saw that it is the intention of the home to re-issue staff with a copy of the homes complaints procedure, which should help to ensure all staff are familiar of the procedure to follow if a complaint is made. We saw from looking at the training plan that staff have received training in Care Homes for Older People Page 18 of 28 Evidence: safeguarding adults from abuse. We have also been informed that training sessions in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards have taken place and are ongoing for staff. The Act oversees decision making on behalf of adults, and applies when people lose mental capacity at some point in their lives or where the incapacitating condition has been present since birth. It is important that staff know how to put the Act into every day practice and the procedure to follow when peoples freedom may need to be restricted. Two staff we spoke with could confirm their role in safeguarding adults who live at the home from the risk of harm or abuse and were able to give a brief overview of the importance of the Mental Capacity Act and how it might apply to their work. 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. The company needs to follow through with its plans to refurbish the home so that people are provided with improved living accommodation. Evidence: At our last inspection we identified that the environment needed more attention and we required the company to inform us of its intentions to re-decorate and re-furbish the home. We received confirmation after that inspection that certain areas of the home were being targetted for refurbishment. This inspection finds that attention is still needed to the environment, which was agreed by the representatives of the company who were present during our inspection. For example in one bedroom there was a notable smell of urine, the ceiling was discoloured and in need of painting. We saw that a mattress, which is used to help reduce the risk of injury if a person falls out of bed, was heavily stained and therefore did not promote a pleasant appearance. We saw wallpaper peeling off in corridors on the first floor and wallpaper which was stained in a bedroom. Bed linen in some of the bedrooms looked sparse and not particularly homely, although we were later informed that new bed linen has been ordered. The only apparent safety issue we saw was where a join between different floor coverings created a potential trip hazard, which had also been identified by the company representatives for action at the time of this inspection. Care Homes for Older People Page 20 of 28 Evidence: Some bedrooms were more homely in appearance and had improved decor to other areas of the home. Overall our findings are that the environment needs considerable attention and ongoing improvement. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff in sufficient numbers to meet their needs and who have been checked for their suitability to work with vulnerable adults. Evidence: At the time of our inspection sufficient staff appeared to be on duty to meet the needs of people living at the home. Apart from one occasion described earlier in the report, people were seen having their needs attended to promptly and there appeared to be close supervision of people who need more attention. All the staff we spoke with viewed that staffing levels are now sufficient on each shift to meet peoples needs. The staffing numbers at the time of this inspection are the same as at the last key inspection when there were more people living at the home, although the dependency of people remains about the same. Our observations from this inspection indicate people are benefiting from the numbers and improved competency of the staff on duty. Some staff spoke with us about their concerns that when more people are admitted staffing levels will not be adjusted. We discussed this during our feedback with the company representatives who assured us that reviews of staffing levels will be ongoing according to the dependency, needs and numbers of people at the home. This should ensure people receive care when they need it. We looked at the process used by the home to recruit new staff and found that all parts of the recruitment process were accurately recorded and demonstrated that preCare Homes for Older People Page 22 of 28 Evidence: employment information, such as references and Criminal Record Bureau Disclosures had been sought prior to these staff working at the home. Two of these staff had evidence of completing a detailed induction when they first started working at the home, for the other staff member this evidence was not present in their file, therefore we were unable to find out if this staff member had actually completed an induction and highlights a need for improved record-keeping. We looked at written records which show the training which has been undertaken by staff and training which is planned. We saw that since our last inspection training has taken place in fire safety, safeguarding adults, infection control, challenging behaviour and we have had confirmation that training about the Mental Capacity Act also took place. We saw that two nurses are intending to undertake a course in wound care. Training records show that most staff have not had recent updates in dementia awareness or pressure area care, which would be beneficial considering the changing needs of people living at the home. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current management arrangements mean that outcomes for people are improving and their health, safety and welfare is being promoted. Evidence: The manager, Ms Linda Norton, is registered with us as the Registered Manager for the home, was not on duty at the time of our inspection. At the start of our inspection we were assisted by the Deputy Manager who demonstrated a good knowledge about the needs of people at the home. We were also assisted by a senior member of staff from another service who is providing support to the manager to improve the home. Two representatives for the company attended during the day and were present when we gave feedback at the end of the inspection. It is positive that the company took action after our last inspection to look at ways to support the manager in her role and monitor the service more closely. We were informed that questionnaires have recently been sent to people who live at the home and their relatives and saw that people are able to give their views during Care Homes for Older People Page 24 of 28 Evidence: meetings, minutes of which show that people are being listened to. We looked at records relating to the management of small amounts of personal monies for three people and saw the process used by the home appeared robust, which should ensure peoples money is held safely. We saw that regular fire drills take place, so staff should be aware of the procedures to follow in the event of a fire. We saw a selection of written records showing that safety checks are undertaken, such as checks on the temperature of hot water, wheelchairs, window restrictors and fire safety checks. We also looked at how representatives of the company monitor quality at regular intervals with monthly unannounced visits, which generally showed improvement in how the service is monitored. 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 12 The home must continue to develop the range of activities, ensuring they are appropriate and meet with individual capabilities including for people who, because of their illlness are unable to participate in group based activities. This is to promote well-being and ensure that the social needs of people living at the home are met. The home should ensure that it shows how complaints have been dealt with. This is to show the action taken to improve outcomes for people and so that the service can learn from any complaints which are made. 2 16 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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