Care Home: Shalom

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What the care home does well There is detailed information about the home for prospective residents and their relatives or representatives to reference prior to any admission to the home. The staff team were observed during the inspection to ensure that the privacy and dignity of residents is respected at all times. The care and support provided was observed and detailed in residents individual care plans to enable residents where possible to exercise choice whilst at Shalom. Residents are protected by a detailed individual care plan being in place which is regularly reviewed. The home provides residents with a homely, relaxed and caring environment. Residents are enabled where possible to exercise choice and control over their lives whilst living in the home. All the residents spoken with were happy with the overall care provided. What has improved since the last inspection? No Requirements were made following the last inspection. What the care home could do better: No Requirements have been made following this inspection, as where further work is required the Manager stated this would be addressed. Risk assessments for residents who go out from the home independently should be developed and in place to protect residents. The recording of the recruitment process should be developed to fully evidence the process followed. Care workers as well as providing care to the residents also undertake domestic and laundry tasks in the home. This should be kept under review to ensure that the care needs of the residents continue to be met. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shalom 8 Carew Road Eastbourne East Sussex BN21 2BE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judy Gossedge     Date: 2 1 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 27 Information about the care home Name of care home: Address: Shalom 8 Carew Road Eastbourne East Sussex BN21 2BE 01323410926 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) : cjmcmeekin@aol.com Mr David McMeekin,Mrs Sandra McMeekin care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 18 The registered person may provide the following categories of service only: Care home only(PC) to service users of the following gender: Either whose primary care needs on admission to the home is within the following category:old age ,not falling within any other category (OP) Date of last inspection Brief description of the care home Shalom is a three storey detached property in a quiet residential area of Eastbourne. It is situated close to the town centre and is within walking distance of the shops, train station and local bus routes. There is a garden surrounding the home. The home is registered to provide care and accommodation to eighteen older people and is an established family run business. There are eighteen single bedrooms, all with en-suite facilities. There is a communal lounge and dining area on the ground and first floors, in addition to an adequate number of communal bath and toilet facilities. The home has added a stair-lift from the ground to the first floor to allow ease of access. Residents on the second floor will need to be mobile. Care Homes for Older People Page 4 of 27 Brief description of the care home At the time of the inspection fees ranged from 390.00 to 470.00 pounds per week with additional costs for hairdressing, chiropody, personal toiletries and newspapers and magazines. The Statement of Purpose, Service Users Guide and a copy of the last inspection report are available to view in the home. 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 Shalom will be referred to as residents. Since the last inspection an Annual Service Review has been completed. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection. The Provider had been asked to complete an Annual Quality Assurance Assessment (AQAA), this was detailed and information from which is quoted in this report. Care Homes for Older People Page 6 of 27 This unannounced inspection took place over five and three quarter hours on 21 May 2009. A tour of the premises took place to look at communal areas and a selection of residents bedrooms and care records were inspected. Seventeen people were resident and seven were spoken with individually in their bedroom, two in a communal area and a number were spoken with as part of the inspection process. The care that four of the residents received was reviewed. The opportunity was also taken to observe the interaction between staff and residents in the communal areas. Seven residents surveys were sent out and all were returned completed. Two care workers; the cook/care worker, the Manager and the deputy manager were all spoken with. Four care workers surveys were sent out and all were returned completed. 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 set out 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 available for residents and their representatives 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: The Statement of Purpose and Service Users Guide were read during the inspection and were both detailed. The AQAA details that these documents can be made available in different formats to meet individual residents needs and that residents have their own copy of the Service Users Guide to reference. Six of the residents surveys stated they had received enough information about the home and one did not, but commented, recommended by a friend in the past. One new resident spoken with confirmed they had been visited by staff from the home, they and their representative had had the opportunity to visit the home in advance of their admission and had Care Homes for Older People Page 10 of 27 Evidence: received enough information about the home. The AQAA details that a pre-assessment is carried out prior to any admission. This is to ensure individual residents care needs can be met in the home and to provide staff with information on the care to be provided. A detailed pre-admissions format is in place, and for two new residents admitted to the home since the last inspection there was detailed pre-admission information viewed, which had been completed. For both the residents there was also a copy of an assessment carried out by a care manager from the local authority. The deputy manager stated that a letter has now been drawn up and is being sent to prospective residents to confirm that their care needs can be met in the home. 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, where all their personal, health and social care needs are identified at the start of their stay, and which informs staff of the care which needs to be provided. Supporting risk assessments are recorded. Medication policies and procedures are in place to protect residents. Evidence: Four of the residents individual care plans were viewed. These were detailed and gave clear guidance to staff of the care to be provided, residents health care requirements, dietary needs, and social and leisure interests. Daily notes are maintained and these provide an effective tool for care plan reviews. Detailed supporting risk assessments were also viewed and where there are any identified risks the recording detailed how these will be managed. All these documents had been reviewed. Where residents go out independently from the home a risk assessment was not in place. This was discussed with both the Managers who stated this would be addressed with immediate effect, so a Requirement was not made on this occasion. The four staff surveys stated Care Homes for Older People Page 12 of 27 Evidence: they always received enough information about the care to be provided. Comments received were, I can always go through the care plan or anything that I need. The most important information like who have to drink more or things like that are available to view in the staff room, and regular team meetings, monthly, supervision two monthly, appraisal annually and one to ones when required. The home maintains and promotes residents health and helps them access health care services to meet their needs. Records viewed evidenced residents are registered with a local General Practitioner (GP) and have access to other health care professionals, including district nurses, via the surgeries. The home uses the Waterlow scoring system for identifying those at risk. Five of the residents surveys stated they always received the medical support they needed and two usually. The AQAA details the home has a policy for the handling of medication which includes receiving, recording, storage, handling, administration and disposal of medicine. Residents are able to self medicate under the risk management assessment framework. None of the residents self medicated at the time of the inspection. Medication is stored in a locked cupboard, and a sample of the recording of medication administered was viewed. Changes to the requirements for the storage of control drugs was discussed with both the Managers, who stated they will seek advice to ensure current storage arrangements were adequate. The Managers stated that a pharmacist regularly visits, the records of the visits were not viewed on this occasion, but that no actions had been required following the last pharmacists visit. Some medication was being kept in a refrigerator, which is not locked. This was discussed with the Manager who arranged for the medication to be removed and stated that a risk assessment would be completed in future, so a Requirement was not made on this occasion. The care worker spoken with confirmed they had received medication training and for the other it was not applicable. Residents spoken with individually felt that their medical care needs were met in the home. The staff was observed to deliver care, which maintained the residents privacy, dignity and respect. All the residents spoken with individually felt the care provided respected their privacy and dignity. Three residents surveys stated they always received the care and support they needed and four stated usually, and all stated staff act and listen to what they say. 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, there are opportunities to participate in social and recreational activities provided, residents are encouraged to maintain contact with family and friends as they wish and a varied diet is provided. Evidence: The AQAA details that over the last twelve months there has been an increased number and choice of activities provided in the home with two staff acting as activities co-ordinators. That over the next twelve months it is planned to continue to develop the range of activities provided, to facilitate more time for staff to provide activities and to enable staff to undertake training in facilitating activities. Records have been developed which detailed a four week activity plan is in place and records of activities individual residents had participated in. A sample of these records were viewed. One resident spoken with was planning to run a quiz in the home for all the residents. Residents social interests are recorded on their individual care plans. Some of the residents spoken with stated they did not always wish to participate in the activities, some went out with family and friends and two residents stated they were not aware of what activities were planned which they could join in. This was discussed with the Care Homes for Older People Page 14 of 27 Evidence: deputy manager who stated she would review how residents are made aware of the activities. That there had been a period in the home when a number of the residents had not wanted to participate in the activities provided, but that as new residents come in to the home staff are trying to encourage increased participation. Three residents surveys stated there were always activities arranged and four stated usually. One commented, I am not a joiner, but there are plenty of entertainment. The outcome of the homes own quality assurance undertaken detailed when asked about activities the response from residents was varied. The care and support provided was observed to enable residents where possible to exercise choice whilst at Shalom. The four residents files viewed, observations on the day, staff and the residents spoken with confirmed this. The cook was spoken with, who works five days a week, with a second cook covering the weekends and she stated she holds a basic food hygiene certificate and that there are good opportunities for attending training. A rotating menu is in place with three choices available including a vegetarian option, from which residents are asked daily to select their choices. Staff and residents all confirmed if residents do not like what is on the menu there are always a range of alternatives which can be provided. Special diets are catered for. The meals are freshly cooked on site. All the residents spoken with stated they enjoyed their meals. Records are kept of food consumed individually by each resident to ensure they are receiving an adequate diet. Three of the residents surveys stated they always like the meals provided and four usually. One commented, the food is very good. The outcome of the homes own quality assurance undertaken detailed when asked about the food and drink provided that residents were either satisfied or very satisfied. The home has dining areas on both the ground and first floor, and some residents prefer to take their meals in their own rooms. The deputy manager stated that since the last inspection practices have been reviewed to ensure that food taken to the rooms is covered. Snacks and drinks are available at any time, with sandwiches available during the evening if required. 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 detailed complaints policy and procedure in place. The AQAA detailed that sixteen complaints had been received at the home during the last year. The homes complaints book was viewed during the inspection and the sample of complaints viewed demonstrated that complaints are recorded and any actions taken to address any issues. The CQC have not directly been made aware of any concerns in relation to the care provided at Shalom. Three residents surveys stated they always knew who to talk to if they were unhappy and two usually, and all knew how to make a complaint. Comments received were, I have not been here long but so far no complaints, and management very helpful. All the staff surveys stated they knew what to do with any complaints received. The AQAA detailed that there are policies and procedures in place in relation to the safeguarding of vulnerable adults. Training records viewed evidenced staff had received safeguarding adults training. The one care worker spoken with confirmed they had attended this training and demonstrated an awareness of the policies and procedures, for the other it was not applicable. One incident was investigated under Care Homes for Older People Page 16 of 27 Evidence: safeguarding adults procedures. The CQC had been notified of the incident, but not that it had then been investigated under these procedures. This was discussed with both the Managers to ensure the CQC is notified as required. Care Homes for Older People Page 17 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 room. Evidence: The AQAA detailed there is an ongoing maintenance programme. That over the next twelve months it is planned to further improve the decor internally and externally and a business plan has been drawn up detailing the proposed improvements. A tour of the building was made. The home is decorated and furnished in a homely style and generally all areas were well maintained. There was some staining on the ceilings in the home. The deputy manager stated this was due to roof repair work which is required and that this was due to be addressed. There are eighteen single bedrooms on all floors in the home. A number of bedrooms were viewed and displayed residents individual styles and interests. All bedrooms have an emergency call bell system and the AQAA detailed that options are being considered to replace this over the next twelve months with a new system. All of the bedrooms has an en-suite facility of a toilet, wash-hand-basin and either a bath or Care Homes for Older People Page 18 of 27 Evidence: walk-in shower. The AQAA details all these have had a new flooring fitted in the last year. Communal bathroom facilities are provided in the home. All the residents spoken with confirmed there is adequate heating and hot water in the home. A stair lift has been installed between the ground and first floor, and residents will need to be mobile to access bedrooms on the top floor. Residents have access to a garden and also to a covered porch, which provides seating. There are two lounges and dining areas for residents to access in the home. The AQAA details that there is a policy in place for managing infection control and that Department of Health Guidance has been used to assess current infection. The home was clean, although there was evidence of an odour in a couple of areas. This was discussed with the deputy manager who stated she would address these issues and that a carpet shampoer has been purchased to help remove any odours. The AQAA detailed that staff receive yearly infection control training. Feedback from the residents surveys was that the home was always or usually fresh and clean. One commented, if one has to be in a care home it could not be better. Feedback on the day from residents was that they felt their rooms were kept clean and tidy. Staff confirmed that there was good access to protective clothing, liquid soap and paper towels. The AQAA detailed that over the last twelve months further improvements have been made with infection control boxes containing the necessary equipment having been placed strategically in the home where required. There are laundry facilities in the home, and laundry is undertaken by the care workers. Generally residents were happy with the laundry service provided. Some comments were received that shirts and blouses can be creased as are not always returned to residents ironed after washing. Recording was viewed of routine fire checks that had been carried out in the home. 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. There are recruitment policies and procedures in place to protect residents. Staffing levels should be kept under review to ensure residents care needs continue to be met. Care workers are provided with the required training or updates to ensure they have the skills to meet all the residents care needs. Evidence: Staff rotas were viewed. On the day the Manager had been on duty during the morning, and the deputy manager was on duty during the afternoon. The Manager returned to the home during the inspection. Three care staff were on duty during the morning and two during the afternoon. Agency staff are not used in the home. A cook is on duty each day. Domestic and laundry tasks are undertaken by the care workers,and this should be kept under review to ensure that all the residents care needs continue to be met. At night the home deploys one waking night member of staff and both the Managers stated that staffing levels in the home at night is kept under review to ensure that all the residents care needs continues to be met. There are on call arrangements for staff to access if required. The AQAA detailed that eight of the twelve care workers holds an NVQ Level 2 in care, which equates to 57 of the staff team and a further 14 of care workers are working towards this qualification. That one care worker is working towards NVQ Level Care Homes for Older People Page 20 of 27 Evidence: 3 and three are working towards NVQ Level 4. The AQAA detailed that new staff working in the home had satisfactory preemployment checks. The documentation was viewed for four new members of staff, who had been recruited since the last inspection. All demonstrated the completion of an application form, had two written references, and had completed a Criminal Records Bureau check (CRB) and a Pova First check. The deputy manager stated that all these checks are completed prior to a member of staff commencing work or being inducted and introduced to residents in the home. The recording of the recruitment process did not always evidence when references were received, and the start date for workers. This was discussed with the deputy manager who agreed to improve the documentation to fully evidence the process followed. A sample of staff documentation was viewed and all had had a CRB check completed. The AQAA details that induction training for new members of staff is in place, which meets the requirements of the General Skills for Care induction standards. Three new care workers documentation viewed recorded that an induction had been completed. One care worker spoken with confirmed they had completed an induction and a new care worker confirmed they were in the process of undertaking their induction. All the care workers surveys stated the induction covered everything very well. Care Homes for Older People Page 21 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 Managers have strived to create an atmosphere within the home, which is open, relaxed, homely and caring. Quality assurance systems in the home enable ongoing feedback about the care provided in the home and systems are in place to ensure a safe environment for staff and residents. Evidence: The home is a family run business; the provider is the Registered Manager and his daughter the deputy manager. The Manager has a management in care qualification to Level 4 which is compatible with National Vocational Qualification Level 4 in care and also holds the Registered Managers Award. The AQAA details that the deputy manager has now completed NVQ Level 4 in health and social care and is working towards the Leadership and Management Award. There have also been further training opportunities which both the Managers have attended. Feedback received was that the running of the home was open and transparent and there were opportunities for staff, Care Homes for Older People Page 22 of 27 Evidence: residents and their representatives to affect the way in which the service is delivered. A quality assurance system is in place. It was evidenced that feedback about the service provided has been sought from residents through residents meetings and surveys. Minutes from staff and residents meetings were viewed and it was evident that both groups are given the opportunity to influence how the home is run. The deputy manager stated that following discussions with the residents a residents meeting have not been held recently, but a letter has been sent to all the residents with a view to restarting this forum. Feedback from the outcome of the quality assurance process undertaken in the home has been collated and is available to read in the home. The AQAA detailed that policies and procedures are in place and that these have been reviewed. 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. The home does not get involved with the financial arrangements of residents and neither does it hold any monies or valuables for safekeeping. When items are purchased on behalf of residents the cost is added to the monthly invoice. Supervision for care staff is in place. A plan for supervisions to be completed during the year and a sample of the records were viewed, and staff spoken with confirmed they received supervision. Three of the care workers surveys stated they regularly and one often meets with manager, and one commented, supervision every two months. Training records were viewed, and staff spoken with confirmed they have received the required training/updates in moving and handling, basic food hygiene, first aid and infection control within the required timescales. The Manager stated that there is an ongoing rolling programme for training and updates of training. All the care workers surveys stated yes to training being provided, and one commented, we can pretty much attend what training we wish, and another I just started working and I am already going for courses to more understand the individual needs of the residents. A detailed check of the environment had been completed. This was dated June 2008, but detailed this was due to be completed every three months. The deputy manager stated that this would be addressed with immediate effect. The AQAA detailed that the maintenance of equipment and services has been carried out. There were records of testing of the hot water temperatures at outlets accessed by residents to ensure these are being maintained at close to the recommended safe temperature of 43 degrees centigrade. Where the records had indicated the temperature was higher, this was discussed with the Manager who stated that work had been undertaken to address this Care Homes for Older People Page 23 of 27 Evidence: when identified. A fire risk assessment is in place, which recorded that it has been reviewed in the May 2009. Records were viewed of regular checks of the fire procedures in the home. Records viewed evidenced staff had been provided with fire training. Staff spoke with confirmed that had completed this training. A sample of recording was viewed of incidents and accidents, which had occurred in the home. Care Homes for Older People Page 24 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 25 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 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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