Care Home: Shotley Park

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What the care home does well The home always ensures that people have the opportunity to visit before deciding if they wish to move in. Good contact with resident`s families is maintained and they are kept up to date with what is happening within the home. The home ensures that there are good links maintained with health professionals and this ensures that all aspects of residents health needs are met. Individual written plans of care are in place for each resident and this ensures that staff follows consistent practices when helping people. In discussion held with individual residents they confirmed the following, "staff are very nice and always respectful" "staff are always there when you need them and nothing is of a bother to them" "The home is a nice place to live, you could not get anywhere better" In discussion with relatives they said that the home provided a very high standard of care and always kept them informed of what was happening. A good programme of recreation and activity that takes place both inside and outside of the home is in place for the residents. The building is well maintained, clean and tidy and offers people a nice environment in which to live. The staffing levels on each shift day and night are in excess of the minimum standards and this ensures that staff have sufficient time to care for people correctly. There is a good atmosphere within the home and staff morale is high. The manager and management team follow consistent practices and are always looking at ways of how the service can be improved. What has improved since the last inspection? Introductory days, short break stays and trial periods have assisted in helping people to make a decision to move into the home. Links with health care professionals have continued to be developed and this has resulted in involving specialist nurses who can offer training to staff. An additional recreational coordinator has been appointed for 28 hours per week and this has enhanced and improved upon the range of activities being provided. Polices and procedures for all aspects of the home have been reviewed and developed where appropriate. The staff training programme has been reviewed and a new format of recording is now in place to confirm that staff receive formal supervision on a regular basis. What the care home could do better: The individual written plans of care should contain a little more written detail about work that is being carried out by staff. This level of detail will then support the observed positive practices that are being carried out. A form should be implemented that confirms residents have consented to staff administering their prescribed medicines. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Shotley Park Shotley Park Shotley Bridge Consett Durham DH8 0TJ     The quality rating for this care home is:   three star excellent 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: Clifford Renwick     Date: 0 7 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 30 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 30 Information about the care home Name of care home: Address: Shotley Park Shotley Park Shotley Bridge Consett Durham DH8 0TJ 01207502052 P/F01207502052 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Shotley Park Homes for the Elderly Limited care home 45 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Shotley Park is a former stately home which was built in the 18th Century. The house stands in a parkland setting of 15 acres of trees and meadows. The home provides lovely views of the surrounding countryside. People living at the home are free to make use of the private grounds around the home. The home is registered to accommodate 45 older people. The majority of bedrooms are single occupancy however a few double rooms are also available. The accommodation has been adapted to meet the needs of the people living at the Care Homes for Older People Page 4 of 30 Over 65 45 0 Brief description of the care home home whilst still retaining the overall character and many of the original features of the house. Despite the size of the building the accommodation presents and feels homely. There are spacious south-facing lounges and dining rooms which are well furnished and equipped with televisions. All bedrooms are well lit, tastefully furnished and decorated and there is space for people to bring any personal effects with them. Each bedroom has thermostatically controlled heating, a vanity unit, access to toilets and specially adapted bathrooms. A number of the rooms have en-suite facilities. The home has a shaft lift to the first floor and a stair lift to bedroom accommodation on the second floor. The home endeavours to provide a lifestyle for each resident that satisfies his or her social, cultural, religious, and recreational interests and needs. There are regular visits from a hairdresser, and a therapist who offers aromatherapy and reflexology massage. The fees at the time of inspection were #405.00 and were the same as the Durham County Council contracting rate. There were no top up fees and people were not charged any extra if they contracted themselves. The home has its own transport which is made available to people living there on a regular basis. Care Homes for Older People Page 5 of 30 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: three star excellent 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 quality rating for this service is 3 stars. This means that the people who use this service experience Excellent quality outcomes. The last inspection of this service was carried out in May 2007. Before the Visit: We looked at. Information we have received since our last visit. How the service has dealt with any complaints or concerns. Care Homes for Older People Page 6 of 30 Any changes to how the service is run. The providers view of how well they care for people from information they provided in the annual quality assurance document (AQAA) that they sent to us. The Visit. An unannounced visit was made on the 7th May 2009. During the visits we. Met with the people who live in the home. Spoke with the staff who were on duty. Held discussion with the manager who was present during our visits. Spoke with relatives who were present during our visit. Had lunch with the residents. Observed staff working practices. Looked at information about the people who are receiving support and how well their needs are met. Looked at other records which must be kept in relation to health and safety and staffing. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it was accessible, well maintained, safe and free of any hazards. We also gathered information from looking at, care records to assess how staff support people with their assessed needs. We also looked at the records for the 4 people who are currently receiving a service we refer to this as case tracking. And this involves looking at all of the records for a named individual. We told the manager and the owner what we had found. The people who live in this home prefer to be known as residents therefore this term of reference is used throughout the report. What the care home does well: What has improved since the last inspection? Introductory days, short break stays and trial periods have assisted in helping people to make a decision to move into the home. Links with health care professionals have continued to be developed and this has resulted in involving specialist nurses who can offer training to staff. An additional recreational coordinator has been appointed for 28 hours per week and this has enhanced and improved upon the range of activities being provided. Polices and procedures for all aspects of the home have been reviewed and developed Care Homes for Older People Page 8 of 30 where appropriate. The staff training programme has been reviewed and a new format of recording is now in place to confirm that staff receive formal supervision on a regular basis. 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 9 of 30 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 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A full pre-admission assessment of needs ensures that new residents are offered the right type of care at the home. Evidence: In discussion with the manager it was confirmed that before anyone is offered a place in the home a full assessment of needs is carried out . And in addition to this people are offered the opportunity to have introductory visits to the home. As well as having a trial period of living in the home. This ensures that people have the opportunity to test the service before making any decision to move in. During the assessment process the manager ensures that information about the ethos of the home and the services offered are shared with prospective residents and their Care Homes for Older People Page 11 of 30 Evidence: families. Once the decision has been made to move into the home the manager issues written confirmation to the resident that their assessed needs can be met in the home. From the individual care files that we looked at it was evident that the pre admission assessment was comprehensive and listed when people had visited the home as part of a trial period. The files also confirmed that the families of residents had also been involved in the admission and assessment process. In discussion with families they stated that from the moment the enquiry had been made the manager and staff had involved them with every process of the admission into the home. And they felt that this had helped there relative to settle in. Intermediate care is not provided so this standard was not assessed. Care Homes for Older People Page 12 of 30 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. Individual written plans of care confirm that staff takes appropriate actions to ensure that each residents health and social care needs are met, and in a way that suits them. Evidence: As part of our visit we carried out a process known as case tracking and this involved looking at all care records for four named people. This enabled us to assess the information held on people and also establish what individual care needs people had. And how staff were supporting people. Each person has an individual written plan of care that sets out instructions as to what support someone requires. It offers information about a persons assessed need, what staff intend to do to address this and also what outcome staff hope to achieve. The style and layout of the care plans are easy to read and easily understood by staff which ensures that staff are consistent in their approach. Care Homes for Older People Page 13 of 30 Evidence: Discussion was held with the manager about some of the positive care practices that are in place but not fully reflected in the care plan. For example one person who was previously prone to urine infections has been supported by staff to have a regular fluid intake. And as a result of the support of staff there has been no recurring infections. The care plan for this person requires a little more written detail to reflect how fluids are provided, the amount and also the frequency. Other good care practices are also in place and for one person this relates to their personal appearance and how staff follow a specific way of supporting this person. In discussion with staff they confirmed what actions they carry out to support this person so that they are able to retain as much independence as possible. It is this level of detail that needs to be added to the care plan. This will ensure that the observed positive care practices that are carried out are also documented. It was good to see that individual risk assessments are carried out wherever there has been an aspect of risk identified. At the same time staff encourage acceptable risk taking as part of people following an independent lifestyle. Wherever possible residents and their relatives are involved with their care plans. And steps are in place to ensure that care plans are evaluated monthly and changes are made if necessary. Individual record sheets are in place that demonstrate when someone has been seen by a health professional. And in addition, other records are in place that confirm that staff follow appropriate actions in meeting peoples health needs. The home have good links with a range of other professionals some of whom are, continence advisors, the tissue viability nurse, community nurses, infection control liaison officer and G.P practices. This ensures that residents have access to all services provided by the N.H.S.and ensures that their health needs are kept under regular review. Diabetic screening is carried out on a regular basis and the chiropodist visits the home Care Homes for Older People Page 14 of 30 Evidence: every month and the cost of this is paid for by the registered provider. In addition to this the registered provider also pays for exercise sessions to be carried out three times weekly and has also purchased a range of foot spas for the use of residents. Should someone require specialist equipment such as mattresses and alternating cushions to assist with pressure care, then these are provided. The staff also ensure that appropriate assessments are completed for pressure care and seek advice accordingly if there are any concerns. For those persons who have been assessed as requiring bed rails, a full assessment has been completed, and the rails are visually checked on a daily basis to ensure their safety. In brief discussion with the community nurse who was present during our visit it was confirmed that good links between the nurses and the home have been established. The nurse described the home has being very well managed and a place that offered very good services to the people who live there. Prescribed medicines are administered by staff and they have received appropriate training in the safe handling of medicines. Good systems are in place for the administration, receipt and storage of medicines. Every 6 months a nurse from the G.P practice visits the home to review medicines and this ensures that prescribed medicines are up to date. Though residents have agreed to staff administering their medicines they have not signed a written consent form. This was discussed with the manager who agreed to organise this. At all times staff respect the privacy and dignity of the residents and personal and intimate care tasks are carried out in the privacy of residents bedrooms. Care Homes for Older People Page 15 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lead fulfilling lifestyles through exercising choice and control over how they spend their day. And a planned programme of stimulating activities and events ensure that the residents receive appropriate stimulation. A wholesome, appealing and balanced diet in pleasing surroundings at times convenient to residents contributes to their health and well being. Evidence: Discussion held with residents confirmed that they have the opportunity to exercise their choice in relation to how they spend their day. Some residents prefer to spend time in their rooms and follow their own daily routines, listening to the radio or watching television. The residents said that that it was good that you can choose when to socialise and when to spend time on your own. There are no restrictions on visiting the home and the manager confirmed that they always try to involve residents and their relatives in discussion about developments in Care Homes for Older People Page 16 of 30 Evidence: the home. Relatives are able to have a meal in the home when they are visiting and they are always offered refreshments. For those relatives who visit from outside of the area and wish to stay over, the manager is able to make arrangements for bed and breakfast using local contacts. In discussion the manager stated that there were times that it was felt that the regular residents meetings were not productive even though they continued to be held. What happens now is that there is a yearly meeting held with relatives and this is used to discuss any matter relating to the services. In addition to this the manager has an open door policy and is always available to talk with people should they want to discuss any aspect of the operation the home. There are two recreational coordinators in post and this ensures that a regular and planned programme of activities is in place. The activities programme is organised around peoples interests and abilities and incorporates a range of personal activities, such as cooking preparation and baking. As part of the activity programme outings are arranged and some have included trips to the shops and supermarket, whereby people have the opportunity to purchase their own toiletries. The home have a 7 seater car and this has also been used for outings to the DLI museum, Durham, Holy Island, Weardale outdoor centre and a range of other local places of interest. The home have their own film and book library and also make use of the local library who provide large print books and also audio books. In addition to this large screen televisions and satellite television are provided. A loop system is installed for persons with hearing impairments and this ensures that they can listen to the television. The home also have an aromatherapist and reflexologist who visit twice weekly and as Care Homes for Older People Page 17 of 30 Evidence: previously stated in this report, there are three times weekly exercise sessions. The exercise sessions consist of carrying out Tai - chi from your armchair, so everyone is able to participate if they want to. The home is set in 16 acres of grounds and a range of outdoor garden furniture is available so that residents can sit outside when the weather is good. One resident said that it was nice just to sit outside and watch the squirrels playing. Menus are in place that include a variety of meals based upon residents likes and dislikes and this also includes a range of vegetarian meals. Specialised diets are also catered for. Discussion was held with the cook and this confirmed that they had a good knowledge of what people liked to eat. The cook stated that for those people who needed to have a pureed diet the meal items are blended and served separately on the plate. This ensures that people have the opportunity to enjoy the different flavours of the food being served as well as the meal being presented in an appealing way. For anyone who has been assessed as having additional nutritional needs, naturally fortified drinks and food supplements are used when necessary. All staff are aware of the nutritional risks and have completed a special course on food. Lunch was taken with residents and this was a nice relaxed occasion offering the opportunity to hold conversations while eating lunch. The dining room was nicely set out with tablecloths, napkins and condiments on the tables. The lunch was hot and tasty and the portion was of a good size. The residents were asked what they wanted to eat from the choices available and as well as seeing the food on the heated trolley, there were menus on the table to inform residents of what was on offer at each mealtime. Lunch was unhurried and people took time to catch up through discussion with others who were at the table. In discussion with residents they confirmed that the food is always very nice and there is always a choice of what to eat. One resident stated that you could not find fault with Care Homes for Older People Page 18 of 30 Evidence: the food and that the staff did everything possible to ensure that you enjoyed the meals. Care Homes for Older People Page 19 of 30 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. A clear accessible complaints procedure gives residents and their relatives confidence that they will be listened to and taken seriously. The manager and staff have a good understanding of local adult protection procedures, which helps to ensure the protection of residents from potential abuse. Evidence: The home have appropriate polices and procedures in place that deal with complaints. In addition to this information is made available to all residents and their relatives about how to raise a concern or a complaint. There have been no formal complaints in the last 12 months. Policies and procedures are also in place that deal with safeguarding adults. And all staff have received training in the safeguarding of vulnerable adults procedures to ensure that residents are protected from the potential of abuse. For those residents who have no family support, they are offered the choice of receiving support with managing their finances from the Local Authority. Care Homes for Older People Page 20 of 30 Evidence: Their are 5 people who currently receive this service and this works well as they are kept fully informed of their financial situation. And also receive any support that is needed. The home do not hold any monies for anyone who lives in the home. Discussion held with the residents and also their families confirmed that they had no concerns about the services being offered in the home. They went on tosay that if they did they would raise them with the manager knowing that they would be addressed to their satisfaction. Care Homes for Older People Page 21 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean and hygienic home maintained to a high standard. Evidence: During our visit we looked at all communal areas and also a number of the bedrooms on the ground and first floor. The building is well maintained and in good decorative order and any maintenance issues are addressed immediately by the homes own maintenance person. There were no noticeable defects or safety hazards. Discussion was held with the manager about 4 bedroom doors that were wedged open. The manager has dealt with this appropriately by carrying out an individual fire risk assessment for each room and also by seeking advice from the fire authority. We have received written confirmation from the fire authority that the arrangements put in place by the manager are satisfactory and do not compromise the fire safety within the home. All of the bedrooms that we looked at have been personalised by the residents and this gave them a homely and personal feel. Care Homes for Older People Page 22 of 30 Evidence: Due to the age,design and the status of being a listed building all alterations within the home have been carried out in a sensitive way. This has resulted in retaining many of the period features of the building as well as making each room slightly different in layout. Care Homes for Older People Page 23 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels exceed the minimum standards and ensure that residents needs are met. Furthermore staff receives sufficient training to support them in their work to ensure that residents receive good, consistent quality care. Robust recruitment procedures are in place to prevent unsuitable people being employed, which ensures residents are protected and their welfare is promoted. Evidence: Good staffing levels are in place for all areas of work and this includes housekeeping, catering,recreation and maintenance. Rotas are available to confirm which staff are on duty and at what times and also who is responsible for the management of the home. A range of training is provided for the staff and information provided by the manager confirmed that the home hope to have a full N.V.Q staff trained team by the end of 2009. The manager has links into local clinical nurse specialist teams, which provide training sessions on dementia, control of infection, nutritional assessments and a range of other training. Care Homes for Older People Page 24 of 30 Evidence: In addition to this the home also use a training agency as well as Gateshead college and this ensures that all staff have the opportunity to receive training that is appropriate to their work. A copy of the training programme that runs from May 2008 -2009 was received and this confirmed what training had been completed and also what future training has been planned. Good recruitment processes are in place and this ensures that all of the necessary documentation is received before someone is offered employment within the home. Once someone starts work in the home they are on a 3 month probationary period and they also undergo induction training. Staff turnover is low and this ensures continuity of care to the residents. Discussion was held with someone who had recently commenced work in the home and they stated that it was a good home to work in with good opportunities for training. When they compared this with a home they had previously worked in they stated that this home offered more support and opportunities for personal development. Care Homes for Older People Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced and qualified manager is in post, who manages the service so that it is effectively run in the best interests of the residents. And furthermore procedures are in place to ensure the health, safety and welfare of residents and also the staff who work in the home. Evidence: The manager is experienced and qualified and ensures that her knowledge and skills are updated by continuing to attend training courses. All management staff have recently undertaken training in the Mental Capacity Act and the new Deprivation of Liberty standards. The manager continues to ensure that the service is run in the best interests of the people who live here and carries out evaluations of the service three times yearly. Care Homes for Older People Page 26 of 30 Evidence: The views of residents and their relatives are sought and this assists in developing the service. Good supervision arrangements are in place with all staff having the opportunity to receive formal supervision from their supervisor, with all staff receiving at least six formal supervisions per year. Part of the supervision process also includes observing staff practices. Each member of staff has a supervision file and written actions are recorded to show what developments people need to make. Polices and procedures in the home are reviewed annually and amended accordingly. The home have chosen not to hold monies on behalf of the residents. And as previously stated in this report have assisted those residents without family involvement to receive independent advice and support with their finances from the Local Authority. The manager confirmed that the home have recently completed their third review for the investors in people award that they hold. Records that are required to be kept for health and safety are in place and this includes fire safety. A record is maintained of any accident in the home and also the actions taken. The manager ensures that the standards continue to be improved in the home and was receptive to advice that we offered during our visit. Care Homes for Older People Page 27 of 30 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 28 of 30 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 7 Care plans to contain a little more detail especially for those people whose fluid and food intake is being monitored. Written consent should be obtained confirming that the residents agree to staff administering their prescribed medicines. 2 9 Care Homes for Older People Page 29 of 30 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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