Care Home: Somerset Nursing Home

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What the care home does well People are not admitted to the home if their needs cannot be met. People said they received care in a way that respected their privacy and dignity. Specialist equipment is available in the home so people`s special needs can be met. Key workers and named nurses are allocated to people so they can spend some dedicated time with them to help people settle into the home and monitor their health and wellbeing. An excellent range of activities are provided to meet people`s preferred social needs. Food being provided looks appetizing and nutritious. People said " The food is good". Management make sure that staff receive the training they need. Some people living in the home help to interview prospective staff this helps people feel involved in this process. People spoken with said the staff very friendly, one person commeneted " I have a named nurse and a named carer, the girls here are super, I could not wish for nicer." Staff and visitors spoke highly of the manager comments received included " The manager is absolutely wonderful, she listens to us". What has improved since the last inspection? Medication is recorded when it is given and there are no gaps on the medication administration records. Balances of medications being received are recorded to make sure that stock control can take place. Safety information about the cleaning chemicals being used around the home is available on the cleaner`s trolley and these items are not left unattended, this helps to protect people. Hand sanitizing products have been gained by the home and these are now available for people to use to help infection control for visitors to the home. Fire training is undertaken regularly to make sure that staff are aware what action they must take to help protect people. Repairs have been made to some broken tile`s in the kitchen and the fly screen has been repaired to make sure that food safety is maintained. What the care home could do better: Pre admission assessments should be signed and dated to make sure that it is known when the information was gained and by whom. Care profiles for all people must be kept current and up to date to make sure people`s care neeeds are known and being provided. Risk assessmants for all people must be completed timely and these documents must be reviewed monthly or when people`s needs change.Eye drops should have the date they were opened recorded so that staff are aware when these need to be discarded.Products which have to be placed in people`s drinks to thicken them to aid safe swallowing should be signed for on the medication administration record(MAR). The management team must look at how the serving of meals can be undertaken swiftly and effectively, to make sure people are not having to wait for their drinks and deserts for a long period of time. Management must undertake an audit of the dependency levels of people living in the home and look at how staffing levels at the home can be improved at peak times of the day such as mealtimes, to make sure that people receive the services they need timely. Currently fifty percent of care staff do not hold the National Vocational Qualification in Care at level two or three. Staff should continue to work towards achieving this. The manager should continue the process to become the Registered manager for this service by attending her fit person`s interview. She should commence a management qualification to help her develop her manegerial skills. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Somerset Nursing Home Somerset Nursing Home 1 Church Lane Wheldrake York North Yorkshire YO19 6AW     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: Denise Rouse     Date: 1 9 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 28 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 28 Information about the care home Name of care home: Address: Somerset Nursing Home 1 Church Lane Somerset Nursing Home Wheldrake York North Yorkshire YO19 6AW 01904448313 01904448022 somerset@rochehealthcare.co.uk 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) : Roche Healthcare Limited care home 46 Number of places (if applicable): Under 65 Over 65 0 46 0 dementia old age, not falling within any other category physical disability Additional conditions: 46 0 46 The maximum number of service users who can be accommodated is: 46 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 - Code OP; Dementia - Code DE, Physical disability Code PD Date of last inspection Brief description of the care home Somerset Nursing home is a care home for older people providing personal & nursing care for up to 46 people. The home is situated in the village of Wheldrake, approximately 8 miles from the centre of York, there are 14 elderly persons bungalows within the grounds of the home. The business is owned by Roche Healthcare Limited. Care Homes for Older People Page 4 of 28 Brief description of the care home The home provides both single and shared accommodation on two storeys and has a passenger lift. The range of fees charged are from social services rates to private rates of £645.00 per week for residential care and £745.00 for nursing, minus the Registered Nurse Care Contribution. Fees include all services apart from hairdressing, dry cleaning, reflexology, newspapers, chiropody and private taxi hire. Information is available in the form of the homes brochure, service user guide, statement of purpose and last inspection report. This helps people to make an informed decission about if the home is the right place for them. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. The evidence used in this report has includes: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment, AQAA. Information received from surveys completed by eight people living at the home, three Care Homes for Older People Page 6 of 28 staff and one health care professional. An unannounced visit to the home which lasted seven hours and ten minutes, undertaken by one inspector. Evidence gained by direct observation during the site visit. This involved speaking with people living at the home. Speaking with the manager and staff from all departments, visitors and a general practitioner visiting the home. Inspection of records, including care profiles, medication administration records, staff files and some of the homes policies and procedures. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. But only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will take place. What the care home does well: What has improved since the last inspection? What they could do better: Pre admission assessments should be signed and dated to make sure that it is known when the information was gained and by whom. Care profiles for all people must be kept current and up to date to make sure peoples care neeeds are known and being provided. Risk assessmants for all people must be completed timely and these documents must be reviewed monthly or when peoples needs change. Care Homes for Older People Page 8 of 28 Eye drops should have the date they were opened recorded so that staff are aware when these need to be discarded.Products which have to be placed in peoples drinks to thicken them to aid safe swallowing should be signed for on the medication administration record(MAR). The management team must look at how the serving of meals can be undertaken swiftly and effectively, to make sure people are not having to wait for their drinks and deserts for a long period of time. Management must undertake an audit of the dependency levels of people living in the home and look at how staffing levels at the home can be improved at peak times of the day such as mealtimes, to make sure that people receive the services they need timely. Currently fifty percent of care staff do not hold the National Vocational Qualification in Care at level two or three. Staff should continue to work towards achieving this. The manager should continue the process to become the Registered manager for this service by attending her fit persons interview. She should commence a management qualification to help her develop her manegerial skills. 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are offered a place in the home so that peoples needs are known and can be met. Evidence: People are assessed before they are offered a place in the home. The assessment is undertaken by staff who are experienced and competent in assessing peoples needs. Information is gained from care managers,discharging hospitals and the persons relative or representative to make sure all necessary information is gained. One pre admission assessmant was not signed or dated, this should be undertaken to make sure that it is known when the information was gained and by whom. A place is only offered to people if staff can meet the persons needs. Prospective residents are invited to spend some time at the home before making a decision about if the home is the right place for them. Information is provided in the Care Homes for Older People Page 11 of 28 Evidence: statement of purpose,service user guide, homes brochure and last inspection report to help people understand what the home has to offer them. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are known and are met. However some care profiles for some people require updating to reflect peoples full and current needs. Peoples privacy and dignity is protected. Evidence: Care profiles for three people were inspected for two of the three the information was relevant, person centered and had been reviewed monthly. For the third person there were issues with care plans and risk assessmants and other care documentation that had to be addressed at the time of the site visit. Management must make sure that all care plans and risk assessmants are detailed enough, falls risk assessmants and waterlow monitoring forms must be completed timely, and they must include all necessary detail to make sure staff are fully aware of peoples needs. care documentation must be reviewed monthly or as a persons needs change. The manager knew that there were some shortfalls in some care records and had started to address this issue but not all of the files had been completed by the time of the unannounced site visit. The management team must audit the care files to make sure Care Homes for Older People Page 13 of 28 Evidence: that there are no shortfalls and action must be taken to address any shortfalls promptly. Health care professional attend the home so that people get the medical support they need to maintain their health. One general practitioner visiting the home was spoken to they spoke highly and positively about the home and the care that was given to people who live there. People living at the home said their privacy and dignity was respected. Staff addressed people by their preferred names and knocked on bedroom doors before entering. Medication systems operating in the home were generally robust. However eye drops should have the date they were opened recorded so that staff are aware when these need to be discarded. Also products which have to be placed in peoples drinks to thicken them to aid safe swallowing should be signed for on the medication administration record(MAR). Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social needs are met. People have access to good home cooked food, however the meal time service requires reassessment and action to be taken to make sure people receive their meals timely. Evidence: All people who were case tracked had social care plans in place and these had details of peoples preferred activities. The activity co-coordinator asks people what they would like to do and undertakes one to one activities as well as group activities. A weekly programme of activities is produced so that people know what is available to them. People can follow their chosen daily routines and say when they would like to get up and go to bed, this helps to protect peoples individual rights and choices. People are encouraged to keep links with their family and local community. Relatives are helped by the staff to take their loved ones out and relatives are invited to stay for meals at the home. Family pets are welcomed. One visitor spoke at length with the inspector about how they felt valued by the staff at the home and how they had been supported by the staff after their loved one had been admitted to the home. They only Care Homes for Older People Page 15 of 28 Evidence: had praise for the staff, they had also been asked to help at Christmas by being Father Christmas and had loved to be included in this and had Christmas Day with their loved one and thoroughly enjoyed it. People can attend the local Womens Institute and visit the local shops and pubs.Dominos and whist are available as well as quizes and board games. Trips are undertaken and one occurred on the day of the site visit to a garden center.On some outings those who go out shop for others in the home and bring them things back so that everyone feel included in the outings. The activities co-coordinator has a shop in the home which allows people to buy a few items themselves. There was a nature table and quiz in the hall and a Spring display in the conservatory which was to be replaced by a summer display, this helps to prompt peoples memories about nature and the seasons. A newspaper review is held on Mondays to discuss issues, this is a group activity and this is also undertaken as a one to one activity in peoples bedrooms if people want to take part in this. People who do not wish to join in with activities and who prefer to spend time in their bedrooms are visited by the activity co-coordinator to have a chat or have a one to one activity. This help make sure that people do not feel isolated and that their social needs are being met. There is a record kept of all social activities undertaken by each person. Outings have been undertaken to the Theater to see the Good Old Daysto a pantomime, to Lotherton Hall and to an art museum. There are plans to take people to the sea side this year. Musical entertainers also visit the home. Reminiscence occurs for people who have dementia, which can help stimulate peoples memories. Peoples religious needs are known and are met. Bible study class is held once a month, the local vicar visits and holds a service every fortnight and Holy Communion is held once a month. A Hairdresser and Chiropodist also visit the home to provide this service for peoples convenience. The kitchen staff surprised the residents and staff with an unannounced special early Christmas event, the conservatory was decorated for Christmas and Christmas dinner was served. People who took part in this really enjoyed this event.Theme days occur, there is to be a French Day held shortly. Special occasions such as Valentines Day, birthdays and anniversarys are celebrated. Easter was celebrated with special decorations and people had easter eggs and cakes with chicks on them. Garden parties are held and there is to be a Summer Fayre later in the year. People have access to home cooked nutritious food. The kitchen staff know peoples Care Homes for Older People Page 16 of 28 Evidence: special dietary needs and these are catered for. The choice of food is advertised outside the dining room. People were asked what they would like to eat. People who needed assistance were helped by patient staff who assisted people in an unhurried manner. However there was meant to be a 12.00 to 12:15 start for serving lunch to people who needed assistance wit eating from staff. This did not occur. One person was due to have their meal at this earlier time and did not get their meal untill last. People who require help and patient encouragement with meals should be served timely so that the desire to eat has not passed. The management team must look at how the serving of meals can be undertaken swiftly and effectively to make sure people are not put off eating or are having to wait for their drinks and deserts for a long period of time. Three comments had been received in surveys prior to the site visit that the food may not be hot enough. On the day of the site visit the food was seen to be hot enough when it left the kitchen. This issue had been raised at several resident meetings in the last few months and the chef and manager were working to address this issue. People spoken with on the day of the site visit said their food was hot enough. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from abuse and complaints raised are listened to and acted upon, this helps to protect people. Evidence: People spoken with and those who completed surveys said that they knew how to raise issues they may have with the staff or manager. They said they felt any issue raised would be investigated and dealt with appropriately. There have been complaints received since the last inspection. The manager said issues raised would be investigated and dealt with appropriately. People would be notified of the outcome of any investigation. One person spoken with said If I had a complaint I would speak to the staff and know it would be resolved . The home have a safeguarding and whistle blowing policy in place. Staff receive training about how to safeguard people during their induction and at regular intervals thereafter. Staff spoken with knew what to do if an allegation of abuse were to occur. Safeguarding issues would be reported so that they could be dealt with appropriately. This helps to protect people. Care Homes for Older People Page 18 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 good 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 home that is maintained so that it is pleasant for people to live in. People are protected by the infection control measures in place. Evidence: The home has a secure door entry system to make sure unauthorised people cannot gain entry to the home, this helps keep people safe. There are a variety of living rooms and dining areas throughout the home. People personalise their bedrooms to help them feel at home. A passenger lift is available to help people gain access to all areas of the home. There are well kept grounds some paving slabs on footpaths were uneven the manager informed the inspector that work has been planned to address this issue.There is garden furniture available for people to use. General maintenance is undertaken,which helps to keep the home pleasant for people to live in. The laundry was inspected. Infection control measures are in place for handling soiled linen. Hand wash facilities are available for staff throughout the home which helps to maintain infection control. Care Homes for Older People Page 19 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 receive care from staff who are recruited using thorough methods. However management must look at how staff can be deployed to make sure that care and services can be depolyed timely at peak times of the day to meet peoples needs. Evidence: Staff were observed and they were seen to interact positively with people, they were friendly and welcoming and all had a pleasant manner with the people who lived in the home and their relatives. Staffing levels on the day of the site visit appeared adequate however upon observing how people received care and how staff were working it was noted especially at lunch time that staff were under pressure and that there were issues that must be looked at and be addressed to make sure that people receive the care and services they need timely. It was noted that one member of staff had to go home due to being unwell. One visitor praised staff but said they go looking for the staff when their relative wants the toilet to make sure staff can be summoned to help and to make sure time does not elapse, as often time goes by whilst hoists are located and for second members of staff to attend to help accomplish this task. One person said The staff are wonderfully, but I feel theres not enough of them. One comment received on a survey was It often Care Homes for Older People Page 20 of 28 Evidence: takes a long time for the staff to come to my room when I use my buzzer and I am often told they will come back as soon as they can. The whole process from ringing my buzzer to receiving the help I need can often take 30 minutes or longer.This was discussed with the manager and other care staff who said they felt that the high dependency of the people living in the home placed them under pressure and if things occur which are unexpected them staff become under pressure and services do not run as effectively as staff would like. Six out of eight people living at the home who filled in surveys said staff are Usually available when you need them. Staff were seen to have been under pressure to serve lunch timely on the day of the site visit. (See the daily life and social activities section of this report). People spoken with said the staff were very kind and very busy and that they may have to wait for the care they required to be delivered. Management must undertake an audit of the dependency levels of people living in the home and look at how staffing can be deployed to make sure that care and services are always available and are deployed timely to meet peoples needs. The recruitment process is robust and some people living in the home help interview prospective staff this is excellent and helps people living in the home feel involved in this process. The home currently do not have fifty percent of their care staff who hold a National Vocational Qualification in Care at level two or three.There are eight people undertaking this qualification and this ratio should be achieved in the coming months. However the home should continue to work towards achieving this. Staff are recruited using a robust method, all necessary pre employment checks are undertaken and staff do not start at the home without the results of these checks being known, this helps to protect people.Some people who live at the home sit on the interview panel for new care staff, they ask the potential staff set questions and they help to make the decision about which candidates are to be offered employment, this is good practice and helps people to feel involved in staffing the home. New staff receive induction training and this helps them to understand what is required of them and gives them the skills they need to be able to give good care. Ongoing training and development is given to all staff. Supervisions and appraisals take place to make sure that staff are practicing their skills safely and can raise any training needs they may have. This helps staff to keep their skills up to date. There is a training record kept for each member of staff, as well as a training matrix to make Care Homes for Older People Page 21 of 28 Evidence: sure moving and handling, fire, infection control and training in all other relevant subjects is provided regularly for all staff. Staff are invited to attend in- house meetings where they can give their views, those not able to attend can read the minutes. The manager has an open door policy and staff can speak with her at any time to raise any issues, this helps staff to feel valued. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from a competent manager. People are protected from financial abuse. However higher management must audit how the staffing levels at the home can be improved at peak times of the day such as mealtimes, to make sure that people receive the services they need timely. Evidence: The manager is new to the private care sector and has applied to become registered with the Care Quality Commission, she is to undertake her fit persons interview shortly. Staff and people living at the home and their relatives speak highly of her skills and she has clear vision about how the home is currently operating and the changes she would like to implement in time to improve the services being offered. She operates an open door policy and is available for people to speak to at any time. She is about to be put forward to commence a course in management to help her develop her managerial skills. The manager works on the floor a few days each week this helps to keep her nursing skills up to date and makes sure that she can oversee Care Homes for Older People Page 23 of 28 Evidence: how the home is running.There is a higher management team to help and support her. The management team vist the home regularly to give help and support and to undertaken the management audit for the home. Quality audits are undertaken to monitor accidents and wounds that people living at the home have to help look at how these can be prevented. Audits are also undertaken for the kitchen and laundry services to help management look at how these services can improve. Staff meetings are held as well as resident and relative meetings, to make sure that people can air their views about the services being provided in the home. Issues raised are looked into and acted upon to make sure that issues are addressed.However higher management must audit how the staffing levels at the home can be improved at peak times of the day such as mealtimes, to make sure that people receive the services they need timely. Personal allowance accounts are available for people who do not wish to look after their own money whist living in the home.Three accounts were inspected balances were correct and receipts were available for the transactions made this helps to protect people from financial abuse. The home is maintained to make sure the environment and equipment is safe for people to use. Hot water temperatures supplied to peoples bedrooms are checked and action is taken to make sure they are in the correct range to protect people from being scalded. Fire alarm systems are checked regularly to make sure that they would help protect people if a fire occurred. Care Homes for Older People Page 24 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 25 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 1 7 14 Management must make 30/06/2009 sure that care plans and risk assessmants are reflect peoples current needs. Falls risk assessmants and waterlow monitoring forms must be completed when people have needs relating to these issues. Care plans must be reviewed monthly or as peoples needs change. Care documentation must include all necessary information so that care staff are fully aware of peoples needs. and are informed about how to protect people from potential risks. The management team must 30/06/2009 look at how the serving of meals can be undertaken swiftly and effectively. To make sure people receive their meals whilst they are hot enough to enjoy and do 2 15 16 Care Homes for Older People Page 26 of 28 not have to wait excessive amounts of time for their deserts or drinks. 3 33 18 Higher management must audit how the staffing levels at the home can be improved at peak times of the day such as mealtimes. To make sure that people receive the services they need timely. 30/06/2009 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 3 Pre admission assessments should be signed and dated to make sure that it is known when the information was gained and by whom. Eye drops should have the date of opening recorded so that staff are aware when the drops need to be discarded. Products which have to be placed in peoples drinks to thicken them to aid safe swallowing should be signed for on the medication administration record (MAR). To make sure that thorough records are kept. The manager should continue the process to become the Registered manager for this service by attending her fit persons interview. She should undertake a management qualification to help her develop her managerial skills. 2 9 3 31 Care Homes for Older People Page 27 of 28 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). 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. 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