Care Home: Springfields

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What the care home does well Springfields provides a homely, comfortable and well-maintained place to live. The Registered Manager has a good assessment system in place to ensure that people`s needs can be met before they are offered a place in the home. We found a high standard of care planning and recording which supported similarly high standards of care and support. This included good links with and prompt referral to health care professionals where necessary. A varied daily activity programme is provided and the home makes sure that people maintain social contact with the wider community and people important to them. Staff listen to people`s concerns and act upon them. There are robust procedures for dealing with any abuse that might be suspected or witnessed. Staff recruitment practices also protect people from abuse. A well organised training programme means that staff have the training they need to provide the care and support people need. The home has an experienced and well qualified manager who is well organised and respected by the people who live in the home, staff and relatives. What has improved since the last inspection? The home continues to maintain the high standards found at our last inspection and seeks ways to make further improvements through an excellent quality assurance system. What the care home could do better: There are no recommendations or requirements arising from this inspection. Key inspection report Care homes for older people Name: Address: Springfields Springfields Bridestowe Okehampton Devon EX20 4ER     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Graham Thomas     Date: 1 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Springfields Springfields Bridestowe Okehampton Devon EX20 4ER 01837861430 01837896430 springfields.bridestowe@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Byrne,Mrs Byrne Name of registered manager (if applicable) Mrs Byrne Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Springfields is an old Rectory on the edge of the village of Bridestowe, 7 miles from Okehampton. The village has a vibrant community and facilities including, shop/post office, pub and church. The home provides accommodation and personal care for 34 older people who may have additional physical disabilities, dementia or mental disorders. It is privately owned and managed. The district nursing service provides nursing input as necessary. Many of the bedrooms have sufficient space to be used as Care Homes for Older People Page 4 of 26 0 0 0 0 Over 65 34 34 34 34 Brief description of the care home sitting rooms. All have en-suite toilets and some also have en-suite shower rooms. A number of the bedrooms have French windows on to balconies or patios. There are three large lounges, one with a conservatory extension that is used for dining. A separate dining room and a separate seating area are located at the front of the house. Level access is available throughout the home. Current fees range between £322 and £560 per week. Additional charges are made for items other than accommodation, meals, personal care and laundry. This includes personal lockable storage and key operated door locks in bedrooms. Prospective residents are sent copies of the Service User Guide. Then they are invited to visit if they wish, and are informed that CSCI reports are available for inspection either in the office or online. Care Homes for Older People Page 5 of 26 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: Before we visited the home, we reviewed our own records about it. This included complaints and records of accidents and incidents sent to us by the provider. These are called notifications We also reviewed the Annual Quality assurance Assessment (AQAA) that the provider completed and returned to us. Ten staff also completed and returned our questionnaires. We spent approximately six hours at the home. During this time we spoke with Mr & Mrs Byrne and some of the staff on duty. We looked around the premises and saw all the shared areas and some peoples individual rooms. A detailed examination was made of the care and support provided to three people. This included meeting the people, looking at their care plans and speaking with staff about their care. We also spoke with a visitor who told us about the care their relative was receiving. Care Homes for Older People Page 6 of 26 We looked at issues around the staffing and management of Springfields by examining records and speaking with the staff, manager and people living in the home Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 26 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 26 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. Standards 3 and 6 People considering a move to Springfields can feel confident that the home will make a very thorough assessment before they move in to make sure their needs can be met. Evidence: The Annual Quality Assurance Assessment (AQAA) completed and returned to us by the home told us: Our care needs assessment is detailed to ensure we can meet a persons needs. This involves acquiring relevant information from the client, their family, friends and health care professionals. We looked at the file of someone who had recently moved into the home, met the person and discussed their admission with the registered manager. The person told us Care Homes for Older People Page 10 of 26 Evidence: that the manager and staff had made moving into the home as easy as such a move could be. The persons files showed that a very thorough assessment of the persons needs had been made before they moved in. This comprised an initial tick list which was followed up with more detailed assessments of the persons physical, psychological and social needs. An osteoporosis questionnaire was also completed. A drugs profile with details of the persons medication had been taken on admission. The manager told us about the meet and greet part of the homes admission process. This involved liaising other professionals such as the local GP. We learned that through the homes initial assessment, a possible previous undiagnosed stroke had been identified. A referral had subsequently been made to the Speech and Language Therapy service to help the person with speech difficulties they were experiencing. The persons previous history of diabetes had also been noted and treatment promptly arranged. Based on these initial assessments, a detailed care plan had been produced with clear aims that had been agreed with the person and their representatives. Springfields does not provide intermediate care. Care Homes for Older People Page 11 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 7, 8, 9 and 10 People living at Springfields receive a high standard of well-organised care which promotes and preserves their dignity and independence. Evidence: During our visit to the home we looked in detail at the care and support provided to three people. One person told us that the care and support they received was exceptional and that they had everything they needed. We met another person and told them that we had come to check if they were being properly cared for. They replied: I should think that would be completely unneccessary. Its marvellous here! Three care plans we examined were very clear, well organised and up to date. These were organised into two parts. The main file is kept in the office. This contains all the detailed information concerning the person, their needs and how these are to be met. Care Homes for Older People Page 12 of 26 Evidence: A separate plan is kept for carers describing the persons day-to-day care needs and daily records. The plans described each persons physical, social and psychological needs including, for instance, their hobbies, interests and religious beliefs. All the plans we examined had been regularly reviewed. They set out very clearly the detailed needs of each person and provided carers with all the information they needed to provide specific care and support. This included assessments of risk including, for example, moving and handling and bathing. The plans also identified areas of personal care where the persons independence was to be encouraged and maintained. All the plans had been reviewed monthly and there were effective monitoring systems in place. The daily notes provided a clear account of the daily support provided and treatments given. We found these notes to be exceptionally clear, informative, objective and well-written. In one plan we saw that the person had diabetes and arthritis and some difficulties with continence. In the plan we saw that their feet required careful monitoring. A recent review indicated that they should not bear weight because of treatment to their feet. We visited the person in their room and saw that they were comfortably seated with a pressure relieving cushion under their feet. There was also a pressure relieving mattress on the bed. The persons call bell was readily to hand and there was a drink within reach. The persons glasses were clean and they appeared clean with clean hair and nails. The room was totally odour-free, suggesting that their continence needs were being well met. In the persons plan we saw records of regular monitoring of blood sugar, blood pressure and cholesterol. There were also records of regular weight monitoring. In the persons records we saw that an episode of confusion had been rapidly identified and a referred to the persons GP. This had resulted to modifications to the persons medication and recommendations concerning pain management. In another persons plan we saw that the person had a hearing loss, was receiving anticoagulant medication and was attending dermatology appointments for treatment to their legs and feet. Daily notes and reviews confirmed that the person had attended these appointments as well as other appointments for blood and hearing tests. The anticoagulant medication requires regular blood testing and may require the dosage to be varied. When we looked at the system for administering medicines we saw that there was a very clear system in place for making sure that the person received the correct dosage. We looked more generally at the homes system for administering medicines. The medication was stored in secure cabinets with additional security for controlled drugs. There was a dedicated trolley for transporting medication around the home which was Care Homes for Older People Page 13 of 26 Evidence: kept empty when not in use. The area in which medicines were stored was clean and tidy and included hand-washing facilities. All the records we examined were up to date and in good order and provided a clear audit trail of the medicines in use. This included the controlled drugs register in which we saw two staff signatures for each occasion a medicine had been administered. The good standards we found were echoed in a recent Pharmaceutical assessment report which we have seen. We looked at how the home protects and preserves peoples privacy and dignity. We noted that the home was clean and completely odour free throughout. This helps to preserve peoples dignity as well as providing a pleasant living environment. We also noted that all the people we met in the home were clean, well-groomed and appropriately dressed. We saw staff knocking on peoples doors before entering rooms and heard people being addressed in their preferred manner. At one point a staff member sensitively directed one person away from a toilet which was in use but which the person had not locked. During our visit we met a visiting relative who felt that the home was brilliant. This person told us told us that there had nothing to say about the home that was not exemplary and that its response to medical needs was impressive Care Homes for Older People Page 14 of 26 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. Standards 12, 13, 14 and 15 People living at Springfields are well supported to enjoy a fulfilling lifestyle and follow their interests. They enjoy a nutritious, varied diet which meets individual preferences and health care requirements. Evidence: In our visit we noted a relaxed atmosphere in the home. People living at Springfields have the use of several lounge and communal areas and sitting rooms. Outside there is also a patio area with shade and seating. There are large windows overlooking manicured lawns. At the time of our visit we saw people around the home chatting amiably in the sunny conservatory and other areas. People with whom we spoke confirmed that they were always able to follow their own daily routine including their time for rising and retiring to bed. Some routines such as meal times and bathing are set by the home. However, the people with whom we spoke were satisfied with this arrangement. We saw an activities programme which included, for example, nail painting, cookery, quizzes and board games as well as Care Homes for Older People Page 15 of 26 Evidence: walks and physical activities. We saw one staff member leading a quiz during our visit in accordance with the activity plan. The Registered Manager told us that appointments for hairdressing and with the doctor had previously taken place in the home. Now, wherever possible the person is taken to such appointments. This has provided opportunities for people to maintain social contact in the wider community. One person told us that they liked to join in activities but that staff respected their choice if they wished to spend time alone. People living in the home told us that their visitors were always made welcome. This was confirmed by a visiting relative with whom we spoke during our visit. The visitor told us that they were routinely offered refreshments when visiting. They also strongly approved of the above-mentioned arrangements for attending appointments away from the home. We observed a mealtime. Before the meal we saw that people living in the home were involved by staff in laying the table. The dining area was attractively laid out with clean table cloths and fresh flowers. People sat in groups of between two and four enjoying their lunch in a convivial atmosphere. We saw that staff offered a choice of meal, either sausages or fish followed by apple crumble which people appeared to enjoy. Everyone had a drink with their meal. Where people required help, staff assisted discreetly and without fuss. We spoke with kitchen staff and looked at menus in the kitchen. The menus were based on a five week rotation and appeared to provide a balanced and nutritious diet. In the kitchen there were records of peoples dislikes and food intolerances. Staff had a clear understanding of individual needs such as the requirement for pureed and sugar-free meals. Care Homes for Older People Page 16 of 26 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. Standards 16 and 18 People can feel confident that any concerns will be treated seriously and acted upon by staff. There are sound policies and procedures in place to protect people from abuse. Evidence: We looked at how the home manages complaints and protects people from abuse. People with whom we spoke told us and they felt safe at the home and could think of why they might need to make a complaint. Our observations suggested that people were relaxed and confident in the presence of staff. A visitor told us that the staff were very good at keeping relatives informed of any changes or other matters of concern. The home has a clear complaints procedure. Although there were no complaints we saw a file with a great many compliments, reflecting the feedback we received during our visit. We checked our records and found that there had been no complaints about the home since we last visited. A staff member with whom we spoke confirmed that they had received training in safeguarding vulnerable people from abuse. The staff and manager were very clear about dealing with any abuse that might be suspected or witnessed. This included and awareness of the external agencies that might be contacted in such circumstances. Care Homes for Older People Page 17 of 26 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. Standards 19 and 26 People living at Springfields live in a homely, comfortable and exceptionally wellmaintained environment that is suited to their needs. Evidence: Springfields is an old Rectory on the edge of the village of Bridestowe, seven miles from the town of Okehampton. The village has facilities including, shop/post office, pub and church. Outside the home there is ample parking space for visitors, lawned areas and a patio for people living in the home. Shared space comprises three large lounges, one with a conservatory extension. A separate dining room and a separate seating area are located at the front of the house. Level access is available throughout the home. A shaft lift provides access to the upper floor. Many of the bedrooms have sufficient space to be used as sitting rooms. All have en-suite toilets and some also have en-suite shower rooms. A number of the bedrooms have French windows on to balconies or patios. During our visit we toured the home including all the shared areas and some individual rooms. All parts of the home were decorated and maintained to a very high standard. Furnishings were comfortable and of a homely, traditional style. We saw that external areas were also tidy and well-maintained. The space available throughout the building Care Homes for Older People Page 18 of 26 Evidence: is excellent for residents who rely on a wheelchair. Adaptations to the environment help people to be more independent and coloured carpets help those with dementia to find their way about effectively. We saw records of daily room checks carried out by staff with any items for repair clearly identified. We also saw recent maintenance records including, for example electrical checks, gas checks and a lift maintenance certificate. A water fittings inspection had revealed some items requiring attention and this work had been completed within the required timescale. We saw that environmental risk assessments had been produced and that these had been reviewed. The AQAA returned by the home told us of plans to improve the lighting in half the rooms to make them more bright and welcoming in the winter months. We looked at measures to maintain hygiene and control infection. During our tour we noted that the home was spotlessly clean throughout and completely free from any offensive odour. We saw an excellent supply of equipment and materials for residents and staff use. This included, for example liquid soap, disposable hand towels and cleansers. We saw that staff wore protective clothing when preparing for personal care and handling laundry. The laundry has enough space to separate soiled laundry from clean. We saw that it is very well equipped with commercial washing machines and dryers. When we visited we found that it was clean and tidy. We discussed the laundry arrangements with staff and the manager who described suitable arrangements for handling heavily soiled and potentially infected laundry. Care Homes for Older People Page 19 of 26 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. Standards 27, 28, 29 and 30 People living at Springfields are supported by sufficient numbers of well motivated and trained staff. The recruitment procedure is robust and offers good protection from potentially unsuitable or abusive staff. Evidence: Before we visited the home we looked at ten survey that head been completed and returned to us by staff. One staff member commented that Springfields was a fabulous place to work The staff with whom we spoke during our visit appeared well motivated and understood the needs of people living in the home. People living in the home made many positive comments about the staff including theyre marvellous and they will do anything for you. We looked at the numbers of staff on duty and whether this was sufficient to meet peoples needs. Of the ten staff who completed the surveys. Seven said that there were always enough staff on duty to meet the individual needs of all the people living in the home. Two stated that this was usually the case and one did not respond to the question. People living in the home told us that staff always attended promptly when they were needed. Our own observations during the inspection visit suggested Care Homes for Older People Page 20 of 26 Evidence: that there were enough staff to meet peoples needs to a high standard, maintain the home very well and complete necessary domestic tasks. We looked at two staff files and spoke with staff to check the homes recruitment procedures. The staff files revealed a robust recruitment procedure involving a formal application, references, an interview, and check of health and checks for criminal records. In one file we found that a telephone reference had been taken and there was a clear record of the conversation. One staff member had commenced their duties before their criminal record check was completed. A check had been made with the Independent Safeguarding Authority which holds records of potentially unsuitable staff. Mr Byrne told us that before the criminal records check had been completed, the person was supervised by a senior colleague. Our conversations with staff confirmed these processes. We saw that all staff had individual training files detailing their induction / foundation training and ongoing development. The training was linked to an assessment of training needs resulting from observed practice and annual appraisal. Mrs Byrne told us that 70 of the current carers hold a National Vocational Vocational Qualification in care at at least level 2. We saw evidence of training relevant to the needs of people living in the home such as moving and handling, dementia, and more recently, the Mental Capacity Act. Mrs Byrne told us that a combination of staff development techniques was used including distance learning, and research of web based materials. Care Homes for Older People Page 21 of 26 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. Standards 31, 33, 35 and 38 The management of Springfields reflects a thoughtful and very well organised approach to meeting the needs, safety and best interests of people living there. Evidence: Mrs Byrne has many years experience of running a care home and maintains her registration as an Occupational Therapist. She has achieved the Registered Managers Award and continues to update her knowledge. The staff, residents and visitor with whom we spoke all expressed complete confidence in her. A relative told us that he was very impressed by the way everything in the running of the home appeared to have been so well thought through. Staff told us that they felt well supported and all were clear about their roles and responsibilities. All the records we inspected during our visit had been maintained in an exemplary way. This included accident records, care plans, health and safety checks and Care Homes for Older People Page 22 of 26 Evidence: medication records, amongst others. There were good systems in place to ensure appointments were followed up and that people were receiving the care and support they needed. Mrs Byrne showed us her ongoing work on quality assurance. These included a clear, detailed analysis of the information about how Springfields was performing in various areas and included feedback from people with an interest in the home. This information was summarised and plans made for development and improvement of the service. We saw, for example, that as a result of quality assurance review, a falls checklist had been developed with a specialist osteoporosis Nurse. Mr and Mrs Byrne told us that the home has no involvement is peoples finances which are managed by family members or other representatives. Valuables and cash can be held securely for people living in the home if they wish. We saw that where the home had spent money on peoples behalf receipts were obtained and there was a clear system of recording. As previously mentioned in the Environment section of this report, we saw evidence of regular servicing and maintnenace to ensure the continued health and safety of people using the service and staff. Where other regulatory bodies had indicated shortfalls, these had been addressed within the given timescales. For example, a food premises inspection had highlighted some areas for improvement. The home was reinspected and it was confirmed that the necessary action had been taken. We saw that individual and environmental risk assessments had been produced for issues such as moving and handling and windoe restriction. Staff had received training in health and safety topics such as fire safety, first aid, and food hygiene. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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