Care Home: St Ann`s

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What the care home does well The home is clean and has a homely atmosphere. One person told us that I `like to stay in my room` and likes the room. They say the `food is lovely` and says when `I first came I did not eat much but now I eat lots`. We were told that they `have two options to choose from` and `we can choose something else to eat if we do not like what is on the menu`. We were also told that `the staff are very kind` The people told us that they like their bedrooms and the rooms seen were individualised to meet the needs of that person. The people do activities in the home and enjoy this. One person told us that the activity person took `me around the church where I got married` and `we looked around the place where I used to live` and then they had a pub lunch. The people tell us that `we get good care and `I ring the bell if I am not well` and the `staff comes`. It was also said `you get to know the staff well as they have a low turn over of them`. The staff enjoy working at the home and it was said `I like working with the residents` The staff work very hard to meet the needs of the people. They get training to help them meet the people`s needs. They were observed talking and listening to the people and offering advice in a positive manner. They say they get good support from the deputy managers. What has improved since the last inspection? The requirements and recommendations from the last inspection had been met. The upstairs lounge area was decorated and looked very pleasant. Two wide TV`s were purchased for the two lounges. The people were able to see the picture better. The lighting had also been changed in the lounges. The carpet had been replaced in most areas of the home. New furniture was also purchased in the lounge areas. The home had received a grant and a sensory lighting which is displaced in the downstairs lounge and some furniture was purchased from this money. What the care home could do better: The home should ensure all staff receives at least 6 supervisions per year to find out how they are working in the home. Review the staffing rota to ensure that there are adequate numbers of staff on duty at peak times. This is to meet the needs of the people. Provide more team meetings so the staff can get together more often to discuss the needs of the people, and issues that they might want to discuss and to be told what is happening in the home. Provide a team building day for the home. This is to improve communication between all levels of staff. Provide staff support and give them positive recognition when they have worked well. Ensure that the people`s and staff views are documented in the monthly monitoring of the home. This shows that their views of the standard of care being provided in the home is taken into account.Undertake the people`s questionnaire surveys to get their views on how the home is meeting their needs. This should also include views from staff, families, and other professionals. Provide staff at least supervision 6 times per year to monitor their practice in how they are looking after the needs of the people. Ensure that the medication trolley is fixed to the wall as stated in the medication in care homes guidance. This is to keep the medication safe. Key inspection report Care homes for older people Name: Address: St Ann`s The Crescent Kettering Northants NN15 7HW     The quality rating for this care home is:   two star good 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: Ansuya Chudasama     Date: 0 9 0 6 2 0 0 9 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 27 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: St Ann`s The Crescent Kettering Northants NN15 7HW 01536415637 01536519304 stanns@bmcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Collycare Limited T/A B&M Care care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: A maximum of 14 service users with dementia may be accommodated on the ground floor A maximum of 4 service users with a Physical Disability can be accomodated on the first floor. Up to 7 service users with Dementia may be accommodated on the First Floor Date of last inspection Brief description of the care home St Anns is a care home providing personal care and accommodation for 39 older people over the age of 65 years. Collycare Ltd trading as B & M Care owns the home. The home is located in Kettering Town and within walking distance of the train station and town centre shops and amenities. The home is purpose built and separated into two self-contained units on two floors. A passenger lift provides access to the first floor. On the ground floor, the home can care for 14 Older People who have Care Homes for Older People Page 4 of 27 Over 65 21 39 4 0 0 0 Brief description of the care home dementia. On the first floor the home can care for Older People including up to 7, who have a mild form of dementia and up to 4 with a physical disability. 27 of the bedrooms are single occupancy and 20 have en suite toilet facilities. The home has an enclosed garden, which is well maintained, and has a small raised fishpond accessed directly from the ground floor lounge. The following fees were provided by the registered manager as being current at the time of this inspection, between £338 and £505 per week. The fees include personal care, accommodation, meals and laundry. Chiropody and hairdressing services can be arranged and are charged separately. The Registered Manager stated that residents are provided with a service users guide to the services the home offers, when requested by them or their relatives. The home?s Statement of Purpose is displayed in the reception with a copy of the last Inspection Report so that this information is accessible to residents and visitors. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out in accordance with the Commission for Social Care Inspections (CSCI) policy and methodologies which require review of key standards for the provision of a care home for older people that takes account of the peoples views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. The report refers to we this is because the report is written on behalf of the Quality Care Commission. We last inspected this service on the 11th of June 07. This key inspection was carried out on the 9th of June 09. The registered manager was not working on the day of the inspection because they were on holiday. The deputy managers of the home helped out with the inspection process. Care Homes for Older People Page 6 of 27 During this inspection we tracked the care of three people who use this service. This involved reading their care records and also talking to them wherever possible to obtain their views on the service. We also spoke to some of the other people who live in the home. Documentation relating to staff recruitment, training and supervision, medication administration, complaints and health and safety were also examined. We had the opportunity to talk to some of the staff who were on duty and a tour of the home was also conducted. On the day of the inspection we were privileged to be part of a 100th birthday celebration. The current weekly fees for care range from three hundred and thirty eight pounds to five hundred and five pounds per week for a person. Additional charges are required to pay for hairdressing, news papers, and chiropody, Information on the cost for these services can be obtained from the home. The homes statement of Purpose and the last inspection report are displayed in the reception area for people to access. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The home should ensure all staff receives at least 6 supervisions per year to find out how they are working in the home. Review the staffing rota to ensure that there are adequate numbers of staff on duty at peak times. This is to meet the needs of the people. Provide more team meetings so the staff can get together more often to discuss the needs of the people, and issues that they might want to discuss and to be told what is happening in the home. Provide a team building day for the home. This is to improve communication between all levels of staff. Provide staff support and give them positive recognition when they have worked well. Ensure that the peoples and staff views are documented in the monthly monitoring of the home. This shows that their views of the standard of care being provided in the home is taken into account. Care Homes for Older People Page 8 of 27 Undertake the peoples questionnaire surveys to get their views on how the home is meeting their needs. This should also include views from staff, families, and other professionals. Provide staff at least supervision 6 times per year to monitor their practice in how they are looking after the needs of the people. Ensure that the medication trolley is fixed to the wall as stated in the medication in care homes guidance. This is to keep the medication safe. 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Needs assessments and visits to the home are carried out for all the people admitted to the home to ensure that their needs will be met. Evidence: The people spoken to tell us that their family had chosen the home for them to live in. It was also said that they were given information about the home when they visited the place. One visitor told us when they visited the home, it looked clean and they were very pleased with the room and could not fault it. One person told us that they had visited the place and liked it. Another person told us that the staff visited them to do an assessment to find out if the home could meet their needs. They were also given information about the home. It was said that it was nice for them to see the staff who visited them to make them feel more settled at the home. Care Homes for Older People Page 11 of 27 Evidence: The people have a contract, which gives them information about their rights and responsibilities with the home. This was confirmed by talking to some of the people living in the home. The peoples files looked at showed that there were good pre assessment admission details of the person being admitted to the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The peoples personal and health care needs are met by the home. Evidence: We looked at three peoples care plans in detail and discussed the peoples care needs with staff on duty. The staff showed that they had very good understanding of the care needs of the people. Evidence showed that these plans were being reviewed on a monthly basis. The care plans we saw clearly set out peoples support needs and preferences in receiving personal care. We observed staff interaction and noticed that they talked to people in a respectful manner and were careful to preserve their dignity. The people we spoke to informed us that the staff knocked on their doors and maintained their privacy and dignity when doing personal care. One person says they are ever so good and they wash me twice a day. We were also told that the hairdresser comes to the home and they have their hair done. All the people we spoke to informed us that they would tell staff or ring the call bell if Care Homes for Older People Page 13 of 27 Evidence: they are not feeling well. However staff were asked how they would know if a person who was not able to tell them that they are not feeling well due to their mental state. We were told that they would know this by understanding the person and the behaviours they displayed. One visitor we spoke to informed us that they visit their relative every other day. It was said that the staff looks after her well and said that their health and medical needs were being met. It was also said that the staff kept them informed of any changes that took place in the persons health needs. We spoke to another visitor who used to look after the person in the community before they came to the home. We were told that the person was looking so well and they told them that they were happy at the home. Evidence in the care records showed that people are offered support for their physical and emotional health needs. There were records of general practitioner, and hospital appointments, and people have access to the opticians, dentists, and other health care professionals. Compliment letters read showed that families were happy with the care provided at the home. The senior staff at the home gave out medication and had received the accredited training. We observed staff giving out medication and this was given by talking to the people. There were medication profiles for each person and these had been updated. The home did not have any controlled drugs but had a controlled drugs cupboard. The records and medication checked was satisfactory. The medication trolley is locked secure in a room; however it was not fixed to the wall. Most of the staff spoken to had done the training on dying and death. We were told that the experienced staff on duty would support new care staff to carry out this task. A range of risk assessments are in place that enables the people to take risks as part of an independent lifestyle. However the five steps to assessing risk needed to be undertaken. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals served are nutritious and plentiful with a menu which changes each week so that the people have a balanced diet with choices Evidence: On the day of the inspection, the home was celebrating one of the peoples 100th birthday. The persons family and friends were invited to the party and every one was observed enjoying the party. We were told by the person that they were very happy and they had a lovely family and the staff are very nice. They had received lots of presents and had a lovely card from the queen. We observed the people downstairs having their lunch. This was eaten in a relaxed atmosphere with staff talking to the people and encouraging them to eat in a kind manner. There was music playing in the background, which was relaxing. All the people spoken to said that the food cooked is lovely. One person told us if they dont like what is on the menu and, if I want something different I only have to ask. We were told that two options are offered at meal times. The meals recorded were healthy and staff had good understanding of the peoples likes and dislikes of food and this information was recorded in their files. The people also had the choice to have their meals in the dinning room or in their own room. Care Homes for Older People Page 15 of 27 Evidence: The people told us that they liked their bedroom, and each persons bedroom seen was individualised to their taste. Some people enjoyed spending time in their rooms as they preferred this. One person told us that they like their room and chose to stay in their room and said this is my home. We were also told that if they want any thing staff will help me and I have a bell and I can use it any time and staff come. We were also told that you get to know the staff well as they have a low turnover of them. Most of the people in the home maintain contact with their families/friends. One person told us that the staff are very kind and they used to live on their own but says its nice to be in company. It was also said that they could not fault the place. The home has an activity person and they worked five days a week from 10am to 3pm. It was observed that in the mornings they did activities upstairs and we observed people playing Jenga game. In the afternoons they did activities downstairs and we observed the activity person playing the key board and singing old fashion songs and the people were observed singing and enjoying this activity. There were other staff who helped out with this activity. We were told that the activity organiser was very good with the people and they interacted well with the person. This was observed on the day of the inspection. Some of the activities include, playing key board, bingo, music, sing songs, quizzes, and games, potting plants, and making cards and having a one to one. One person told us that the activity person took me around the church where I got married and looked around the place where they used to live and then they had a pub lunch. It was said that they enjoyed this. One person used to attend day care in the community before coming to the home. Staff told us that they were trying to get this to continue for the person. It was said that an assessor was coming to do an assessment from the day centre. The garden was very pleasant and we were told that the people enjoyed sitting in the garden when the weather is warm. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have good understanding of the peoples behaviours to ensure they are protected from any abuse. Evidence: The home has a complaints policy, and the procedures for making a complaint is recorded in the service user guide and displayed on the notice board. The homes records were inspected and evidence showed that two complaints had been received since the last inspection. These were being managed appropriately in line with their procedures. The staff spoken to informed us that they had completed the safe guarding of vulnerable adults procedures training. They had good understanding of this and understood the peoples behaviours to know if they were unhappy or not feeling well. We were told that the home has not made any referrals to the safe guarding team of social services. Some of the people spoken to were capable of informing staff if they had any concerns. They told us that they would tell the manager, deputy managers or staff if they had any concerns. Families spoken to informed us that they would tell the staff or the manager if they had any concerns. The peoples finances inspected showed that the balance was correct and this was managed well. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and has a relaxing atmosphere and the programme of redecoration is on going to meet the needs of the people. Evidence: A tour of the home showed that the place is clean and homely. The home was divided into two units. The floor upstairs was used for people who were mentally alert. The down stairs floor was used for people who had dementia. All the bedrooms seen were indivualised to the people and those spoken to tell us that they like their rooms. The doors of bedrooms had the peoples photos. This was good because the people could easily identify their room if they for got where it was. The other communal rooms also had picture signs. One person had brought their own furniture to make the place homely and the home encouraged also encouraged people to bring their personal items to make their room homely. The bedrooms downstairs were locked, we were told that the reason for this was because one person went into other peoples rooms and put other peoples clothes on. The families also asked for this. However if a person wanted to go into their room, the staff opened their door. We were told that this was recorded in their files. The upstairs lounges had been turned into one big lounge. We were told that this was better for the people. A new wide screen TV was purchased so the people could see Care Homes for Older People Page 18 of 27 Evidence: the picture better. All the people also had TVs in their rooms. The room also had new lighting, pictures, and a new carpet. The room looked very pleasant and had a homely feel to it. The down stairs has a small sitting area with soft toys and we were told that the people use this area. It was also said that this area was being painted. The lounge with dinning area was pleasant and had the view of the pleasant garden. The room had new lighting and a wide screen TV. There was sensory lighting on the wall and this was very pleasant to look at. The garden was beautiful with a water feature and colourful plants. We were told that the people like to sit outside in the garden in the summer months and some of them also helped with gardening. We were also informed that the peoples families and staff when they off duty help out with the gardening. The bathroom 3 ventilation was not working properly and we were told that this would be sorted. A bath with hoist had been painted and looked very clean and pleasant. The corridor down stairs near the staff room needs to be kept clear. This is in case there was a fire and this corridor was needed to be used for getting out. This was discussed with the deputy manager and it was stated that this would be done. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have good understanding of the needs of the people to ensure their care needs are met fully. Evidence: The staff recruitment files were looked at in detail. Evidence showed that the home was obtaining all the relevant information required to safe guard the people in the home. Staff files inspected and staff spoken to said that they had received an induction at the home when they started. They also completed the skills in care induction training. The staff told us that training was very good. The AQAA states that 11 out of 15 care staff has NVQ level 2, 0r 3 training in care. The other staff were doing this training. We were told that the two deputy managers also had the Registered Managers Award certificates. The staff had also completed training in dementia care, challenging behaviours, infection care, first aid, moving and handling, the Mental Capacity Act and deprivation of liberty training. Senior Staff spoken to asked for further training on supervision and appraisals. Some staff spoken to said that they needed an extra staff in the mornings and in the evenings from 8 pm to 11 pm to help the people with bed time. It was said that three Care Homes for Older People Page 20 of 27 Evidence: staff waking staff on duty was not enough especially when they had to give out medication, supper, and get people washed and ready for bed. We were told that a laundry assistant was also needed in the upstairs unit. Some staff said that there were enough staff on duty. The staff spoken to say that they enjoy working here, and it was said that they looked after the peoples needs well. It was also said that the people tell us about their life and its lovely. We were told that the home has staff meetings but it was said that this needed to happen more often, rather than every 3 to 4 months. A separate meeting for staff who work at night time was asked for by staff. We were told that this meeting was promised but it did not happen due to unforseen circumstance. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of the people to ensure their needs are met. Evidence: We were told by staff spoken to that they get support from the deputy managers. It was said that the concerns raised to the manager are listened but not always acted upon. We were told that the manager ensures the peoples needs are met. However we are told that the staff do not get support or recognition for the good work they do from the manager. We were told that the home is run well by staff and the deputy managers who are constantly on call for the home. The home carries out regulation 26 visits to monitor the home. However this does not always happen on a monthly basis. We looked at one visit randomly. Evidence showed that no reference was made to talking to staff or the people to get their views about living or working in the home. The conversation was mainly seen to be undertaken with the manager. The AQAA says that we encourage all service users to have a say in the daily running of their home. But it does not say how this is done. However the AQAA says that the Care Homes for Older People Page 22 of 27 Evidence: home is planning to make these changes as a result of listening to the people. This is to encourage service users and relatives to take part in committee meetings. The home also needs to undertake a questionnaire survey of the people, staff, families, and other professionals involved with the home to find out their views on how the needs of the people are being met. Discussion with staff and staff records showed that they were not all receiving supervision or annual appraisals on a regular basis to monitor their practice. There was evidence to show that this has started. The accident and incident records show that these were being recorded appropriately. However the CQC has not received any regulation 37 notifications since November 08 last year. We were shown evidence of information being faxed, however this number was incorrect. We discussed this with the manager after the inspection and they were sending this information by post. The manager now has the right address of where to send the information. The finances of one person were looked at in detail. This was well managed by the home and the balances checked were correct. The fire alarm system was being tested on a weekly basis. The emergency lighting was done on a monthly basis. We were told that fire drill practice was also happening on a weekly basis. We were told that fire training was booked but this did not take place. The heating system was serviced on the 4/2/09. The fire fighting equipment was serviced on the 1/2/09. We were told that a new heating system had been replaced last year. The Environmental Health Officer had visited the home on the 26/1/09 and gave the home two stars which is adequate. We were told that this was because of the menus they had, but these are now changed Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Ensure that the medication trolley is fixed to the wall as stated in the medication in care homes guidance. This is to keep the medication safe. . Provide more team meetings so the staff can get together more often to discuss the needs of the people, and issues that they might want to discuss and to be informed of what is happening in the home. Review the staffing rota to ensure that there are adequate number of staff on duty at peak times. This is to meet the needs of the people. Provide a team building day for the home. This is to improve communication between all levels of staff. Management needs to act upon concerns raised by staff. This is to ensure that they are being listened to and concerns are addressed professionally. Provide staff support and give recognition when they have worked well. Ensure that the staff and the peoples views are Page 25 of 27 2 27 3 27 4 5 32 32 6 7 32 33 Care Homes for Older People 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 documented in the monthly monitoring of the home. This shows that their views of the standard of care being provided in the home is taken into account. 8 33 Provide the peoples questionnaire surveys to get their views on how the home is meeting their needs. This should also include views from staff, families, and other professionals. Provide staff at least 6 supervisions per year to monitor their practice in how they are looking after the needs of the people. Provide staff fire training that is recognised professionally. This is to ensure that the people are kept safe. 9 36 10 38 Care Homes for Older People Page 26 of 27 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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