Care Home: St Anne`s Convent

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What the care home does well St Anne`s Care Home provides a well maintained and peaceful place for people to live. There are extensive grounds that are well maintained and are well used by people in good weather. There is a chapel for daily worship. The manager and the deputy have worked well together in order to make sure the home meets the Regulations and that there are good outcomes for people in the home. Staff are dedicated to providing a good quality of care and people who returned surveys and those spoken with said that staff are caring and patient. There is a thorough recruitment process for staff and an induction and ongoing training programme to make sure they have the knowledge and skills they need to do the job well. Staff who returned surveys said they felt well supported by the manager. Comments that people made about the home include: `The home is a well run care home for the elderly. The residents are kept informed and all seem to be very happy. Good quality food is provided. Very clean and tidy home`, `The atmosphere of the home is relaxed and welcoming`, `The home provides care and understanding for each and every resident`, `As a visiting practitioner I have always felt the residents are generally happy, well cared for and treated with respect by all the staff`, `Good personal attention in all areas` and `They (the staff) are kind, caring and considerate, in my opinion everything is done to 100% standard`. What has improved since the last inspection? There are building works going on in the home to improve the environment and seven rooms that are being refurbished will have ensuite facilities. The disruption to people in the home has been kept to a minimum as the work is being done in a wing that is separate from the bedrooms that are in use. One bedroom has been upgraded in the past twelve months and a new bathroom has been fitted on the first floor. Pre-admission assessments are now only carried out by the manager or the deputy, both are experienced and qualified to do so. Risk assessments have been carried out in all aspects of people`s lives where a risk has been identified. Risk assessments have been carried out for people who have been self medicating. The storage for controlled medication now meets current requirements. All staff and both managers have attended training in safeguarding vulnerable adults and are clear about their responsibility to report any concerns to the appropriate agency. Criminal Record Bureau (CRB) checks are now carried out before a new member of staff begins work. There is an induction and ongoing training programme to ensure that all staff have attended mandatory training sessions. Policies and procedures have been reviewed and all the key policies are now available to staff. What the care home could do better: The manager and deputy said that they would be continuing to monitor and develop the service to ensure that people living at St Anne`s experience good quality outcomes in their daily lives. Key inspection report Care homes for older people Name: Address: St Anne`s Convent 92 Mill Road Burgess Hill West Sussex RH15 8EL     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: Annette Campbell-Currie     Date: 2 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 Anne`s Convent 92 Mill Road Burgess Hill West Sussex RH15 8EL 01444233179 01444254603 stanneshomeltd@btconnect.com www.franciscan.co.uk Franciscan Missionary Sisters Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Hudson Type of registration: Number of places registered: care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 19 The registered person may provide the following category of service only: Care home only( PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home St Annes is registered with the Care Quality Commission to provide personal care for up to nineteen older people. The home is situated in Burgess Hill, close to a range of local amenities. The service is owned by the Franciscan Missionary Sisters, a religious order. The responsible individual acting on behalf of the order is Sister St Anastasia Mc Gonagle. Mrs Jackie Hudson is the registered manager for the home. The fees are 0 Over 65 19 Care Homes for Older People Page 4 of 27 Brief description of the care home currently £425 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. The previous key unannounced inspection took place on 25th July 2008. Mrs Jackie Hudson was appointed as manager of the home in January 2009 and became the registered manager for the service on 23rd June 2009. We (the Commission) carried out the site visit over five hours. Mrs Hudson and the deputy manager assisted with the inspection. The information and documents we needed to help make an assessment of the service were available. There were twelve people living in the home at the time and one person was in hospital; the manager said that alternative plans were made for some people while building work is being carried out to improve the home. Care Homes for Older People Page 6 of 27 The manager completed an annual quality assurance assessment form (AQAA) before the inspection. There was very little information in the AQAA to show how the home ensures good outcomes for people living there or to help plan the site visit. We sent out surveys to find out what people think about the home. Seven people living in the home returned surveys, six staff and five health or social care professionals also returned surveys. The comments people made have been used to help make an assessment of the service. We spoke with five people living in the home and three members of staff including the cook and the deputy manager. We saw the communal areas of the home and three bedrooms. The following documents were read: the case records for four people living in the home, the complaints policy and records of complaints, policies and procedures, menus, staffing rotas, the recruitment records for two newly appointed members of staff, training and development records, a sample of medication records, quality assurance documents and a sample of Regulation 26 reports. We observed the handover session between shifts and the administration of one persons medication. The outcomes for people have been assessed in relation to twenty-two of the thirtyeight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. The eight requirements made following the previous inspection have now been fully met. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? There are building works going on in the home to improve the environment and seven rooms that are being refurbished will have ensuite facilities. The disruption to people in the home has been kept to a minimum as the work is being done in a wing that is separate from the bedrooms that are in use. One bedroom has been upgraded in the past twelve months and a new bathroom has been fitted on the first floor. Pre-admission assessments are now only carried out by the manager or the deputy, both are experienced and qualified to do so. Risk assessments have been carried out in all aspects of peoples lives where a risk has been identified. Risk assessments have been carried out for people who have been self medicating. The storage for controlled medication now meets current requirements. All staff and both managers have attended training in safeguarding vulnerable adults and are clear about their responsibility to report any concerns to the appropriate agency. Criminal Record Bureau (CRB) checks are now carried out before a new member of staff begins work. There is an induction and ongoing training programme to ensure that all staff have Care Homes for Older People Page 8 of 27 attended mandatory training sessions. Policies and procedures have been reviewed and all the key policies are now available to staff. 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 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. People have their needs assessed before a decision is made about whether or not the home could provide the care they need. Intermediate care is not provided at St Annes Convent. Evidence: The manager said that she is updating the Statement of Purpose to make sure that people have the information they need about the home before they move in. The manager or deputy manager visit people interested in moving to St Annes to carry out an assessment to make sure the home could meet their needs. Mrs Hudson gave examples of situations where she felt it would not be appropriate for the person to move in. In one persons circumstance this has involved liaising with other professionals to make sure the person is supported to make the best decision for their future. Care Homes for Older People Page 11 of 27 Evidence: There is a standard format for completing the pre-admission assessment. The form covers all aspects of the persons physical, emotional and spiritual needs. The manager said that assessments are also carried out with people interested in coming to the home for respite care. We saw the assessments that had been carried out with three people. There was some information about key aspects of their care needs. The manager said that she would be completing these forms in more detail in the future so that there is plenty of information to help make a decision about whether or not the staff team would be able to meet the persons needs. People who returned surveys and those spoken with indicated that the home provides the care they need which shows that the assessment process is working well. St Annes does not provide intermediate care however respite care is available. 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. People have their health and personal care needs set out in a plan of care so that their needs are fully met. The medication policies and procedures protect people living in the home. People are treated with respect and their privacy is respected. Evidence: A care plan is drawn up from the assessment when people move to the home. These forms are completed with the person and they sign to say that they agree with what has been written about them. A standard format is used and all aspects of the persons care needs are included. There is also space for information about peoples emotional well being and spiritual needs. People spoken with and those who returned surveys said they are very satisfied with the care they receive. We read the case records for four people including two people who had recently moved to the home. The key workers had completed information about each persons background, their family members and previous careers. There was information about the way people need and prefer their care to be provided, for example: X needs full support with personal care. Likes to have a bath every day, now with helpand staff to Care Homes for Older People Page 13 of 27 Evidence: assist with dental care ie. put toothpaste on the brush as X tends to forget. Staff spoken with and those who returned surveys indicated that they understand the way people prefer their care to be provided. The care plan format provides information about some aspects of risk to be monitored, for example for mobility, skin integrity and nutritional risks. These had all been completed on the forms that we read and there was evidence to show that they had been kept under review. One person had been referred for a falls risk assessment as this had been identified as a problem that was causing concern. Staff from the falls prevention team had carried out an assessment and made a recommendation. However the person was choosing not to follow the guidance so further information had been provided to staff so that they can be aware of the ongoing risk and how to avoid this. Separate risk assessments had been carried out where an individual risk had been identified, for example for people using the small kitchen independently. These risk assessments had also been kept under review. Peoples health needs were also noted and records kept of referrals and contact with healthcare professionals. People said they are able to see their doctor when they need to. The manager said that the home has a good relationship with the local primary care team and the professionals who returned surveys were very positive about the way the home ensures that people have their healthcare needs provided for. One person was having assistance for an urgent dental appointment and it was clear from the case records that people have access to an optician, hearing aid clinic and chiropodist when they need to. There are policies and procedures in place regarding medication practices. The storage facilities for controlled medication now meets the current requirements. People are encouraged to control their own medication for as long as they are able to. Risk assessments are now carried out to make sure that people continue to be safe to do so. All staff who administer medication have attended training so they are competent to do so. We observed the administration of medication for one person and the member of staff was clear about how this should be done. Not all staff had signed to say that the medication had been administered; the manager said she would follow this up as a matter of urgency and put a procedure in place to ensure that this is monitored each time medication is administered. Care Homes for Older People Page 14 of 27 Evidence: Staff are given guidance about providing personal care as part of their induction and those spoken with were clear about the need to protect peoples privacy and dignity. People said that staff are patient and do not rush them, one person said: the staff are excellent, very kind. Care Homes for Older People Page 15 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. People usually find the lifestyle they would choose in the home. People are supported to maintain contact with relatives and friends and to make some choices in their lives. People are provided with a balanced diet and take their meals in pleasant surroundings. Evidence: The manager said that she has been trying to encourage people to say what activities they would enjoy and to take part in the activities that are arranged in the home. A volunteer has been coming to the home to do some activities such as quizzes. A minibus is available and people have been offered the opportunity to go to a local swimming club and concerts in the community. The manager said that people like the idea but often when the time comes they prefer not to go out. She said she would continue to try to develop the activity programme. There was some information about peoples interests and hobbies in their care plans. Several people spoken with said they are content spending time in their rooms. The opportunity for daily worship is important to many people who choose to live at St Annes. As people enjoy individual activities the staffing levels should be reviewed to ensure that staff have time to spend some time with people so that they have some Care Homes for Older People Page 16 of 27 Evidence: stimulation during the day. On the day of the visit there was only one member of staff on duty in addition to the manager and deputy from 2pm until 4pm, so there would not have been an opportunity to spend individual time with anyone. A music evening had been arranged recently and several people said they had enjoyed this. The manager said that relatives had been invited to share a social evening with everyone in the home at Christmas. She said this had been a great success and the first time that some relatives had met all the staff. People are encouraged to maintain contact with relatives and friends. On one persons care plan it was noted: X looks forward to her Sunday am telephone call with her daughter. People spoken with said that their visitors are made welcome in the home. People have some choices in their daily lives including when to get up in the morning and when they retire at night. People can choose to take their meals in their rooms. People are provided with a varied and balanced diet. Most people said they like the food and always have a choice. All food is home cooked and special dietary needs are catered for. There is now a four weekly rotating menu so that meals can be planned in advance. A hot meal is provided at lunch time however people could have salad if they wish. The dining arrangements have changed while the building work is going on. Meals for people who do not wish to eat in their rooms are taken in the downstairs dining room. Food is kept hot in a trolley and vegetables are now served in dishes on the table so that people can help themselves to as much or as little as they wish. Care Homes for Older People Page 17 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. People can be confident that their concerns and complaints would be listened to and acted upon. There are procedures in place to help protect people from harm and abuse. Evidence: There is a complaints policy that is given to everyone who moves to the home. The complaints book is available in the reception area for people to make comments. Complaints are recorded and investigated. The home has received two written complaints in the past twelve months and it was evident that these have been appropriately investigated and action taken. The manager said she would consider a different way of recording complaints and investigation to protect peoples privacy. She said she prefers to make sure she speaks with everyone in the home each day so that issues and concerns can be addressed at an early stage. People spoken with and those who returned surveys said they know how to make a complaint and are confident that they would be listened to. The home follows the West Sussex multi disciplinary policy and procedure for safeguarding vulnerable adults. All staff have now had training regarding adult abuse and the safeguarding procedures. The staff and managers were all clear about the need to immediately report concerns to the appropriate agency. Care Homes for Older People Page 18 of 27 Evidence: Criminal Record Bureau (CRB) checks are carried out for all new staff and volunteers before they begin work. Care Homes for Older People Page 19 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. People live in a safe and well-maintained home that is clean and hygienic. Evidence: St Annes Convent is a spacious building with gardens on level ground that are easily accessible for people living in the home. The home is well maintained and the manager told us in the AQAA that all the equipment is serviced as required. Improvements are being made and building work is due to finish in September. One bedroom on the first floor has already been refurbished and work is ongoing to improve seven other bedrooms that will have ensuite facilities. Disruption has been kept to a minimum by keeping the number of people living in the home low while work is going on. The dining room arrangements have been changed so that people can take their meals in a peaceful setting away from the building work. The home employs a number of domestic staff; three of the domestic team were on duty at the time of the visit. The home was clean and hygienic. Most staff have attended training in infection control so that they understand the need to protect people from the risk of cross infection. The laundry facilities are suitable for the needs of people in the home and are away from the kitchens and peoples bedrooms. Care Homes for Older People Page 20 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. Peoples needs are usually met by the numbers of staff on duty. The recruitment policy and procedure protects people in the home. People receive their care from competent and well trained staff. Evidence: The manager and deputy have been working on changing the staffing rotas to better meet the needs of the people in the home. Staffing numbers have been reduced while there are fewer people in the home. We looked at the staffing rotas; usually there are three care staff including a senior carer on duty in the morning and two in the afternoon. There are two waking staff on duty at night. On the day of the visit there was one senior carer on duty in the afternoon between 2pm and 4pm. Although the manager and deputy are also available in case of an emergency there was not sufficient time for staff to spend one-to-one with anyone in the home. At times when there are only two staff on duty and neither of the managers are available, this could present a risk if there was an emergency that two people need to deal with. The manager said she would discuss this with the responsible individual for the home. There has been an emphasis on training since the current manager began in post. Eight of the sixteen permanent care staff have now achieved the National Vocational Care Homes for Older People Page 21 of 27 Evidence: Qualification (NVQ) at level two or above. The manager and deputy have registered for an NVQ at level four in management and one person is studying for an NVQ in leadership. There is a recruitment policy and the manager has ensured that all the required checks are carried out before a new member of staff begins work. Prospective staff complete an application form and any gaps in their employment record are checked with them at the interview. Two written references are obtained including one from the most recent employer. An Enhanced Criminal Record Bureau (CRB) check is also obtained. Volunteers in the home also have a CRB check before they can work there. We read the recruitment records for two people who have recently started work in the home. It was clear that all the required checks had been carried out before people began work in order to protect people in the home. Mrs Hudson has introduced a formal induction programme that meets the Skills for Care standards. This provides staff with a good foundation for understanding how to provide good quality care. A training programme has been developed and all staff have attended mandatory training sessions. Mrs Hudson said that she is keen to make sure that the training provides the knowledge and skills that people need to do their job well and safely. Staff spoken with and those who returned surveys indicated that they are provided with the training and support that they need. Care Homes for Older People Page 22 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. People benefit from living in a well run home and their views are taken account of in the development of the service. There are policies and procedures in place. Peoples finances are protected. The health, safety and welfare of people living in the home and of staff are promoted and protected. Evidence: Mrs Hudson became the manager of the service in January and has just completed the process to become the registered manager. She has experience of working in homes for older people and has enrolled on an NVQ at level four in management. Mrs Hudson is committed to providing a good quality of care for people living at St Annes and good support to staff. The deputy manager began work in August 2008 and provides good support for the manager. Regulation 26 visits are carried out each month and a written report is provided in order to monitor the progress and quality of care in the home. We read samples of these forms. The manager said that she is always keen to seek feedback from people Care Homes for Older People Page 23 of 27 Evidence: living in the home, their relatives and staff. Residents meetings are held from time to time. The manager is developing a quality assurance system that will ensure that peoples views are sought and taken account of in the development of the service. There is a system for supporting some people with their day-to-day finances. Records of each transaction are kept and there is an annual audit to make sure peoples finances are protected. The policies and procedures have been reviewed and updated. Policies that were not in place at the previous inspection are now available to staff so that they have the information and guidance that they need. There are health and safety policies and procedures in the home and all staff have attended training in health and safety matters. There is a fire risk assessment and evacuation procedures are in place. Incidents and accidents are recorded and monitored to make sure that risks to people in the home are minimised. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 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). 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. 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