Care Home: St John`s Home

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What the care home does well St John`s Home provides prospective people and their relatives with written information about the services the home provides. People are encouraged to visit and spend time at the home before making a decision to move in. The pre-admission and assessment process is robust, which ensures that people`s individual needs can be met upon admission. The provision of care and support to meet people is provided by trained staff who have a good understanding of the needs of residents. People are encouraged and consulted in the development of their plan of care and assessments. People have named staff, known as a `key worker`, who have a responsibility to regularly review the care plans and ensure individual needs and requirements are met. The home has Activities Organisers that plan a range of activities and social events both at the home and in the community that people can participate in. There is an `activities programme and a `newsletter` published detailing special events and important information, which are displayed on notice boards and provided to people at the home. People are supported to take part in social activities and events; pursue their individual social interests and maintain contact with the community. This promotes their quality of life and maintain links with family and the community. People who live at the home and their relatives are supported to influence the care and support services they receive through meetings and quality assurance questionnaires. People can approach the Matron (Registered Manager) or staff at any time to express their views or discuss specific issues. The Matron (Registered Manager) operates an `open door` policy to the residents, visiting relatives or professionals and the staff. St John`s Home is a well-maintained home with regards to the decor and cleanliness. There is a homely and welcoming ambiance in the home. People are encouraged to personalise their bedrooms to suit their lifestyle and their privacy is promoted with the provision of en-suite facilities. The people who live at the home are supported by staff who work well together as a team and who have access to a range of training, which enables them to provide a quality service. The staffing levels are sufficient to meet people`s needs and there are a number of staff with long service, which promotes continuity of care. Staff are encouraged and supported to attain skills and experiences through attending training and develop specialist knowledge as part of their personal professional development. The Matron (Registered Manager) and staff work well together to promote an inclusive and a friendly atmosphere for the people who live at the home. There are good management systems and record keeping to ensure the health, safety and well-being of the people that live at the home. There are robust management and monitoring systems, along with the commitment of staff to ensure people continue to experience a quality and a tailored service. The comments we received in the surveys from people who use the service, staff and from our discussions during our site visit included:"It`s re-assuring to have staff that you know care for my mother in this way, willing to get the small things that she needs" "The girls are very good to me, especially as I`ve not been well recently and sometimes will fall down" "The food is very good here but I prefer not to have sweets as I`m diabetic" "It`s a lovely place, the staff are kind and caring" "It`s like home from home and the boys and girls are very good to me here" "Its lovely here, they look after you, care for you, which you just can`t buy" "St John`s Home makes the people who live there feel safe in the knowledge that they are well looked after and all their needs are met" "I have been happy with all the activities, entertainment and facilities on offer. Also if I choose to have quiet time on my own that is respected" "We are also exceptionally grateful to the volunteers that bring a social side to the home. This is very important for uplifting residents" "Food is lovely and entertainment is very comprehensive" "We have the opportunity to express our views about most things like the food, which has definitely improved recently" "Just to congratulate all the hard working staff, keep it going and many thanks" "Staff levels are excellent and give a very good level of overall care" "St John`s is a very well organised and caring home" "Management always available to listen and discuss problems with staff and residents that they might have" "All the staff work well as a team, which is really good" "I have never worked in a residential home before, but I`m really enjoying it. Everyone helps each other and we all pull together when needed" What has improved since the last inspection? St John`s Home has improved the documentation with regards to the assessment of needs and care planning in order to provide personalised care. Staff are trained in care planning and reviewing processes to ensure people`s individual care and support needs are met. New social events and activities have been arranged by the home for people to participate in. These have included Valentine Tea Dance, Tropical Animals, `A day at the seaside` theme and the Easter Chick Hatchery. There is a new large Summerhouse in the grounds, where some activities have taken place such as the Painting Club. A number of new staff have been appointed. These include care staff, domestic staff, Activity Organiser and a Facilities Manager, all having clear roles and responsibilities. Staff have continued to access training and work with health care professionals to improve their awareness and the quality of care they are able to provide. There has been on-going refurbishment to the home, which includes refurbishing ensuite facilities, provision of assisted baths and wet rooms and the decoration. The new courtyard has been landscaped to include garden furniture, shrubs and planters. The patio areas are decorated with small plants and ornaments. There is a ramp installed leading to the summerhouse and a seating area in the garden. A new CCTV system has been installed together with a panic alarm to improve safety within the home. What the care home could do better: This was a positive inspection of St John`s Home. The Matron (Registered Manager) and staff demonstrated there are robust systems in place to ensure people experience a quality service with regards to meeting their individual needs and promoting their choice of lifestyle. We have made some good practice recommendations that should be considered to improve the monitoring of financial records and the quality of information provided to people about the home. Key inspection report Care homes for older people Name: Address: St John`s Home Wellingborough Road Weston Favell Northampton Northants NN3 3JF     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: Rajshree Mistry     Date: 0 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 39 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 39 Information about the care home Name of care home: Address: St John`s Home Wellingborough Road Weston Favell Northampton Northants NN3 3JF 01604401243 01604414722 admin@stjohnsreshome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Johns Home Name of registered manager (if applicable) Mrs Jane Elliott Type of registration: Number of places registered: care home 50 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 who can be accommodated is 50 The registered person may provide the following categories of service: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Date of last inspection Brief description of the care home St Johns Home is a registered care home for older people. It is run by a Charitable Trust that has been in existence for 850 years and has received a Royal Charter from King Charles 1st. The Board of Trustees oversees and monitors the service. St Johns Home provides accommodation for up to 50 older people. It is situated in the Care Homes for Older People Page 4 of 39 Over 65 50 0 Brief description of the care home Weston Favell suburb of Northampton, easily accessible by public transport. There is car parking available at the home. St Johns Home is a large manor house styled building with an extension. The accommodation is on two floors and the upper floor is accessible via a passenger lift. All the bedrooms are single rooms with en-suite facilities. The communal facilities include lounges, quiet areas and dining rooms. There is an established large garden with a Summer House and seating for people to use. St Johns Home employes qualified nurses on the management team for historic reasons, although the home is not registered to provide nursing care. The Matron (Registered Manager) provided us with the range of fees, which are £440.38 to £728.14 per week. There are additional charges for personal expenditure such as hairdressing and personal toiletries. People who are interested in using St Johns Home are encouraged to contact the Matron (Registered Manager) to discuss individual needs and requirements. Further information about St Johns Home and any specific requirements can be obtained from the home in the form of Service User Guide and Statement of Purpose or by accessing the St Johns Home website. The latest inspection report from the Care Quality Commission (CQC) is available at the home or can be accessed via the CQC website: www.cqc.org.uk Care Homes for Older People Page 5 of 39 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: We as it appears throughout this Inspection Report refers to the Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA). This is a self-assessment tool completed by the Matron, (Registered Manager) of the home. We also reviewed the previous Inspection Report dated 16th April 2007 and any other information we have received. The unannounced site visit commenced on 6th April 2010 and took place between 9:30am and 17:30. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspecting was case tracking. This involves identifying people with varying levels of care and support needs and looking at how these are met by the staff at St Johns Home. We identified five people to case track and had discussions with Care Homes for Older People Page 6 of 39 them along with other people who were in residency and visiting relatives. We also spoke with a number of staff of various designations and looked at records with regards to the provision of care, staff recruitment and training, and the management of the home. Care Homes for Older People Page 7 of 39 What the care home does well: St Johns Home provides prospective people and their relatives with written information about the services the home provides. People are encouraged to visit and spend time at the home before making a decision to move in. The pre-admission and assessment process is robust, which ensures that peoples individual needs can be met upon admission. The provision of care and support to meet people is provided by trained staff who have a good understanding of the needs of residents. People are encouraged and consulted in the development of their plan of care and assessments. People have named staff, known as a key worker, who have a responsibility to regularly review the care plans and ensure individual needs and requirements are met. The home has Activities Organisers that plan a range of activities and social events both at the home and in the community that people can participate in. There is an activities programme and a newsletter published detailing special events and important information, which are displayed on notice boards and provided to people at the home. People are supported to take part in social activities and events; pursue their individual social interests and maintain contact with the community. This promotes their quality of life and maintain links with family and the community. People who live at the home and their relatives are supported to influence the care and support services they receive through meetings and quality assurance questionnaires. People can approach the Matron (Registered Manager) or staff at any time to express their views or discuss specific issues. The Matron (Registered Manager) operates an open door policy to the residents, visiting relatives or professionals and the staff. St Johns Home is a well-maintained home with regards to the decor and cleanliness. There is a homely and welcoming ambiance in the home. People are encouraged to personalise their bedrooms to suit their lifestyle and their privacy is promoted with the provision of en-suite facilities. The people who live at the home are supported by staff who work well together as a team and who have access to a range of training, which enables them to provide a quality service. The staffing levels are sufficient to meet peoples needs and there are a number of staff with long service, which promotes continuity of care. Staff are encouraged and supported to attain skills and experiences through attending training and develop specialist knowledge as part of their personal professional development. The Matron (Registered Manager) and staff work well together to promote an inclusive and a friendly atmosphere for the people who live at the home. There are good management systems and record keeping to ensure the health, safety and well-being of the people that live at the home. There are robust management and monitoring systems, along with the commitment of staff to ensure people continue to experience a quality and a tailored service. The comments we received in the surveys from people who use the service, staff and from our discussions during our site visit included: Care Homes for Older People Page 8 of 39 Its re-assuring to have staff that you know care for my mother in this way, willing to get the small things that she needs The girls are very good to me, especially as Ive not been well recently and sometimes will fall down The food is very good here but I prefer not to have sweets as Im diabetic Its a lovely place, the staff are kind and caring Its like home from home and the boys and girls are very good to me here Its lovely here, they look after you, care for you, which you just cant buy St Johns Home makes the people who live there feel safe in the knowledge that they are well looked after and all their needs are met I have been happy with all the activities, entertainment and facilities on offer. Also if I choose to have quiet time on my own that is respected We are also exceptionally grateful to the volunteers that bring a social side to the home. This is very important for uplifting residents Food is lovely and entertainment is very comprehensive We have the opportunity to express our views about most things like the food, which has definitely improved recently Just to congratulate all the hard working staff, keep it going and many thanks Staff levels are excellent and give a very good level of overall care St Johns is a very well organised and caring home Management always available to listen and discuss problems with staff and residents that they might have All the staff work well as a team, which is really good I have never worked in a residential home before, but Im really enjoying it. Everyone helps each other and we all pull together when needed What has improved since the last inspection? St Johns Home has improved the documentation with regards to the assessment of needs and care planning in order to provide personalised care. Staff are trained in care planning and reviewing processes to ensure peoples individual care and support needs are met. New social events and activities have been arranged by the home for people to participate in. These have included Valentine Tea Dance, Tropical Animals, A day at the seaside theme and the Easter Chick Hatchery. There is a new large Summerhouse Care Homes for Older People Page 9 of 39 in the grounds, where some activities have taken place such as the Painting Club. A number of new staff have been appointed. These include care staff, domestic staff, Activity Organiser and a Facilities Manager, all having clear roles and responsibilities. Staff have continued to access training and work with health care professionals to improve their awareness and the quality of care they are able to provide. There has been on-going refurbishment to the home, which includes refurbishing ensuite facilities, provision of assisted baths and wet rooms and the decoration. The new courtyard has been landscaped to include garden furniture, shrubs and planters. The patio areas are decorated with small plants and ornaments. There is a ramp installed leading to the summerhouse and a seating area in the garden. A new CCTV system has been installed together with a panic alarm to improve safety within the home. 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 10 of 39 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 11 of 39 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 moving to St Johns Home can be confident their needs will be met by the home, through the information provided, opportunity to visit, involvement in the robust assessment process to ensure a planned move to the home. Evidence: We wanted to find out how people who require residential care can be confident that St Johns Home can meet their individual needs. We did this by reading the selfassessment tool called the Annual Quality Assurance Assessment (AQAA) completed by the Registered Manager known as the Matron. We also spoke with the people who live at the home, their relatives, staff and we also looked at the records when we visited the home as part of our Key Inspection. We read the Statement of Purpose, which provides information about the range of services people can expect to receive, the facilities available at the home and the services within the local community. This also includes information about the staff, Care Homes for Older People Page 12 of 39 Evidence: significant policies and procedures such as the admission and the complaints procedures. We noted that copies of this information and a range of other information about local events, activities and the homes newsletter were in the foyer and displayed on the notice boards around the home. We spoke with the Matron (Registered Manager) with regards to the presentation of the information in the Statement of Purpose. It was acknowledged that the print was very small and the contents should be reviewed to reflect the changes made to the home with regards to the accommodation, social events, staffing and results from the various quality assurance and monitoring of the home. The AQAA was completed by the Matron (Registered Manager) and was returned to us prior to our site visit. The information in the AQAA was comprehensive and told us how people considering using St Johns are supported when considering using the home. The AQAA told us that people are provided with information, encouraged to visit the home at any time, take part in the activities and have a meal to help them make a decision about using the home. The AQAA also told us that there is an preadmission assessment process that is carried out with the person to ensure their care needs can be met by the home. We sent out surveys to the people who live at the home, of which 9 were returned. The responses and comments received in the surveys told us that people received enough information about the home prior to moving in. The responses also told us they were involved in assessment process to ensure their care needs would be met and this home was the right place for them. Comments received included: I have only been in the home a few months and I did not know what to expect. I am more than happy with the way everyone has helped me settle in We spoke with seven people who live at the home, ranging from someone living at the home for several years, a one person that had been in the home for a few months and another person that arrived on the day of our site visit. All have different care and support needs and interests. They told us their experience of moving in, which involved their relatives identifying and visiting the home on their behalf. Another person told us that the social worker had arranged for them to move to the home. They all told us that the Matron (Registered Manager) spoke with them to find out what help they and involved the family, where possible to ensure the home was the right place for them. Some of the comments we received from our discussion with people who live at the home and the visiting relatives, included: Care Homes for Older People Page 13 of 39 Evidence: My daughter visited a few homes before finding this one for me She asked me questions about what I can do for myself and what I need help with Id heard about the home before I move here Its re-assuring to have staff that you know care for my mother in this way, willing to get the small things that she needs We looked at the care files for 5 people who reside at St Johns Home. We found an up to date assessment of care needs had been carried out by the home for the newest people. We also found in one instance, an assessment carried out by the Care Manager from Social Services. The quality and content of the assessments were good, following the improvements made as detailed in the AQAA. The information from the assessments are used to develop plans of care to support individuals with their personal care, daily routines, cultural needs and choice of lifestyle. People living at the home told us that they have very good boys and girls that look after them. People told us that they are able to have either a female or male carers to help them with their personal care needs, which promotes choice and dignity. The staff we spoke with told us they have information about new people that are moving to the home, their individual care needs and interests. Staff told us there is a key-working system in place, whereby named staff are responsible for care planning and reviewing peoples care needs and are introduced to the new person at the point of moving to the home. Staff receive good training to deliver the care and support people require and are supported by external links with health care professionals who have specialist areas of expertise. This ensures staff maintain their skills and knowledge in line with new practices to benefit the people residing at the home. We spoke to Matron (Registered Manager) with regards to accepting emergency admissions to the home. They told us they prefer to have planned admissions to the home to ensure they are able to meet the needs of that individual. In addition, they told us the home has a waiting list of prospective people wishing to move to the home, as and when there is a vacancy. This shows the home recognises the importance and value to people that have a planned moved into the home at a sensitive time in their life. St Johns Home does not provide intermediate care services. Care Homes for Older People Page 14 of 39 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. The health and well-being of people is monitored and reviewed regularly to ensure they receive the care and support they need and want, promoting their lifestyle and independence. Evidence: We wanted to find out whether people living at St Johns receive the care and support they need and whether the service is tailored to their individual preferences. We sent surveys to the people who live at the home, of which 9 were returned. The responses and comments received in the surveys told us that they always receive the care and support that they need including support with their medication and external support with their health needs. Some of the comments received in the surveys told us what they thought of the service and their experiences: Provides the necessary care Very caring and considerate Care Homes for Older People Page 15 of 39 Evidence: We, as a family are very impressed of the care that our mother receives, especially in a crisis e.g. when mum has fallen over or for some other reason cannot sleep, she is always checked and brought a cup of team and monitored The AQAA, completed by the Matron (Registered Manager) and returned to us prior to our site visit, was comprehensive. It told us how people are supported and have their individual personal care needs met. It also told us that the home has a system of keyworking, whereby each resident has a named member of staff that has a lead responsibility for developing the care plan with the person, reviewing the care plans at least every 3 months or sooner and ensuring their needs are met. The AQAA also detailed the improvements made to the home and the quality of care people receive. These included the development of comprehensive and holistic care plans, reflecting individual preferences, routines and supporting people to maintain their independence. People who reside at the home also can choose whether they want a female or male member of staff to support them to alleviate any anxieties that they may have. This shows people can expect to receive tailored and personalised service. We spoke with five people who live at the home and this included three people whose records were also viewed. Everyone spoke positively about the quality of care they receive and praising the staff. The comments we received from people that we spoke with supported the comments were received in the surveys. These included: The girls are very good to me, especially as Ive not been well recently and sometimes will fall down The food is very good here but I prefer not to have sweets as Im diabetic Its a lovely place, the staff are kind and caring Its like home from home and the boys and girls are very good to me here Its lovely here, they look after you, care for you, which you just cant buy We looked at the care files containing the assessment of needs, assessments of risk, care plans and daily records for five people when we visited. We found the care plans had been improved compared to the older care plans we found in the care files. Care plans were developed from the information gathered from the assessment of needs. Care Homes for Older People Page 16 of 39 Evidence: The safety measures from the risk assessments were also reflected in the care plans where people needed help mobilising or were at risk of falling. The care plans had been personalised reflecting peoples preferences with regards to being supported by a female or male member of staff and their individual daily routines. For example, one care plan stated, ..... likes to be woken up with a cup of tea around 7am People using the service and their visiting relatives told us they have good health support from the visiting District Nurse and General Practitioner (GP). This was supported by the records that saw in the care files, showing visits made by the District Nurse or the GP and the treatment prescribed, if any. A visiting relative told us that the District Nurse had been to change the dressing on their mothers leg where an ulcer had developed. Another lady also told us, Ive got an appointment at the eye infirmary, which my daughter will take me to. This showed peoples health needs were met and people can be supported by their family to attend health appointments. We sent surveys to the staff, of which, 6 were returned. All the responses and comments received told us staff receive up to date information and care plans about the people who reside at the home. The responses also told us that communication between staff was good, there were sufficient staff on duty, they receive regular training and they receive good support from their manager. The comments in the surveys supported this practice, included: All the staff work as a team, which is really good St Johns Home makes the people who live there feel safe in the knowledge that they are well looked after and all their needs are met Staff of various designations told us that they initially found the new care plans challenging but once they identified individual care and support tasks, recognised the benefits. Staff told us they do refer to the care plans and showed a good understanding of peoples needs, ability and how they help people maintain their level of independence. As key workers, staff said they have between 3-5 people that they key work and are responsible for doing reviews of the care plans with person and their relative, if necessary. The care plans we read showed reviews were carried out involving the individual and that supported what staff had told us. We spoke with staff of various designations regarding their skills, knowledge and training. Staff confirmed they have regular training and refresher training to ensure their knowledge and practice is up to date. We found out all staff including domestic staff are required to complete induction training consisting of the policies and Care Homes for Older People Page 17 of 39 Evidence: procedures for the home, moving and handling, fire safety, infection control, health and safety and safeguarding adults. The staff training records viewed confirmed this. We observed throughout our site visit to the home that staff promoted the privacy and dignity of those living at the home. Staff were seen knocking on doors before entering a persons bedroom, addressing several people by their preferred names and listening to people when they were speaking. The staff we spoke with gave us examples of how they ensure peoples privacy and dignity is respected. One member of staff referred to the good training they had when they started to work at St Johns Home many years ago. They told us; the first thing I learnt about privacy, was to always cover people because you know yourself how vulnerable you would feel in their place. The AQAA told us that the home works closely with the GP and District Nurse when caring for people who are dying. Staff told us they had attended training on death, dying and bereavement and end of life training. They said how they have found knowledge gained from the training to also support the person and their family. The Matron (Registered Manager) also demonstrated how the new care planning format takes into account the guidance provided by Liverpool Care Pathway in providing end of life care and making the person comfortable until the end. There is a surgery, which is used to store medicines and is used by the District Nurse and the GP. The Senior Carer told us they are responsible for the management of medicines including the ordering, administering and returning of medication. Information with regards to medicines, policies, procedures and information on best practice is displayed and accessible to the staff. The Senior Care confirmed that the Pharmacist prepares the medication into cassettes and carried out an inspection on 17th March 2010. The AQAA told us that people can choose to continue managing their own medication. The Senior Carer told us three people prefer to manage their own medication. To ensure the persons safety an assessment of risk is completed, along with confirmation from the GP and the provision of secure storage within the persons bedroom, which we noted when we were invited in to see a bedroom. This demonstrates peoples rights and independence is promoted. People who use the service told us they always have their medication on time. This was consistent with the responses with received in the surveys. One lady recited to us: I get 11 tablets in the morning, 2 at lunch-time, 5 at tea-time and 3 at 8pm. Care Homes for Older People Page 18 of 39 Evidence: We observed in part the medication being given out at lunch time by the Senior Carer. It was managed consistently with good practice, checking the name and medication, giving medication out individually and completing the records once the medicine with taken. We also checked the medication records and the medication for three people whose records we had viewed and found these to be in good order. Staff told us that although they are trained, the Senior Carers and trained staff are allowed to administer medication. The prescribed Controlled Drugs are stored in approved controlled drugs storage. We checked the prescribed controlled drugs and records for two people and found these to be in good order. Care Homes for Older People Page 19 of 39 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the home influence the range of activities, events and meals provided by the home, which has a positive impact on the quality of life they experience. Evidence: We wanted to find out what opportunities are available for people at St Johns Home to engage in social and leisure activities, and participate in community events. We wanted to find out whether people were able to maintain contact with family and friend. We also wanted to know what peoples views were about the choice of meals provided. The AQAA was completed by Matron (Registered Manager) and returned to us prior to our site visit. The information in the AQAA told us the Activity Organisers, arranges a variety of activities every day that people can take part in. These ranged from seasonal crafting, flower arranging, Communion Services in the homes Chapel, monthly Songs of Praise, music appreciation of classical, big band and 40s - 50s music. Various festivals and important days are celebrated such as Easter, Christmas, Birthdays and Valentine Hearts. The AQAA told us the new developments that had taken place at the home, which Care Homes for Older People Page 20 of 39 Evidence: include the appointment of another Activity Organiser and the new large summer house. The newer activities that people have taken part in include the Painting Club, Motivation sessions, gardening club, Valentine Tea Dance, Easter Chick Hatchery, where eggs were brought in and people were able to watch the chicks hatch and Tropical Animals, were brought into the home such as the Meerkats and Spiders. We sent surveys to the people who live at the home and 9 were returned. All the responses told us the home organised activities and events that they could take part in and that they always liked the meals provided. Some of the comments we received in the surveys in response to what the service does well supported the information in the AQAA and included: Well organised everything, activities, religion, day-to-day care I have been happy with all the activities, entertainment and facilities on offer. Also if I choose to have quiet time on my own that is respected We are also exceptionally grateful to the volunteers that bring a social side to the home. This is very important for uplifting residents Food is lovely and entertainment is very comprehensive During our site visit we saw people were in the Metcalfe Lounge, taking part in an activity in the morning, led by the Activity Organiser. A number of people choose to spend time in their bedroom watching television, reading, or entertaining their visitors. We saw people moving around the home independently, sitting in the lounge or the quiet area, known as the sanctuary. We observed a number of people preferred to have their own newspapers delivered. We saw one lady getting ready to go out for a short walk, saying its a lovely day today, so I thought Id go for a walk before lunch. The Matron (Registered Manager) told us that they have improved and enhanced the quality of life of those in residence by installing a Loop System, which supports those with a hearing impairment. The Matron (Registered Manager)and staff were aware that occasionally they would have to remind or check peoples hearing aid to ensure it was set correctly. One lady with a hearing impairment said how she can now hear what is being during the activity session even though she may be sat at the back. The atmosphere and the ambiance in the home was relaxed and welcoming. People were moving around the home independently. Throughout our site visit to the home Care Homes for Older People Page 21 of 39 Evidence: we observed people living at the home were happy and smiled. Staff greeted residents and visitors with a smile and were hospitable. Staff spoke with people in a respectful manner, addressing them by their preferred names. This showed the ethos of the home and the conduct of staff promoted peoples well-being and made them feel valued and important. People who use the service spoke about the things that they like to do and take part in. One lady told us about the different animals that were brought to the home. These included a hawk that sat on her arm and recently waking up in the middle of the night to watch the chicks hatch. Another gentleman whose been at the home for a short while, felt they had a new lease of life and opportunities to do different things. Some of the other comments we received further supported that the home organised a variety of social events and activities that people can take part in every day. This showed the home promoted stimulation and opportunities for people to have new experiences. Some comments were received from the people we spoke with included: As you get older I like to spend time reading event though there are activities that you can join in with. I like to sit in the sanctuary - quiet area I like reading, there;s a good selection of books available here for me I have to wear my glasses for reading; my daughter often brings me a good reading book. I do enjoy reading a good novel Weve had exotic animals here from Hawks to Meerkats and watched Chicks hatch recently The children from the school next door come and play on the lawn, which is really nice in the summer Ive celebrated my 80th birthday with my family and all my friends here We saw the notice boards throughout the home, displaying photographs and the Activity Programme. The range of activities for the morning and afternoon and occasionally the evenings included Easter festivities, Friendship House, Friends bus trip to see daffodils and have tea at a garden centre, activity and sherry, residents meeting, songs of praise, music, manicure and evensong. Care Homes for Older People Page 22 of 39 Evidence: We saw a number of ladies in the salon having their hair done. One lady told us that she has her own stylist and books an appointment when it needs doing. Staff told us that residents are encouraged and supported to make their own appointments, which maintains their independence. The staff we spoke with demonstrated good awareness of peoples interests and lifestyle, from taking part in activities, family and friends. Staff told us that part of developing the care plan, looks at peoples social and leisure interests, including observing their religious beliefs. The care plans we read showed individual social interests and how the staff supported people to continue with their interest. The daily records we read reflective the activities the person had taken part in, had visitors or had been out with their family. This showed routines, activities and plans were person centred to reflect individual lifestyle. We received 9 surveys from the people that live at the home. All the responses told the always like the meals provided. We asked people about the meals provided, which were positive and noted the improvements. The comments included: I was asked what I prefer to eat and whether there are foods I do not like Theres always a choice of 3: meat, fish or salad The meals have so improved recently, I think things have settled down in the kitchen and a little bit more organised We are asked what we like for lunch the evening before and at lunch time we choose what wed like for tea Specialist diets are catered for, which are recorded within the individual care plan and are monitored. We observed meals being service at lunchtime, the majority choosing to have their meals one of the two dining rooms. We observed the meals being served at the dining table individually. Meal times were relaxed and people were enjoying conversations, which created pleasant experience. Two people told us that they have the opportunity to express their views at the residents meetings or in the questionnaires they receive about the meals and activities. People felt confident to express their views and felt they were listened to, thus the improvements made to the meals. This showed that people who live at the home do influence the quality of service they receive. Care Homes for Older People Page 23 of 39 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 who live at the home are supported and cared for by trained staff who are confident in promoting individual rights, choices and are encouraged to raise concerns and contribute their views on the quality of service. Evidence: We wanted to find out how the rights of people who use the service are support, and whether they know how to raise concerns. We also wanted to find out whether people feel safe in the home and by the staff that support them. The AQAA was completed by the Matron (Registered Manager) and returned to us prior to our site visit to the home. The information in the AQAA was comprehensive and told us the home had received one complaint, which was resolved within the set timescale. We read the complaints log that detailed the investigation, actions and confirmation of the response to the complainant. The AQAA also told us that staff receive training to enable them to respond and promote the rights and welfare of those who live at the home. We sent surveys out to the people who live at the home, of which, 9 were returned. All the responses received told us people knew who to speak with and how to make a formal complaint. All the responses told us that staff were available, listened and acted to their requests, which was evident from our observation during our site visit. We read the information people receive about the home, which included the Care Homes for Older People Page 24 of 39 Evidence: complaints procedure. It clearly set out the process by which people could raise concern or make a complaint. We spoke with five people who use the service, which included two new residents and a visiting relative. They told us whilst they had no complaints, they were confident that minor problems were swiftly rectified and would see Matron (Registered Manager), if necessary. They also told us they have the opportunity to express their views and opinions and can also speak at the residents meeting, which was scheduled for 7th April 2010. This showed people were aware of their rights. The comments received in the surveys were and from the people we spoke with included: 2.5yrs resident and no complaints St Johns does a wonderful job and there is little to criticize No reason to complain We have the opportunity to express our views about most things like the food, which has definitely improved recently We have residents meetings and the staff and the Matron is always available if we needed to speak to her One gentleman told us they had been listening to the announcement of the Election, the debates and said they would be voting. Although he was unsure how this would be done, having recently moved to the home, was confident that he would be able to vote. The Matron (Registered Manager) told us residents are assisted to take part in politics through the use of postal voting. We wanted to find out whether staff knew what safeguarding issues meant and how they would respond to any allegations. Safeguarding means the promoting and protecting the well-being and safety of people using the service from harm, risk or abuse. We spoke with three members of staff of various designations, all were knowledgeable as to their role and responsibilities in ensuring peoples welfare was maintained. All were able to talk about how attending refresher training in safeguarding adults recently and awareness of the various forms of abuse that may occur, and their responsibility in reporting concerns. The newest member of staff and domestic staff told us that part of the induction training included safeguarding adults Care Homes for Older People Page 25 of 39 Evidence: and individual responsibility to report concerns that affect peoples well-being. The staff training records viewed confirmed staff do receive training and regular updates on current best practices. The AQAA told us there was one safeguarding investigation, which we were notified of at the time. During our site visit to the home, Matron (Registered Manager) provided us with the information and details of the actions taken to ensure robust systems are in place. The documentation we read as part of our site visit included the assessment of needs, care plans and reviews, daily reports and the minutes of the residents meeting. The care plans clearly showed peoples ability to make day-to-day decisions. The Matron (Registered Manager) was aware of the new legislation relating to peoples capacity and ability to make decisions for themselves. We also viewed the complaints procedure, safeguarding adults procedure, the report from the quality assurance carried out in September 2007 and the monthly visit report, carried out by the representative of the Management. This demonstrated that there are robust guidance, systems and monitoring in place for people who live at the home to express their views and their rights. Care Homes for Older People Page 26 of 39 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. St Johns Home provides people with a safe and comfortable environment to live in that is well maintained. Evidence: We wanted to find out whether St Johns Home provides a comfortable and well maintained environment for people to reside. The AQAA was completed by the Matron (Registered Manager) and returned to us prior to our site visit to the home. The AQAA told us the improvements that have been made and the on-going refurbishment of the home. These include the refurbishment of the en-suite facilities, new hoist assisted bath, summer house and level access, improved lighting outside, new courtyard and landscaping of the garden and the installation of a CCTV system with panic alarm to the front of the home. Staff have completed further training and updates in infection control procedures. The management of the laundry has been improved and benefit from using the Essential Steps to Safe Clean Care to monitor practice. St Johns Home has also appointed a Facilities Manager, who is responsible for the maintenance and management of the building and equipment. We sent surveys to people who live at the home, of which 9 were returned. All the responses told us that the home is always well maintained, fresh and clean. Care Homes for Older People Page 27 of 39 Evidence: St Johns Home is a large detached property with high ceiling and traditional features and has an extension. The Matron (Registered Manager) showed us around the home, including the bedrooms with the newly refurbished en-suite facilities, bathrooms with the new assisted baths and the communal areas. The environment is bright, spacious, benefiting from ample natural light and decorated to create a warm and homely ambiance. People who reside at the home enjoy the greenery and seasonal blossoms with the views from the windows. We spoke with four people regarding the accommodation. All complimented the environment and commented on the decoration that has been carried out. One gentleman told us how minor faults have been promptly fixed after reporting the problem to the Facility Manager. We were invited to speak with one lady in the privacy of her bedroom. She told us she liked her room, having the benefit of privacy with the en-suite facility and access out onto the patio garden. The bedroom was personalised with family portraits and ornaments. We saw a number of bedrooms, communal areas and communal bathrooms, which were clean and with the required equipment to meet peoples individual needs and safety. We also noted that equipment and adaptations are provided to promote peoples well-being, care and safety. These included special beds, known as profile beds. The Matron (Registered Manager) told us following assessments of risk and support from the Occupational Therapist, some people have benefited from using the profile bed, which can be adjusted to their height and in some cases lowered where they may be at risk of falling out of bed and injuring themselves. The staff we spoke with of various designations demonstrated a good understanding of infection control practices. One member of staff told us that they have completed additional training in Infection Control and improved the laundry system. The positive impact on the laundry arrangement was commented up on by two people that use the service. They told us I know my laundry will be collected and returned promptly, in some cases within hours. There is a team of domestic staff who were seen cleaning the bedrooms and bathrooms. They showed good knowledge and practice with regards to safe storage of cleaning materials, infection control practices and health and safety, having been in post for a few months. This showed the home employs staff with specific duties and are trained to ensure the cleanliness of the home. We also saw staff wearing protective clothing such as gloves and aprons handling food or preparing to assist people with their personal care tasks. Care Homes for Older People Page 28 of 39 Evidence: Some of the comments were received from the people we spoke with were: The cleaners are very good and would come and clean later in the day when I am ready to move to the lounge or go out Its good to have an en-suite, Im very private Staff always wear gloves and aprons, even the cleaners Theres been much improvement to the laundry, the new lady knows what items belong to whom Care Homes for Older People Page 29 of 39 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. People are supported by staff who have undergone a robust recruitment process and access regular training that enables them to provide good quality care and support. Evidence: We wanted to find out whether the care and support people receive is provided by staff who have been recruited using a robust recruitment process. We also wanted to find out whether staff have the relevant training and experience and are supported by the Matron (Registered Manager). The AQAA was completed by the Matron (Registered Manager) and returned to us prior to our site visit to the home. The content and quality of information demonstrated the recruitment process and the pre-employment checks that are in place to ensure the suitability of the staff employed. It also told us about the mandatory induction and training staff are required to complete in their respective roles. The AQAA told us the improvements that have been made to the home with regards to the staff and training, which has positively benefited the people who live at the home. This includes the appointment of the Facilities Manager and Activity Organiser, extension to the induction programme and staff training including attaining the National Vocational Qualification (NVQ) in care, level 2 and/or above. Care Homes for Older People Page 30 of 39 Evidence: We sent survey to the people who live at the home, of which 9 were returned. All the responses told us people found staff were trained, knowledgeable and experienced to look after them. It also told us that staff were available, listened and acted upon requests. We spoke with five people who live at the home and a visiting relative. All complimented the staff with regards to their conduct, kindness and professionalism when they are helped with their personal care tasks. This supported the responses and comments received in the surveys and included: They look professional and have their names on badges, which helps me Mother now has a new key worker, and she made time and introduced herself to us When they say they will come back - they do Its nice to have a young man help you, theres too many women here Its lovely here, they are wonderful to me. You cant buy this type of care We looked at the staff rota, showing the number of care and domestic staff on duty and their specific roles, in addition to the Matron (Registered Manager). Our observations during our site visit to the home showed there were sufficient staff to meet the needs of the residents. We noted that staff promptly responded to the emergency call bells, and our conversations with people confirmed this. We looked at the recruitment records of three staff, which included the newest member of staff. The records we viewed showed that the home has a robust recruitment process. This means that two satisfactory written references are obtained along with a satisfactory Criminal Records Bureau (CRB) disclosure prior to commencing employment, which means that those employed to work with vulnerable people are vetted. We sent surveys out to the staff, of which two were returned. All the responses told us staff underwent a fair and thorough recruitment process and that the employer carried out checks before they started work. This supported the information in the AQAA. We spoke with three members of staff including a new care staff and domestic staff. They told us that they were required to complete an induction, which consisted of Care Homes for Older People Page 31 of 39 Evidence: undertaking training in a variety of topics such as moving and handling, protecting vulnerable people from abuse, health and safety, food and hygiene, infection control and fire safety. Domestic staff said they were required to also complete COSHHE training, which focuses on the safe handling and storage of hazardous cleaning products. The staff training records viewed contained certificates of training completed, which showed staff maintained their knowledge and skills. Some staff we spoke with told us that they have undertaken courses to become the trained trainer and have a lead responsibility on specialist topics. These include training in infection control and improving the laundry arrangements, pressure care management and moving and handling trainer. This showed staff are encouraged to develop themselves and influence and train new staff to provide consistent and a quality service to people who live at the home. Staff told us that they benefit from on-going training and regular updates. Staff were confident to request to attend specialist training to improve their understanding when caring for people with specific illness or disability to improve their quality of life. This showed the staff are pro-active in improving their knowledge to benefit the people they look after. Care Homes for Older People Page 32 of 39 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. St Johns Home is managed by a competent and experienced person who actively promotes and encourages views from a range of sources to ensure the home is run in the best interests of its residents. Evidence: We wanted to find out whether St Johns Home continues to be well managed in order to promote the health, welfare and safety of those in residence and is run in their best interest. The AQAA was completed by the Matron (Registered Manager) and returned to us prior to our site visit. The AQAA was comprehensively completed and told us the Matron is now the Registered Manager for the home. Both the Matron (Registered Manager) and the Deputy Manager are Registered General Nurses (RGN), experienced and committed to the continued development of the home. The AQAA told us that there are robust management systems in place ranging from the deployment and supervision of staff; compliance with health and safety including Care Homes for Older People Page 33 of 39 Evidence: maintenance of equipment, supporting residents with their money and providing those who live at the home and their relatives opportunity to express their views and influence the running of the home. We spoke with the Mrs Jane Elliott, Matron who is the Registered Manager of the home. Mrs Elliott is a Registered General Nurse and continues to access regular training to ensure she is up to date with current practices. Mrs Elliott told us she and the Deputy Manager have attended the Deprivation of Libertys and IOSH training and has influenced the improvement to practices in the home. This showed the Matron (Registered Manager) continues her own development and keeps up to date with new practices and changes in legislation. The AQAA told us the improvements made since our last Key Inspection of the home. These include improving the organisation and management of records, staff training and review of the policies and procedures. The home seeks support and advice from the Health and Safety Adviser with regards to health and safety issues within the home. We spoke with four members of staff who were on duty when we visited, all said that they found the Matron (Registered Manager) and all the staff at the home were approachable, supportive and worked as a team. All were confident to contribute new ideas or concerns to the Matron (Registered Manager), who operates an open door policy. All confirmed that they have monthly team meetings and supervisions with the Matron (Registered Manager) to discuss work issues, training and personal development. Staff records viewed contained certificates of training and records of meeting held. This was consistent with the responses and comments received in the surveys from staff. The staff rota viewed reflected the staff on duty, showing there were sufficient number of care and domestic staff on duty. The home benefits from having a team of care and domestic staff, all having clear roles and responsibilities to provide quality care and support and maintain the cleanliness of the home. Some of the comments we received in the surveys from staff and the people who live at the home, were: Just to congratulate all the hard working staff, keep it going and many thanks Staff levels are excellent and give a very good level of overall care Care Homes for Older People Page 34 of 39 Evidence: St Johns is a very well organised and caring home The staff work well as a team Management always available to listen and discuss problems with staff and residents that they might have The home keeps us updated with our qualifications and courses All the staff work well as a team, which is really good I have never worked in a residential home before, but Im really enjoying it. Everyone helps each other and we all pull together when needed One lady told us that she prefers her account to be managed by the home with regards to payment for hairdressing. We spoke with the Finance Administrator, who described the system in place. The records we looked at for one lady showed that receipts are kept and the account is accurately reconciled. From our discussion with the Finance Administrator and the Matron (Registered Manager) we noted that there are no monitoring or random checks made on the financial records. We advised that they should consider developing an audit or monitoring system to ensure the money held in safe-keeping is protected. The home produces a newsletter, which includes information on past and future events and activities, local news, information and articles, as well as birthdays, anniversaries and important dates in the calendar. We were told by two people using the service that they regularly have Residents and Relatives Meetings, where they have the opportunity to express their views, be involved in making decisions about the home and events. The date of the next meeting was planned for 7th April 2010, and was programmed into the weekly events programme. They told us: We are consulted and asked what our view is about things such as the meals We are given the opportunity to comment and express our opinions We read the latest monthly visit report, conducted by a Trustee representing the management of the home. The visit was carried out on 15th March 2010. The checklist used showed the specific records checked such as care plans, staff recruitment and the complaint record. The checklist showed that they spoke with some residents and staff during their visit and checked the cleanliness of the home. Whilst only a checklist Care Homes for Older People Page 35 of 39 Evidence: was used it did demonstrate that the service has an internal monitoring system for the home. St Johns Home carried out a quality assurance exercise in September 2009. The Matron (Registered Manager) showed us the report with the results and the actions taken to improve the service. This report told us that the quality of the service people received had improved in comparison to the previous year. This report had also been shared with the residents at the Residents & Relatives Meeting in November 2009. It also told us the actions that have been taken to address issues such as the laundry arrangement and the quality and temperature of meals served. Our findings during the site visit and our conversations with the people who live at the home and staff, confirmed these improvement had taken place. We receive timely notifications, known as Regulation 37 notifications and are a legal requirement. Matron (Registered Manager) provides good information with regards to the event or incident and the actions taken that has affected the health and well-being of people using the service. The information submitted in the AQAA detailed the regular maintenance of health and safety systems within the home, including fire system and equipment, central heating system and the emergency call systems. People using the service and staff confirmed that they have regular fire drills and tests for their safety and welfare. Care Homes for Older People Page 36 of 39 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 37 of 39 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 1 To revise the Statement of Purpose and other information about the home with regards to the presentation i.e. larger print and the content following the changes and improvements made to the home. The home should consider developing a system to randomly check or audit the records and money held in safe-keeping by the home on behalf of its residents. 2 35 Care Homes for Older People Page 38 of 39 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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