Care Home: St Michael`s Rest Home

What the care home does well Care plans are working towards being more person centred and expressing the views, choices and wishes of the residents. Staff treat residents with respect for their dignity and privacy and the inspector observed some good professional and friendly interaction taking place between staff and residents. Residents stated that they were happy in St Michaels Rest Home and that the staff treat them with respect and dignity. Staff reported that while improvements to working regimes were difficult at first they can now see the benefit for the residents in the home. What has improved since the last inspection? Pre-admission assessments forms have been reviewed and now require detailed information so that the manager is able to assess if the environment and staff are able to meet the prospective residents needs. More person centred care plans are being used, with evidence of generally good reporting. The recording, administration and storage of medicines in the home has improved with few minor changes residents can now be confident that their prescribed medicines are managed in accordance with policies and guidelines. Residents are now able to select menu choices via written or photographic menus. While one resident said that she prefers the written menus other residents said they liked the photographic menus. All residents using bedrails have been re-assessed by the community nurse. Specialised adjustable beds have been supplied and bed rails are no longer being used in the home. Many of the bedrooms in the home have now been refurbished and provide residents with a light airy well decorated and furnished bedrooms. All radiators have been covered, a new call bell system has been installed with all residents having access to a call bell both within their own bedrooms and communal areas. Environmentally the home has been improved with the major refurbishment programme, and now provides residents with light and airy communal and bedroom accommodation. The back garden of the home has been landscaped and a large new patio area has been built. Staffing levels have improved and the Head of Care stated that these a kept under review to ensure that staff are able to meet the changing the needs of the residents. Many more staff have gained the NVQ level 2 or above qualification in Social Care since the last key inspection, and mandatory training course have been introduced into the home. The new appointed manager is in the process of registering with Care Quality Commission, and it is expected that the interview for registration will take place towards the end of September 2009. A quality assurance system has been developed, where residents, relatives and staff views have been sought in regard to the quality of care in the home. Systems used in the home are monitored on a regular basis. Some further work needs to be done to seek the views of external professionals who visit the home regularly and to develop an annual report on quality assurance findings. Fire, health and safety risk assessments are now carried out regularly in the home to ensure that none of the residents are placed at risk from fire or poorly maintained environmental areas. What the care home could do better: At present the personal hygiene tasks are not always recorded for each resident in the home, and this should be improved upon so that tasks like mouth and dental care, nail care, hairwashing and shaving are recorded to ensure that residents receive regular attention to these areas. While the enviromment has improved there are many areas of the home where minor finishing work needs to take place, and the back garden of the home needs to be made secure so that residents are able to use this area at anytime. Mandatory training and staff recruitment must be improved upon to help ensure that residents are not placed at risk. Two residents said that they would like more contact with the appointed manager so that they could get to know her better and she could get to know them. Key inspection report Care homes for older people Name: Address: St Michael`s Rest Home 107 Cooden Drive Bexhill-on-sea East Sussex TN39 3AN     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: June Davies     Date: 0 3 0 9 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 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 26 Information about the care home Name of care home: Address: St Michael`s Rest Home 107 Cooden Drive Bexhill-on-sea East Sussex TN39 3AN 01424210210 F/P01424210210 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Balwinder Singh Khera,Baljeet Kaur Khera Name of registered manager (if applicable) Mrs Julie Christine Smith Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 15 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: Dementia (DE) Date of last inspection Brief description of the care home St Michaels Rest Home is situated in a residential area of Bexhill-on-Sea. The home is a detached house with 12 bedrooms comprising of 9 single bedrooms and 3 double bedrooms all bedrooms are fitted with a washbasin and two rooms have en suite toilet. There is a large lounge with integral dining room. A stair lift provides access to the first floor. The front garden has been adapted for car parking, and there is a large rear garden, which is secure for the residents. Details of weekly fees charged can be obtained from the manager. Residents would be expected to pay extra for chiropody, Care Homes for Older People Page 4 of 26 Over 65 0 15 2 3 0 3 2 0 0 9 Brief description of the care home newspapers and magazines, toiletries and other luxury items. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out on the Thursday 3rd September 2009 over a period of seven hours. The appointed manager was on annual leave and the Head of Care was available throughout the inspection. The inspector spoke with the Head of Care, three members of staff and two residents. Documentation in relation to key standards inspected was viewed, and observations took place of lunch medicines administraiton, staff observing privacy and dignity of residents, the communal rooms, some residents bedrooms and the back garden and patio area. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? Pre-admission assessments forms have been reviewed and now require detailed information so that the manager is able to assess if the environment and staff are able to meet the prospective residents needs. More person centred care plans are being used, with evidence of generally good reporting. The recording, administration and storage of medicines in the home has improved with few minor changes residents can now be confident that their prescribed medicines are managed in accordance with policies and guidelines. Residents are now able to select menu choices via written or photographic menus. While one resident said that she prefers the written menus other residents said they liked the photographic menus. All residents using bedrails have been re-assessed by the community nurse. Specialised adjustable beds have been supplied and bed rails are no longer being used in the home. Many of the bedrooms in the home have now been refurbished and provide residents with a light airy well decorated and furnished bedrooms. All radiators have been covered, a new call bell system has been installed with all residents having access to a call bell both within their own bedrooms and communal areas. Environmentally the home has been improved with the major refurbishment programme, and now provides residents with light and airy communal and bedroom accommodation. The back garden of the home has been landscaped and a large new patio area has been built. Staffing levels have improved and the Head of Care stated that these a kept under review to ensure that staff are able to meet the changing the needs of the residents. Many more staff have gained the NVQ level 2 or above qualification in Social Care since the last key inspection, and mandatory training course have been introduced into the home. The new appointed manager is in the process of registering with Care Quality Commission, and it is expected that the interview for registration will take place towards the end of September 2009. A quality assurance system has been developed, where residents, relatives and staff views have been sought in regard to the quality of care in the home. Systems used in the home are monitored on a regular basis. Some further work needs to be done to seek the views of external professionals who visit the home regularly and to develop an annual report on quality assurance findings. Care Homes for Older People Page 7 of 26 Fire, health and safety risk assessments are now carried out regularly in the home to ensure that none of the residents are placed at risk from fire or poorly maintained environmental areas. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The statement of purpose needs further work to ensure that prospective residents are fully aware of the service they are to receive for the fees being paid. Pre-admission assessments now cover all aspects of health, physical and social care to ensure that the home can meet prospective residents needs. St Michaels Rest Home does not offer intermediate care. Evidence: The statement of purpose has been reviewed and updated to reflect changes that have been made in the home, but further information needs to be included in regard to fees being charged and what extras residents will be expected to pay for. The home has not admitted any new residents since the last key inspection, but the new appointed manager has developed a new pre-admission assessment template. Care Homes for Older People Page 10 of 26 Evidence: This pre-admission assessment will required detailed information, to ensure that a basic care plan can be drawn up from the information obtained, and to assess if the home and the staff are able to meet the needs of the prospective resident. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning in the home has improved, showing residents likes dislikes and that choices are taken into consideration for all their care needs. The home has good working relationships with external health specialists ensuring that residents health needs are well met. The administration of medication in the home has improved which helps to reduce errors occurring which might place residents at risk. Evidence: Care plans for two residents were viewed and found to contain good information, with clear guidelines for staff to follow. Some information had been duplicated and this could cause confusion to staff using the residents care plans. Risk assessments had been completed and reviewed.While risk assessments were generic they were specific to individual residents needs. More work needs to be done in producing risk assessments that are individual to the residents, for example smoking. One care plan viewed had been signed by the residents next of kin. Care Homes for Older People Page 12 of 26 Evidence: The home has good working relationships with external health care professionals and there was good evidence in each care plan that residents have access health care specialists when needed. Residents weights are recorded monthly, tissue viability is checked and appropriate pressure relieving equipment supplied to those residents at risk. An external therapist visits the home regularly to provide musical exercises for the residents. The home also seeks assistance from the continence nurse as and when required. This ensures that residents health care needs are well met within the home. Staff were observed talking to residents in a professional and kindly manner and respecting residents rights to privacy and dignity when personal hygiene tasks were being carried out. The administration of medicines in the home has improved since the last key inspection. All staff who administer medicines in the home have recently received updated training from their pharmacy. While there is a medication policy and procedure, the manager still needs to ensure that there is a PRN (as required) medication policy, for each individual resident who might be prescribed PRN (as required) medication. Monthly Administration Records had no gaps, but it was noticed where a resident had not received their medication in some instances the wrong code had been used, and there was no explanation on the back of the monthly administration record as to why the medicine had not been given. A the present time the home does not have controlled drugs for any of the residents. All liquid medicines were dated on the bottle on the day of opening. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to make choices in regard to their daily living routines. While activities in the home have improved, further work needs to done to provide residents with meaningful tactile activities on a daily basis. Residents meetings are held on a regular basis and it at these meetings that residents are able to choose what outings they would like to go on. Written and pictorial menus have now been introduced and residents are able to choose their meals from a format that they can relate to. Evidence: Care plans show that residents are able to make choices in relation to their daily living routines. Activities in the home have improved and the Head of Care has developed a monthly activities photograph album showing residents taking part in a variety of activities and outings. The inspector observed staff spending one to one time with residents in the morning, helping them to do jig saws, or playing board games. During the afternoon, several hours were spent by carers throwing a ball to residents, this was rather extended and some of the time could have been spent giving residents one to one attention. The inspector also noted that just after lunch both the radio and Care Homes for Older People Page 14 of 26 Evidence: television were turned on together in the communal lounge and the noise from both was rather overpowering. There was photographic evidence that residents are able to celebrate their birthdays and other anniversaries. Monthly resident meetings are held where residents are able to say what outing they would like to go on. The Head of Care is also contacting the Alzheimers Association and local library with a view to providing activities in the home which are suited to residents who have a dementia type illness. Residents are able to follow their own religious beliefs if they wish to and can attend a communion service held by the visiting local vicar each month. None of the residents in the home are able to manage their own finances and have appointed power of attorneys to act on their behalf. Residents do have access either to their own private telephone in their bedrooms, their own mobile telephone or to the office mobile phone which is portable so that residents are able to take a call in private if they wish to. From observation on the day of the inspection residents are able to bring personal items into the home with them so they are able to personalise their own bedrooms. The home has now developed menus in written and pictorial format. Both residents and staff said how residents related better to pictorial menus. One resident said that she preferred the written menus. Residents are offered choice of menu at each meal time and at weekends residents can have a cooked breakfast if they choose to. Where residents require a liquidised diet, food is liquidised separately and presented to the residents in an appetising manner. There are special reasons for one resident having their liquidised diet mixed together and this had been recorded in the residents care plan. Residents said the food in the home was very good and that they were given choices at each mealtime. Specialised diets are catered for as an when required. The inspector noted that lunch time meal was unhurried with residents being able to take their time to eat their meal. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives know that complaints will be listened and acted upon approrpriately Some staff have knowledge of Safeguarding Vulnerable Adults and remaining staff are to receive training within the next four weeks, this should help protect residents from being abused. Evidence: Complaints policy and procedure is displayed in the home but needs to be updated to reflect head office address and contact number for Care Quality Commission. Two complaints received 16/07/09 and 20/05/09 since last key inspection. The Inspector found that both complaints had been properly recorded, investigated and that timely response had been made to complainants. Since the last key inspection one Safeguarding Vulnerable Adults referral has been raised by the inspector following the key inspection this related to residents being placed at risk from building work that was taking place in the home. This referral has now been closed by East Sussex Safeguarding Vulnerable Adults team. No further safeguarding referrals have been made. The home has a Policies and Procedures in place for safeguarding vulnerable adults and Whistle blowing these have recently been reviewed. Care Homes for Older People Page 16 of 26 Evidence: The appointed manager and head of care are due to do Mental Capacity Act and Deprivation of Liberty training on the 19th September 2009. Six member of staff including the cook have received Safeguarding Vulnerable Adults training with a further nine members of staff to be trained in September 2009. All newly recruited staff have been had the appropriate Protection of Vulnerable Adults and Criminal Records Bureau checks carried out prior to taking up employment in the home. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Over the six months there has been major building and refurbishment working taking place in St Michaels Rest Home, once this has been completed residents will be provided with a comfortable and bright environment in which to live. Further attention needs to be paid to infection control procedures in the home to ensure that residents are not placed at risk. Evidence: There has been major improvement works taking place at St Michaels Rest Home, many areas still need to be finished and this included the back garden of the home. The home is much lighter now, and provides residents with a warm comfortable home in which to live. All bedrooms have undergone refurbishment and will all eventually have en-suite facilities. Communal bathrooms/toilets have been refitted and refurbished, it was noted that a sealant needs to be put around the bottom of the toilet pedestal, to prevent urine seepage between pedestal and floorboards. All radiators have been covered and there is a new call bell system fitted. Access to first and second floor will be by a shaft lift, which was in the process of being fitted on the day of this key inspection. The back garden of the home has been landscaped and a large patio has been built. This area needs to be finished, with attention paid to residents security, and a receptacle provided for smokers in the home so that cigarette butts are not left laying on the patio area. Some bedroom still have the old Care Homes for Older People Page 18 of 26 Evidence: carpet in situ and there was a slight offensive odour in one bedroom, this was discussed with the head of care, who said that all bedrooms are due to be fitted with new carpets. The use of wood effect non slip vinyl flooring was discussed for rooms that do have an odour. The use of this type of flooring is permissible providing the resident and or their representative are in agreement. While cross infection procedures have improved in the home, with all communal bathrooms/toilets being provided with liquid soap and paper hand towels, it was noted that in the first floor bathroom bar soap was still being used. The laundry room has been re situated in the home, and is provided with industrial washing machine with sluicing facility and an industrial tumble drier, there is hand wash basin for staff, but this did not have liquid soap or paper hand towels available. Staff are provided with disposable aprons and disposable gloves for personal hygiene tasks and blue disposable aprons when handling food. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At the present time staff are employed in sufficient numbers to meet the personal, physical and social needs of the residents. While staff qualification levels are good, further improvement needs to be made to ensure that all staff have receive mandatory training in health and safety issues to protect the residents in the home. Improvements have been made to recruitment procedures, but further work is still required to ensure that all new staff are appropriately vetted prior to taking up employment in the home, to protect residents from abuse. Evidence: At the present time staff are employed in sufficient numbers to meet the residents needs, the Head of Care said that the manager is aware that once more residents move into the home more care and ancillary staff will need to be employed to meet the residents needs. Resident said that there was always a member of staff available to them and that night staff were attentive if they were awake at night. At the present time sufficient ancillary staff are employed for cooking and domestic work. Sixty percent of care staff have achieve their NVQ level 2 or above in Social Care with a further two staff who have recently signed onto the course. Care Homes for Older People Page 20 of 26 Evidence: Recruitment practices are good with evidence of appropriate checks being carried out prior to a new member of staff being deployed to work in the home. Some further work needs to be done to ensure that the application form contains a full employment history, and that a reference is provided by the last employer, and not just two personal references. All new staff receive initial induction and then start the Skills for Care induction pack. While there has been some improvement in staff receiving mandatory training in Moving and Handling, Safeguarding Vulnerable Adults, Infection Control, Dementia, Fire Safety and First Aid there are a number of staff who have not received this training. All staff who adminster medicines in the home have received medication training. Discussion took place with the Head of Care who said that further mandatory training is being booked for those staff who have not received it and all mandatory training should be completed by the end of the year. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The appointed manager has the qualifications and skills to manage and make improvements in the home which will enhance the residents daily lives. A quality assurance system has been developed, which monitors the views of people using the service and the systems used in the home to ensure that residents receive a good quality of care. Generally health and safety issues in the home are checked on a regular basis to protect the residents living and staff working in the home, some further work is required to ensure that all staff have receive mandatory training in health and safety issues so that residents are not placed at risk. Evidence: A new manager has been appointed since the last key inspection. There is evidence that she has obtained her NVQ level 4 and Registered Managers Award in Social Care and that she has also updated her mandatory training. The appointed manager is in Care Homes for Older People Page 22 of 26 Evidence: the process of registering with Care Quality Commission and has an appointment for interview at the end of September 2009. At the time of this inspection the appointed manager was on annual leave and the Head of Care was present throughout this key inspection. The Head of Care was found to be very knowledgeable about the home, and has been very involved in updating the care planning system as well as many other systems in the home. Two residents during conversation said that they would like the new manager to be more involved with them, especially in regard to activities and outings. The quality assurance system has been well developed, and there was good evidence of residents, relatives and staff surveys being recently carried out. All the systems used in the home are closely monitored each month as well as fire and health and safety risk assessments, with good records in place. The inspector did note that external stakeholders have not been surveyed in respect of their views on the quality of care in the home. The registered provider carries out regular Monthly Regulation 26 visits to the home and provides the manager with a monthly report. At present there is no annual report on the quality assurance monitoring of the home and this is something that needs to be developed to ensure that issues that need improvement have been carried out or in the plan for the forthcoming year. The home does not manage any of the residents personal allowances, and where a resident wishes to make a purchase, money is taken out of petty cash, a receipt is retained and the residents family or representative is invoiced at the end of each month. There is evidence that staff now receive regular formal supervision at least six time a year, to be carried out by the appointed manager or head of care. Mandatory staff training in regard to health and safety issues has been report under staff in this report. There is good recorded evidence that fire points, emergency lighting and hot water delivery is checked on a weekly basis. Staff have regular fire drills and these are also recorded. Maintenance certificates were available to show that all equipment used in the home is serviced and fit for use. Particular attention is being paid to the ongoing refurbishment work in the home to ensure that residents are not placed at risk. The accident book showed that accidents are well recorded and that any concerns particularly in regard to one resident who had fallen several times in one month have been reported to the residents general practitioner. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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