Care Home: St Peters Court

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What the care home does well Staff were kind and considerate when helping people who use the service. People who use the service and relatives explained the admission process, this includes a visit from the acting manager. This helps new service users to identify their own needs and enables staff to meet their needs during their stay. The service gives good support to enable individuals to make decisions and participate in the running of the home. People who use the service said, and it was seen, that staff were kind, considerate and supportive. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the care needs of people who use the service. The home and staff create a positive atmosphere, which people commented upon and which is welcoming to families and visitors `I am quite happy here` `I like the staff`. People who use the service are consulted about and enabled to participate in decisions about their lives. Their needs are met and this is evident in their care plans `the staff take care of me well`. The care plan format has been reviewed and updated and now provides a good document to support the needs of the people who use the service. The care plans case tracked were person centred and focussed on the individuals strengths and personal preferences. There are methods to help individuals to contribute to the development of their plan. The care plan can easily be used by people who are not familiar with the individual to deliver a personalised quality service. People who use the service are enabled to participate in appropriate activities of their choice and to maintain relationships with friends and family. People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. going to the cinema, to the pub, eating out, shopping, gardening `I like to get outside in the greenhouse, it is lovely and something to do`. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Staff support people who use the service to maintain existing friend and social relationships. Staff seek permission prior to entering individual rooms and were communicating well with people who use the service. People who use the service were observed to move freely around the home. People who use the service have been involved in the review of menus. They were observed having a leisurely lunch in a relaxed and social setting with good staff support evident.The views of people who use the service and their relatives are taken seriously. This helps to protect them `staff listen well` `my aunt receives lovely care` `she considers St Peters her home` `the service given by the carers during the day is beyond belief nothing is a problem`. What has improved since the last inspection? There have been a number of concerns raised by relatives and health professionals through the surveys but with improvements now being made, comments included `it is reassuring to see changes being made at St Peters` `over the past year (early 2009) the standards were clearly deteriorating` `the place appeared disorganised, messy, dirty (in areas)and the staff morale very low` `we are regular visitors` `it was comforting to see a change in management, although early days, the place is being transformed` `it seems much more welcoming and the care team are being led by someone who cares` `our family are feeling much more positive about St Peters` `the home had really gone down hill in the last two years` `since the new acting manager arrived there has been a distinct improvement in the care home, staff are happier, the facilities are being improved` `staff at night don`t always follow procedure but this has been addressed and things are getting better`. The care plan format has been reviewed and updated and now provides a good document to support the needs of the people who use the service. The care plans case tracked were person centred and focussed on the individuals strengths and personal preferences. There are methods to help individuals to contribute to the development of their plan. The care plan can easily be used by people who are not familiar with the individual to deliver a personalised quality service. The food provided is of a good standard, with good choice and variety. The dining rooms are well laid out with good staff attendance enabling people to have a pleasant and social mealtime. There is a complaints procedure and in addition the views of people who use the service are actively sought. They felt their views were listened to and acted upon. The home is furnished and decorated to a good standard and provides comfortable and pleasant surroundings for people who use the service. Individual bedrooms are well furnished, with aids and adaptations assisting people to move freely and independently around the home. The ground floor communal areas are well decorated and used for a range of social events. The home is staffed with a skilled, consistent staff team giving security to people who use the service. Staff recruitment records were clear and concise and contained all relevant information. The vetting process helps protect people who use the service. The staff have a good understanding of the individual needs of people who use the service, who were very complimentary about the staff. What the care home could do better: The provider will ensure that all staff employed to work at the home receive training appropriate to the work they perform, this must include first aid, infection control and dementia care so that all staff have the knowledge and skills to meet the needs of people who use the service. The provider should ensure that all staff have up to date and relevant company employment guidelines and policies to ensure that staff are following appropriate procedures. The provider must establish and maintain a system for reviewing the quality of the care provided at the home that ensures that the safety and welfare of people who use the service are protected. Key inspection report Care homes for older people Name: Address: St Peters Court 98 Church Bank Wallsend Tyne And Wear NE28 7LH     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: Mary Blake     Date: 2 1 0 1 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 29 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 29 Information about the care home Name of care home: Address: St Peters Court 98 Church Bank Wallsend Tyne And Wear NE28 7LH 01912635100 01912635105 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: 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 - maximum number of places 40 Dementia Code DE, maximum number of places 40 Date of last inspection Brief description of the care home St Peters Court provides a home for up to 41 older people who require residential care due to frailty caused by old age or dementia type conditions. Nursing care is not provided. The fees charged are £361 per week for service users funded through the local authority and £404 per week for privately funded service users. The home is situated on a main road on the outskirts of Wallsend town. There are public transport networks and community facilities in Wallsend and neighbouring town Care Homes for Older People Page 4 of 29 Over 65 0 40 40 0 Brief description of the care home centres. The building is large with a ground and upper floor. All but one of the bedrooms are single and have an en-suite toilet. There are several lounges and dining areas available and a patio and garden. The building has four bathrooms, some of which are equipped for people with disabilities. The home has hoisting equipment. Information about the service, including the latest inspection report, is readily available. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 19th January 2010 with a further announced visit on 21st January 2010. The acting manager was present throughout the inspection. Before the visit, we looked at information we have received since the last inspection in February 2008, how the service dealt with any complaints and concerns and any changes to how the home is run. The providers view of how well they care for people, the views of people who use the service & their relatives, staff and other professionals, including surveys. The Annual Quality Assurance Assessment (AQAA), which is a self-assessment Care Homes for Older People Page 6 of 29 document, was sent to the home for their completion and was well completed. Have your say questionnaires were sent out to people who have used or had interest in the home, eighteen of which were returned to us. During the visits we talked with people who use the service, relatives, staff and the acting manager, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the acting manager what we found. Care Homes for Older People Page 7 of 29 What the care home does well: Staff were kind and considerate when helping people who use the service. People who use the service and relatives explained the admission process, this includes a visit from the acting manager. This helps new service users to identify their own needs and enables staff to meet their needs during their stay. The service gives good support to enable individuals to make decisions and participate in the running of the home. People who use the service said, and it was seen, that staff were kind, considerate and supportive. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the care needs of people who use the service. The home and staff create a positive atmosphere, which people commented upon and which is welcoming to families and visitors I am quite happy here I like the staff. People who use the service are consulted about and enabled to participate in decisions about their lives. Their needs are met and this is evident in their care plans the staff take care of me well. The care plan format has been reviewed and updated and now provides a good document to support the needs of the people who use the service. The care plans case tracked were person centred and focussed on the individuals strengths and personal preferences. There are methods to help individuals to contribute to the development of their plan. The care plan can easily be used by people who are not familiar with the individual to deliver a personalised quality service. People who use the service are enabled to participate in appropriate activities of their choice and to maintain relationships with friends and family. People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. going to the cinema, to the pub, eating out, shopping, gardening I like to get outside in the greenhouse, it is lovely and something to do. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Staff support people who use the service to maintain existing friend and social relationships. Staff seek permission prior to entering individual rooms and were communicating well with people who use the service. People who use the service were observed to move freely around the home. People who use the service have been involved in the review of menus. They were observed having a leisurely lunch in a relaxed and social setting with good staff support evident. Care Homes for Older People Page 8 of 29 The views of people who use the service and their relatives are taken seriously. This helps to protect them staff listen well my aunt receives lovely care she considers St Peters her home the service given by the carers during the day is beyond belief nothing is a problem. What has improved since the last inspection? What they could do better: The provider will ensure that all staff employed to work at the home receive training appropriate to the work they perform, this must include first aid, infection control and dementia care so that all staff have the knowledge and skills to meet the needs of people who use the service. Care Homes for Older People Page 9 of 29 The provider should ensure that all staff have up to date and relevant company employment guidelines and policies to ensure that staff are following appropriate procedures. The provider must establish and maintain a system for reviewing the quality of the care provided at the home that ensures that the safety and welfare of people who use the service are protected. 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 29 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 29 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. Admissions to the home are appropriately managed and people who use the service know how their needs will be met. Evidence: Pre-admission assessments are undertaken and reflect the needs of the people who use the service. Care plans had good information to ensure that the home can meet the needs of the prospective service user. The acting manager is involved in the decisions and in the majority of instances visits the people herself prior to their admission. The service is efficient in obtaining a summary of any assessment undertaken through care management and working closely with the care management team. The assessment focuses on achieving positive outcomes for people and ensuring that the facilities, staffing and specialist service provided by the home meet the diverse needs of individuals. Care Homes for Older People Page 12 of 29 Evidence: People who use the service and their relatives spoke of visiting the home prior to admission and that this was useful to reduce anxiety and make the settling in process easier. The people who use the service also have a care management assessment, which is provided to the home on admission. An individual care plan is produced from these documents. Care Homes for Older People Page 13 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support that is well planned and takes into account their diverse needs whilst promoting their privacy and dignity. Evidence: All people who use the service have a care plan which includes an assessment of their needs and a plan of how these should be met. The providers documentation includes risk assessments for prevention of falls, moving and assisting, as well as assessment tools for clinical areas such as continence promotion. These had been recently reviewed and updated and were now completed to a good standard, which reflected the health needs of the people who use the service. The care plans were now up to date and contained the information to assist the staff to care for the people who use the service. Care Homes for Older People Page 14 of 29 Evidence: Since coming into post the acting manager had addressed the shortfalls and now ensured that all recorded information is reviewed and summarised on a monthly basis. The people who use the service receive personal support the way they prefer and their physical and emotional health needs are met. Staff were confident when giving care and are supported by effective training. The individual health needs of people who use the service are identified and people are supported to access community health services such as doctor, district nurse, dentist and optician. The ordering, storage, administration and disposal of medication were satisfactory and had been reviewed by the community pharmacist. Internal and external audits are undertaken. Staff undertake appropriate training and are competency assessed. People who use the service feel their privacy and dignity is respected and that they are listened to and what they say is acted upon. Staff receive training that helps them to make sure that everyone is treated with respect, and as an individual. Staff help people make their own decisions and provided information and assistance when it is needed. Staff were friendly toward the people who use the service and were attempting to engage them in conversation. They have a good knowledge of the needs of the people living in the home and the senior staff are giving good direction and leadership to help them in the day-to-day delivery of care. Care Homes for Older People Page 15 of 29 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. Daily life and experience of activities meets peoples expectations of the service. People are supported to live full and active lives, and keep links with family and the local community. Evidence: People who use the service were generally happy and enjoyed being able to move freely around the home. Relatives and people who use the service felt that there was a good social activities programme both within and outside of the home and this was thoroughly enjoyed by all. Each individual has a pen picture, which outlines their interests and activities they have taken part in on a daily basis. Individuals have the choice to follow their spiritual beliefs and attend church services if they wish. The home has sought the views of the people who use the service by questionnaires, Care Homes for Older People Page 16 of 29 Evidence: meetings, individual social assessment and family reviews. The daily activities that had been provided were varied and thoroughly enjoyed. The social activities coordinator helps develop and support the social interests of people who use the service. A programme of activities was available and being referred to by people who use the service. People are encouraged to go to places in the local area and families are encouraged and supported to take them out and about. The local community participates in home events, which people said they really enjoyed. People who use the service take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. They said they are able to make choices about how they spend their day. The individuals bedrooms were personalised and the decoration and furnishings were of a good standard. People who use the service have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. The meals served were good and people said they enjoyed the food, which was well cooked. Staff support was on hand. The tables were nicely set and lunch was seen as social occasion with a visiting great grandchild having lunch with the people who use the service, who were thoroughly enjoying the company. Hot and cold drinks were readily available. The chef is part of the staff team and made themselves available to people who use the service for comments and requests. The menu has been reviewed and the Nutmeg system for nutritional balance implemented. People who use the service were positive about the choice and range of food available. Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting the individuals wishes. Staff seek permission prior to entering individual rooms and were communicating well with people. People who use the service were observed to move freely around their part of the home. Care Homes for Older People Page 17 of 29 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 use the service are able to express their concerns have access to an effective complaints procedure and have their safety and rights protected. Evidence: The home ensures that people who use the service and their relatives are aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken and recorded. The complaints procedure is displayed in the home and available to individuals and their families. The complaints record was examined and generally satisfactory although did not contain all complaints prior to the acting managers appointment. People who use the service and their relatives spoken to know how and who to complain to and were confident that their concerns would be dealt with. The acting manager was aware of individual legal rights and how to protect them and she was aware of the need to protect people who may not be able to make individual decisions, the mental capacity and deprivation of liberty legislations and their implications. Staff have undertaken training on the Safeguarding of Vulnerable Adults and there is further training planned. Staff were aware of the whistle blowing policy and felt able to Care Homes for Older People Page 18 of 29 Evidence: raise concerns if necessary. The acting manager was aware of the need to protect all people who use the service. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a home that is comfortable, clean and safe. Evidence: The home is purpose built over two floors to provide care for a range of need. There are bedrooms, bathrooms, communal rooms on each floor. The ground floor is used for support services like the office, staff room, kitchen and laundry. The home has just undergone a major refurbishment on the ground floor and there are plans to commence similar improvements to the first floor. The location and layout is suitable for the people who use the service. There are lounges and dining rooms, which are nicely decorated and furnished. People who use the service were able to move freely around the communal areas and there was a range of television and audio equipment available for their use. Individuals are involved in personalising their own rooms. The rooms are of a good standard well maintained and adapted to meet the wishes of the individual. There are assisted bathrooms and showers on each floor, toilets near to all communal areas. People who use the service were very positive about the home. All maintenance contracts are in place. The maintenance checks had not been appropriately carried out Care Homes for Older People Page 20 of 29 Evidence: with gaps of testing of equipment, however since the appointment of a new maintenance man these shortfalls have now been addressed. Aids and adaptations are evident throughout the building. Individual door display assist people with memory loss. Toilets and bathrooms are clearly identified with plans to further develop environmental support for people with dementias. The laundry was well organised with clean and dirty areas and good hygiene systems and the home was extremely clean and staff have good hygiene practices. Care Homes for Older People Page 21 of 29 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. There are adequate numbers of appropriately recruited, skilled and experienced staff to care for the people who use the service. Evidence: Staffing rotas showed that the following staff are in place: Day duty 2 senior carers and 4 carers Night duty 1 senior carer and 2 carers Individual dependency reviews are undertaken and this is a good staff/service user ratio. There is good ancillary support. Four staff recruitment and training files were inspected and recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. Applicants for employment complete an application form and two references are obtained. A reference from the last employer is requested, plus one other. Any gaps in employment are explored at interview. Each member of staff receives a contract of employment and job description. Discussions with the acting manager, staff and examination of individual staff training files confirmed that staff had not undertaken all necessary mandatory training. Staff Care Homes for Older People Page 22 of 29 Evidence: spoke knowledgeably about the individual needs of people who use the service. Staff have undertaken National Vocational Training in Care (NVQ) at level two or above and additional training, ensuring people who use the service receive care from a skilled and knowledgeable staff team. Staff and resident meetings have been reinstated by the acting manager and are now being held regularly. Care Homes for Older People Page 23 of 29 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 views of people who use the service are supported and underpin the development of the home and their health, safety and welfare are protected. Evidence: The registered manager is currently not working at the home and the home is managed by an acting manager. Observations of staff and people who use the service showed that they felt confident with the openness and approachability of the acting manager. The acting manager communicates a clear sense of direction and leadership and has implemented positive changes to the practices within the home. Regular meetings had been held for people who use the service, relatives and staff to discuss and review practices and the running of the home. The system for monitoring service users monies was not inspected. Care Homes for Older People Page 24 of 29 Evidence: Quality audits and regulation 26 visits were comprehensive but did not always reflect or identify the shortfalls in the service such as lack of staff supervisions, staff training, maintenance checks or fire testing checks. A review of the accident record, showed these were now well documented with acting manager and provider over view and analysis. There was evidence of risk assessment update, fall risk team contacted and risk management strategies put in place. Accident and risks assessment are appropriately documented with good links established with the local health falls prevention programme. Notifications had not always been submitted to CQC this has now been addressed by the acting manager. Staff supervision records showed that staff had not been receiving regular supervision, the acting manager has now introduced a comprehensive process and that the timescales of six per year would be met. All records had been reorganised by the acting manager, and staff said they now have easy to access to up to date policies and procedures. Procedural policies available to staff in office and other areas. Fire and other system testing had not been undertaken at the recommended timescales but this had now been addressed by the acting manager and systems established for maintenance to be undertaken when necessary. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 30 18 The provider will ensure that 12/05/2010 all staff employed to work at the home receive training appropriate to the work they perform. This must include first aid, infection control and dementia care. To ensure that all staff have the knowledge and skills to meet the needs of people who use the service. 2 33 24 The provider must establish and maintain a system for reviewing the quality of the care provided at the home. The provider to have a quality system that ensures that the safety and welfare of people who use the service are protected. 12/05/2010 Care Homes for Older People Page 27 of 29 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 29 To ensure that all staff have completed appropriate recruitment documentation for the current provider. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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