Care Home: Stacey Street Nursing Home

Similar services:

• Townley Road, 2-3
• Foxley Lane (121a)
• Tudor Lodge
• Delrose House Ltd
• Clovelly House Residential Home Ltd
• Abbey Road [53]
• Cherry Tree House
• Ashwood House (Leyton)

What the care home does well The residents we spoke to told us that they were happy living at the home, and that staff were friendly and helpful. Residents are assessed by the home to ensure their needs can be met prior to their moving in. The home develops personalised plans for each resident, and has sound medication practises. Support with personal care is provided in a sensitive and respectful manner. The home is developing its palliative care practise in line with the Gold Standard Framework. The home is able to meet the needs of men and women from diverse cultural backgrounds. People who use the service are supported to access a range of activities within the home and in the wider community. A variety of nutritious meals are provided that reflect the dietary and cultural needs of people who use the service. Assistance with eating is provided in a sensitive and discreet manner. Mealtimes are relaxed, with residents offered a choice of meals. The home is safe, accessible and generally well maintained. Residents have their own room that they are able to personalise. The environment is clean, hygenic and free from offensive odours. Residents are safeguarded and feel that the home listens to them. The home has developed suitable systems to support residents who are not able to manage their finances independently, and appropriate records of finances for residents who receive support are maintained. The Manager and staff are suitably skilled and experienced. The homes recruitment practises safeguard people who use the service. Staff are employed in sufficient numbers, and supported to undertake NVQ level qualifications. Regular mandatory training is also provided to staff. The homes health and safety records indicate sound practise in this area. What has improved since the last inspection? The home has revised its medication stock control systems and updated its safeguarding adults policy and procedure. What the care home could do better: As a result of this inspection seven requirements are made. The home must ensure that plans for each resident address a range of their identified, personal, social and healthcare needs. These plans must be reviewed every month, or more frequently if their needs change. The home must ensure that a risk assessment addressing falls is completed for each resident. Similiarly, self medication by residents must also occur within a risk assessment and management framework. The home must ensure that issues around capacity and consent are addressed within residents plans. Where aids such as cot sides are used, this must be clearly identified in the residents plan and be subject to a risk assessment. Care staff must receive formal supervision at least six times each year. Key inspection report Care homes for older people Name: Address: Stacey Street Nursing Home 1 Stacey Street London N7 7JQ     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: Lea Alexander     Date: 1 6 1 1 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 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: Stacey Street Nursing Home 1 Stacey Street London N7 7JQ 02077002400 02076072842 geoff.holland@familymosaic.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Family Mosaic Housing Association care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: For the provision of Mental Nursing Care for up to 30 Adults mainly elderly, who are not required to be detained at the home under any section of the For the provision of Mental Nursing Care for up to 30 Adults mainly elderly, who are not required to be detained at the home under any section of the MHA. The Staffing Notice Date of last inspection Brief description of the care home Stacey Street is a thirty-place care home with nursing for older people with mental health problems. This is generally people over the age of 65, but can also be those under 65 who meet the other admission criteria. The home was purpose built twelve years ago, as an alternative to long stay hospital provision. Camden and Islington Mental Health and Social Care Trust (the Trust) block purchase the service. Referrals are therefore only taken from the specialist multidisciplinary team for the mental health care of older people. The service is provided by a Housing Association, Family Mosaic, who contract the Care Homes for Older People Page 4 of 29 Over 65 0 30 Brief description of the care home nursing, care, catering, and cleaning staff from the Trust. The home is situated in Finsbury Park on a small housing estate. Holloway Road shopping area is within ten minutes walk, and there are good bus, tube and train links. There are three floors, with access via a lift and stairs. There are three separate residential units, one on each floor with identical layouts. This is ten single bedrooms, dinning and lounge areas, quiet rooms, small kitchen, and staff office. In addition the ground floor houses the manager?s office and the main kitchen, and the first floor has the laundry and some communal staff facilities. There is a small garden located at the rear of the property. Nursing and personal care are provided on a 24-hour basis. Trained mental health nurses are on duty at all times, some of whom are also general nurse trained. The staff team meet complex health care needs with the support of visiting professionals such as Psychiatrists, Occupational Therapists and Psychologists. The cost of the service is from #415.65 to #440.62. This is funded by the Trust, with individual service users? contributions being financially assessed. 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: This inspection was carried out by one Inspector over the course of three days. We visited the home on 5th November, 6th November and the 13th November 2009. During this inspection we examined the Key standards identified in National Minimum Standards, and reviewed the homes progress in complying with requirements made at a previous inspection. We spoke with the homes Manager, with the on duty team leader, two care assistants and the homes administrator. We also spoke privately with eight residents. In addition we examined the personal files of three people who use the service and three personnel files. We also looked at a range of other documentation relating to the running of the home. Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: As a result of this inspection seven requirements are made. The home must ensure that plans for each resident address a range of their identified, personal, social and healthcare needs. These plans must be reviewed every month, or more frequently if their needs change. The home must ensure that a risk assessment addressing falls is completed for each resident. Similiarly, self medication by residents must also occur within a risk assessment and management framework. The home must ensure that issues around capacity and consent are addressed within residents plans. Where aids such as cot sides are used, this must be clearly identified in the residents plan and be subject to a risk assessment. Care staff must receive formal supervision at least six times each year. Care Homes for Older People Page 7 of 29 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 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 9 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 not made until a full needs assessment has been undertaken. Evidence: We spoke with the Manager who advised us that they were currently revising and updating the homes care planning system, and residents personal files. We noted during our visit to the home that staff were updating records and plans and starting to implement the new system. We examined the personal files of three residents within the home. This evidenced that each residents was assessed by the home prior to their moving in. The home does not provide intermediate care. Care Homes for Older People Page 10 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. The service develops individual plans with residents. These are person centred and written in plain english. The plans also include a risk assessment. The home is aware of current policy and practise issues and aims to transfer these into their everday work. Residents views are sought on the day to day running of the home, and on service development. However, the home must ensure that all residents plans address the full range of their health, social and personal needs and that any potential risks are assessed and managed. Evidence: One resident has only recently moved into the home, and an interim plan for their care had been developed whilst the staff and resident were getting to know each other and a more detailed plan developed. Another resident had lived at the home for some time, and their plan addressed a range of personal, social and healthcare needs. For a third resident we noted that whilst they had been a resident at the home for some time, there were some gaps in their plan, and other areas were only briefly covered. Care Homes for Older People Page 11 of 29 Evidence: For example there was no information about activities they liked to participate in, or contact with any family or friends. We also noted that other sections of their personal file identified incidents of challenging behaviour, but this was not addressed within their plan. Some of the residents plans we looked at were not signed or dated. For two long standing residents whose plans we examined we were not able to evidence that monthly reviews had taken place. In each of the personal files we looked at it was evidenced that the home had included some person centred planning and life story work. We were not able to find a risk assessments specifically addressing falls on any of the three residents file we saw. For each of the residents we case tracked it was evidenced that the home had supported residents to attend healthcare appointments and regular opticians and dental appointments. The outcome of healthcare appointments and any follow up required was also appropriately recorded. The Manager told us that no there were no incidents of pressure sores amongst residents at the time of this inspection. We did however examine the personal file for a resident who had been treated in the past for a pressure sore. This evidenced that the home had appropriately referred to the tissue viability nurse and followed the necessary treatment regime. The pressure sore had healed, and the home continued to take appropriate measures to minimise the potential for recurrence of pressure sores. At the time of this inspection no residents were prescribed controlled medication. All medication is stored in lockable cabinets. One of the residents we case tracked was self medicating. We noted that the home had not undertaken a risk assessment addressing this area. We examined the medication records and available medication for three people who use the service. This evidenced that appropriate records of medication stocks were maintained. We also found that the medication available corresponded with that recorded on the Medication Administration Record (MAR). We noted that the MAR sheets had been correctly completed and were in good order. We spoke with people who use the service and to care workers. We also looked at residents plans. This evidenced that residents personal preferences for personal care are identified. We spoke with three staff employed at home. Each was able to describe Care Homes for Older People Page 12 of 29 Evidence: to us the practical steps they would take to promote dignity and respect whilst providing personal care. Some of the residents we spoke to who receive help with personal care told us that staff were sensitive and respectful whilst assisting them. Since the last inspection the home has been nominated and is working toward the Gold Standard Framework (GSF) for palliative care. The home has participated in workshops aimed at sharing and developing best practise in this area. In addition staff have attended training, and the home has been allocated a GSF co-ordinator, who will carry out their own inspection to determine whether the home has met the required standard within the framework. Care Homes for Older People Page 13 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. People who use the service are supported to maintain important personal and family relationships. Residents are involved in meaningful daytime activities of their choice, and according to their individual needs, interests and capabilties. Evidence: The home accommodates men and women from a variety of cultural backgrounds. At the time of this inspection residents from Greek Cyrpiot, Vietnamese, Spanish, Carribean and African backgrounds were living at the home, as well as men and women from a British background. The homes residents also have diverse religious faiths. We were told that the home aims to cater for diverse cultural and religious backgrounds by providing culturally appropriate meals, and by ensuring that some staff are able to speak to residents in their first language. The Manager also told us that the home aims to work closely with families to ensure that the cultural and religious needs of residents are understood and respected. We spoke with the Manager, people who use the service and care workers. We also looked at records maintained by the home. These sources evidenced that some residents attend local day services. Some residents had recently attended a community event at the nearby Arsenal stadium. The Manager advised us that the Care Homes for Older People Page 14 of 29 Evidence: home is seeking sources of funding with which to purchase a minibus so that more community based activities can be organised for residents. A music therapist attends the home regularly. We were told that they are currently providing 1:1 sessions for residents who have expressed an interest. In addition a physical therapist also regularly attends the home, and we were advised that they were currently carrying out assessments to establish service users needs. Within the home staff organise activities for residents according to their wishes, including bingo sessions and music singalongs. Whist we were visiting the unit we also observed staff giving hand massages and manicures to residents who were interested. In addition the home organises a regular summer barbeque and a Christmas party for residents and their families and friends. We also noted that a Christmas pantomime was being organised within the home. The home holds meeting for residents and their families twice each year. We looked at the minutes for these meetings. These evidenced that topics such as staffing and activities for residents were discussed. We looked at the personal files of three people using the service. We noted that none of their plans addressed issues around capacity or consent. During out tour of the premises we noted that cot sides had been fitted to one residents bed. We subsequently examined this residents personal file, including their plan and risk assessments. We noted that the use of cot sides was not mentioned in either. We looked at the homes record of meals provided. The home operates a four weekly menu cycle developed by a nutritionist. Residents are also regularly asked what meals they would like to see appear on the menu. We found the menu to be varied and nutritious. We also noted that specialist dietary requirements and cultural preferences were also reflected in the menu. We spent the lunchtime on one of the units, and observed what happened over the lunch period. We noted that some residents required 1:1 support with eating, and that staff members individually provided this support in a sensitive manner. We found the support given to be discreet and respectful. In addition to staff providing 1:1 assistance several other staff members were on duty on the unit during lunch. We observed residents being given a choice where to eat Care Homes for Older People Page 15 of 29 Evidence: their meal, and a choice of which meal they would like to eat. We spoke to several residents who all commented that the food provided was of an acceptable standard. Care Homes for Older People Page 16 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. The home supports residents to address their personal healthcare needs. Personal support is provided in a flexible manner that promotes dignity and respect. The home has an open culture that allows residents to express their views. The homes safeguarding practises promote the safety and wellbeing of people who use the service. Evidence: We looked at the homes complaints log. This evidenced that no complaints had been received since the last inspection. The residents we spoke to told us that they did not have any complaints about the home, and that if they were unhappy with anything, they would feel comfortable raising this with the staff or manager. Units on each floor are accessed by a locked door. Residents do not have keys, and must ask staff if they wish to leave the unit. During our visit to the home we did not observe any distress on residents behalf by this practise. Those residents we spoke to were happy with the situation. The Manager told us that there had been no adult protection matters since the last inspection. We looked at the homes safeguarding policy and procedure and noted that this had been updated as required at the last inspection. Care Homes for Older People Page 17 of 29 Evidence: During our time on the unit we observed one resident become agitated. We noticed that staff calmed the situation quickly and effectively with a minimum of dispruption to other residents. We spoke with three members of staff. Two were able to readily identify the types of abuse that vulnerable people may experience, and their responsibilities should they have any concerns regarding safeguarding issues. A third member of staff had only recently joined the service and had not yet received safeguarding training. Care Homes for Older People Page 18 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. The home is a pleasant, safe place to live. Residents have their own bedrooms and are able to access a range of shared spaces. Evidence: During our visits to the home we found the premises to be safe, suitable and accessible. We noted that some areas of the home would benefit from redecoration. We were told by the Manager that funds were being identified to carry out this work, and it was anticipated that redecoration would take place in 2010. The home is located in modern, purpose built premises on a small residential estate. It is arranged over three floors, with a unit on each. There is a similiar layout on each floor, with lift and stair access to each. A public payphone is located in the hallway. On each floor there are ten bedrooms, each with a vanity unit. Each resident has their own room, which they are able to personalise with some items of their own furniture or pictures and mementos. Residents room each contain a single bed, built in wardrobe and chest of draws. Each floor has a large bathroom with parker bath, handbasin and WC. There is also a large shower room with a sit down shower handbasin and WC. Two WCs are also located on each floor. There is a large lounge with a range of comfortable seating, and Care Homes for Older People Page 19 of 29 Evidence: a dining area opposite. In the lounge there is a TV and stereo system. In addition there is a quiet room, nurses office and sluice on each floor. On the first and second floors there are also meeting rooms. On the ground floor a large kitchen and store are room located, as well as the Managers office and a service entrance. On the first floor there there is a laundry room, staff room and training room. The boiler machinery is located in rooms on the second floor. The home has a garden that can be accessed from the ground floor lounge. This has a paved area as well as lawns and flowers. Residents we spoke to told us that the home was clean and well maintained and that they were happy with their rooms. One resident told us that they particularly liked the fresh flowers staff put in the lounge every day. We also noted that the walls of the home were decorated with photographs of residents on past day trips. During our visit to the unit we found a relaxed and calm atmosphere on each floor. We found the premises to be clean, hygenic and free from offensive odours. Care Homes for Older People Page 20 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. Staff members undertake external qualifications beyond the basic requirements. The home is appropriately staffed with particular attention given to busy times of the day. The homes recruitment procedures ensure the safety and wellbeing of people who use the service. Evidence: The Manager told us that since the last inspection the skill mix of the staff group had been reviewed. As a result of this there had been some changes in the staffing structure. The home now employs two team leaders, both of whom are Registered Mental Nurses (RMN). There has also been an increase in the number of care workers employed within the home. The home operates a three-shift pattern over a 24 hour period. The morning shift runs from 7.30 am to 3.30 pm, the afternoon shift overlaps this, starting at 12.30 pm and finishing at 8.30 pm. The night shift operates from 8.15 pm until 7.45 am. For the morning and afternoon shifts three staff will be rostered on duty for each floor. The home operates a waking night shift, and two staff per floor are rostered on duty for this. For each shift at least two of the staff on duty will be staff nurses. In addition the home employs domestic staff and two chefs. Care Homes for Older People Page 21 of 29 Evidence: We viewed the homes current staffing rota, and found that this reflected the situation we found in the home on the day of our visit. Discussion with the Manager and care workers and sampling of training records evidenced that staff are encouraged to undertake NVQ level qualifications. At the time of this inspection over 50 of staff had in fact obtained NVQ level 3, which is in excess of the National Minimum Standard which requires at least 50 of staff to have obtained NVQ level 2. We examined the personnel files of three staff members. This evidenced that two satisfactory references and an enhanced Criminal Records Bureau (CRB) check were obtained for each prior to their starting work. It was also evidenced that staff receive a copy of their employment terms and conditions. We spoke with the Manger and care workers. We also examined the homes training records. This evidenced that the home provides an induction to all new staff members. Recent mandatory training that has been provided to staff includes moving and transferring, de-escalation techniques, fire safety, first aid and food hygiene. Care Homes for Older People Page 22 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 Manager is suitably qualified and experienced. They have a sound understanding of current developments and plan the service accordingly. The home has clear health and safety policies that are effectively implemented. Evidence: The Manager has been in post for approximately 8 years. They have appropriate skills and experience. The Manager has obtained a degree in healthcare studies. Some residents we spoke to told us that they appreciated the pleasant atmosphere they thought the Manager had created. The home carried out its most recent feedback survey in October 2008. Questionnaires were issued to residents. The results have been collated and these indicate a 96 satisfaction rating with the service provided. The home has obtained appropriate insurance cover, and a current insurance certificate is displayed. Care Homes for Older People Page 23 of 29 Evidence: We spoke with the homes administrator and with people who use the service. We also examined financial records. This evidenced that each resident will either manage their finances independently, or where this is not possible a family member will support them. Where an appropriate family member cannot be identified, the local authority will act as appointee. The home retains small amounts of cash for residents who are not able to manage their finances independently. This is used to purchase personal items such as toiletries. Requests to the responsible family member or local authority appointee are made as these monies are depleted, or if the resident requires larger amounts for particular purchases, for example a TV for their room. The home retains residents monies seperately within a locked safe. A record of all transactions including the date, amount and nature of the transaction is maintained by the administrator. We examined these records and found them to be in good order. For each of the personnel files we examined it was evidenced that each had undertaken or was undertaking probationary period. Longer standing members of staff were also evidenced as having an annual staff appraisal. However, it was not evidenced that staff have regular, recorded supervision sessions - current regulations require the home to provide a minimum of six supervisions per year to full time staff members. The staff we spoke to told us that they felt supported in their work and felt that their supervisors were always available should they need to discuss any issues. We examined a range of health and safety records that the home is required to maintain. These included the record of fridge and freezer temperatures and records of water temperatures. We found that fridge and freezer temperatures were taken and recorded each day. We noted that the temperatures were within acceptable parameters. We also looked at the homes records relating to fire alarm testing. We found that these tests were carried out and recorded on a weekly basis, and that the alarm system is regularly maintained. The homes fire alarm system was completely replaced in 2008. The home also maintains appropriate accident and incident reports. Care Homes for Older People Page 24 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 25 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 7 15 Residents plans must be reviewed every month, or more frequently if their needs change. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 2 7 15 The home must ensure that plans for each resident address a range of their identified, personal, social and healthcare needs. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 3 8 16 The home must develop a risk assessment addressing falls for each person who uses the service. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 Care Homes for Older People Page 26 of 29 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 4 9 12 The home must ensure that self medication by residents occurs within a risk assessment and management framework. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 5 14 12 Where aids such as cot sides 10/03/2010 are used, this must be clearly identified in the residents plan and be subject to a risk assessment. To promote the health, safety and wellbeing of people who use the service. 6 14 12 The home must ensure that issues around capacity and consent are addressed within residents plans. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 7 36 18 Care staff must receive formal supervision at least six times each year. To promote the health, safety and wellbeing of people who use the service. 10/03/2010 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 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). 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!