Care Home: Stephenson Court Nursing Home

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What the care home does well The needs of people are assessed before they are admitted to the home. The assessment is used to formulate the initial care plan and inform staff of the needs of residents before they enter the home. Residents` medication is appropriately stored and managed. All medication was administered correctly and the whole system is audited regularly. The care of residents was good. They told us that they were receiving enough food and fluids and that staff were attentive to their needs. Residents looked clean and well cared for. They were all wearing clean clothes and were dressed appropriately for the weather. The home was clean and tidy. There were no offensive odours. The domestic team were well organised and knowledgeable about infection control and use of their cleaning products. There was a suitable programme of activities. This included individual and group sessions and was varied enough to suit most residents. Those residents who chose not to join in with activities told us that their wishes were respected. Residents also said that staff respected their privacy and gave them choice within their daily routine. Staff have received training in the management of complaints and adult safeguarding issues. Complaints are taken seriously and there was good documentation to show that thorough investigations take place when issues are raised. There were sufficient amounts of staff on duty to meet the needs of the residents. Staff training was up-to-date and staff told us that they had benefited from this training. Staff were properly recruited. The recruitment files showed that references, identity checks, criminal records checks and background histories were obtained for staff members before employment. There were systems in place to assess the quality of the service provided. This included consultation with users of the service in the form of meetings and quality questionnaires. The manager also reviews all care and management systems within the home to ensure that high standards are maintained. Audits are carried out on finances, medication, hygiene and care on a regular basis. Health and safety checks and tests were up-to-date. There were no obvious hazards within the home. Health and safety is discussed at regular meetings with individual heads of departments such as the housekeeper, cook, nurses, handyman and the manager. What has improved since the last inspection? Staff, residents and relatives told us that the manager has made a lot of good changes to the home. The biggest improvement is in the care that residents receive. Care plans are now clear and contain good information to enable staff to plan and carry out care for individuals. Residents now receive enough to eat and drink and their nutritional status is assessed and planned for. Food and fluid record charts were properly filled in for those individuals who needed to be monitored. Residents are now maintaining or gaining weight. The monitoring, planning and intervention used to maintain residents skin integrity has improved. Residents were on appropriate pressure relieving mattresses and cushions. These were set correctly according to the information in their care plans. In questionnaires residents and relatives said that the care provided in the home was good. They describe the staff as "knowledgeable" "caring" and "efficient". The questionnaires also indicated that the degree of satisfaction in the home had increased. One relative said that staff go out of their way to ensure that residents are happy. Residents and relatives particularly mentioned that the Cook made special efforts to accommodate their individual taste and provided options to the menu on a regular basis. They said that she was very committed, regularly came out of the kitchen to consult with them and knew their individual likes and dislikes. This is a big improvement from the last inspection, when residents` dining experience was not good. The home has been refurbished in most areas. This has resulted in an improved environment for residents to live in. The home now looks fresh and clean, staff also report that the home is a more pleasant place to work and they have better equipment to carry out their job. The manager has maintained a very high profile within the home. Relatives told us that the manager was very visible on a day-to-day basis, they felt able to approach her with any questions or issues and felt confident that she dealt with them quickly. This has resulted in a decrease in the numbers of formal complaints made. Staff told us that they now felt supported by the manager. They said that this has resulted in an improvement in their work. Staff also said that they have received a lot of training in the last few months. All of the staff thought that this training was useful and helped them to improve their performance. The manager ensures that staff are now formerly supervised on a regular basis. That has enabled staff to contribute to the running of the home and provides a forum for managing any supervision or disciplinary issues. Through this process the manager has been able to raise standards of care and ensure that staff work to their best ability. The manager has plans to improve the service further by developing the skills of trained nurses and continuing the education of the care team. What the care home could do better: Although the social care provision has improved for residents, this needs to continue. The recording of social assessments and activities needs to take account of peoples` individual interests and wishes. A more person centred approach to social care planning would improve this area for residents. Key inspection report Care homes for older people Name: Address: Stephenson Court Nursing Home Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Thompson     Date: 2 2 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Stephenson Court Nursing Home Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ 01912702000 01912150040 stephensoncourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Healthcare (Focus) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Should any of the residents in the PD category leave the home, the Commission for Social Care Inspection must be notified immediately. The maximum number of service users who may accommodated is 46. The registered person may provide the following category of service only: Care home with nursing - Code N 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 45. Physical disability, over 65 years of age - Code PD(E), maximum number of places 1. Date of last inspection 0 0 Over 65 45 2 Care Homes for Older People Page 4 of 26 Brief description of the care home The premises are purpose built and are located within a residential area of Forest Hall. The home is close to shops and local facilities including the Metro station. The home can accommodate 46 frail elderly residents who require nursing care. Short stay respite care is also offered when rooms are available. All accommodation is within single rooms with en-suite facilities. There are two dining rooms in the home and three lounges. A passenger lift is available to the first floor. Car parking is situated to the front of the building and there are gardens at the back. The weekly fees for the home vary. Information is available on request from the home. Further information about the home can be found in the service user guide, which is located in the main entrance. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three stars. This means the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they care for people. We sent questionnaires in two batches, two months apart to people who use the service and some of the staff at the service. 27 completed questionnaires Care Homes for Older People Page 6 of 26 were returned to us. An unannounced visit was made on 22 April 2010. During the visit we talked with people who use the service, some staff and the manager. We looked at information about people who use the service and 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 and we looked around the building to make sure it was clean, safe and comfortable. Following the inspection feedback was given to the manager. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Staff, residents and relatives told us that the manager has made a lot of good changes to the home. The biggest improvement is in the care that residents receive. Care plans are now clear and contain good information to enable staff to plan and carry out care Care Homes for Older People Page 8 of 26 for individuals. Residents now receive enough to eat and drink and their nutritional status is assessed and planned for. Food and fluid record charts were properly filled in for those individuals who needed to be monitored. Residents are now maintaining or gaining weight. The monitoring, planning and intervention used to maintain residents skin integrity has improved. Residents were on appropriate pressure relieving mattresses and cushions. These were set correctly according to the information in their care plans. In questionnaires residents and relatives said that the care provided in the home was good. They describe the staff as knowledgeable caring and efficient. The questionnaires also indicated that the degree of satisfaction in the home had increased. One relative said that staff go out of their way to ensure that residents are happy. Residents and relatives particularly mentioned that the Cook made special efforts to accommodate their individual taste and provided options to the menu on a regular basis. They said that she was very committed, regularly came out of the kitchen to consult with them and knew their individual likes and dislikes. This is a big improvement from the last inspection, when residents dining experience was not good. The home has been refurbished in most areas. This has resulted in an improved environment for residents to live in. The home now looks fresh and clean, staff also report that the home is a more pleasant place to work and they have better equipment to carry out their job. The manager has maintained a very high profile within the home. Relatives told us that the manager was very visible on a day-to-day basis, they felt able to approach her with any questions or issues and felt confident that she dealt with them quickly. This has resulted in a decrease in the numbers of formal complaints made. Staff told us that they now felt supported by the manager. They said that this has resulted in an improvement in their work. Staff also said that they have received a lot of training in the last few months. All of the staff thought that this training was useful and helped them to improve their performance. The manager ensures that staff are now formerly supervised on a regular basis. That has enabled staff to contribute to the running of the home and provides a forum for managing any supervision or disciplinary issues. Through this process the manager has been able to raise standards of care and ensure that staff work to their best ability. The manager has plans to improve the service further by developing the skills of trained nurses and continuing the education of the care team. What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 9 of 26 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 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 11 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. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and that they will receive an individual care service. Evidence: A service users guide and statement of purpose are available in the home. These give information to prospective residents about the services and facilities available. Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs of people before admission. Information from other health professionals and carers was included in the assessment. Care Homes for Older People Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Three care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. Care plans were clear, comprehensive and up-to-date. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Three of the residents we looked at required monitoring of their food and fluid intake. The records relating to this were properly compiled. Fluid charts showed that residents were being offered regular drinks and we observed staff helping residents to drink throughout the day. We checked the weight records for 10 people and found that all of those 10 people had maintained or gained weight in the past six months. This would Care Homes for Older People Page 13 of 26 Evidence: indicate that residents are receiving adequate nutrition. We checked the arrangements in place for protecting people from pressure damage in relation to tissue viability. There was equipment in place for staff to use when people were at risk of pressure damage. This included pressure relieving mattresses and cushions. We looked at the records for two people and found that the instructions in their care plans did match the actual care given to them. These people were on appropriate mattresses that were set correctly for their body weight. The actual care people received appeared to be good. We spoke to residents who told us that they were well cared for. They said staff responded quickly if they rang the call bell and were attentive to their needs. We noted that everyone was well dressed and looked clean and cared for. We observed staff supporting residents to complete a range of personal care tasks. Staff were knowledgeable about individual needs of people and staff told us that they thought the care of people was a priority within the home. We spoke to two visitors who said that the care of residents had greatly improved in the past few months. A relative told us that staff seem willing and happy to carry out their job, any request for help was immediately responded to and nothing seemed to be too much bother. Medication ordering, administration, storage and disposal were examined. All medicines were accounted for and all those administered were signed for. There were not any controlled drugs in use at the time of the inspection. Staff were seen to treat residents politely and respectfully. Minutes of staff meetings showed that they are reminded about issues to do with residents privacy and dignity. Residents told us that staff do try to protect their privacy when carrying out personal care tasks. We observed two staff members assisting a resident to the toilet using a hoist. This was done discreetly with the minimum amount of disruption. A relative told us that he was very impressed that staff knocked on doors and waited for permission to enter rooms. They did this even if the door was already open. The relative confirmed that staff respect peoples right to privacy at all times. Care Homes for Older People Page 14 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. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: There is a staff member in charge of activities. She supports residents to use a range of services within the local community. Residents are encouraged to be in control of their own lives as far as possible. There is a broad plan of activities which showed that residents are offered things such as bingo, skittles, music, crafts and card games. There is also a plan of larger group activities and themed events which take account of current events and special days in the calendar year. Residents wishes and aspirations in respect of their social lives are recorded, however, these records needed to be improved to be more person centred. The records could also include better information about whether residents enjoyed the activity and the extent of their participation. Residents told us they could choose exactly how to spend their day. One resident said she did not enjoy joining in with group activities very often and preferred to spend time alone in her room. She said that staff respected her wishes and often passed a few minutes chatting with her whenever they could. Care Homes for Older People Page 15 of 26 Evidence: Visitors to the home confirmed that they felt welcome. They said they were able to speak to people in private and were offered refreshment whenever they visited. A visitor told us that the only restrictions to visiting were at the request of the resident, they also said that residents were encouraged to keep in touch with them by telephone. Residents also said they liked the food. We ate the food at the home. It was well presented. The food was hot enough and very tasty. The standard of the cooking was good. Residents told us that the cook regularly came out of the kitchen to chat with them. They said that the cook was familiar with their likes and dislikes and would often make them an entirely different meal to those meals already on the menu. During the inspection the cook was on sick leave, however she appeared at the home with some special ice cream for one of the residents. A relative said that the meals were very good and the cook went out of her way to accommodate everyones wishes. The standards of hygiene in the kitchen and dining areas were good, the kitchen was clean and tidy and cleaning schedules were in place. Dining tables were attractively set as were trays for people eating in their own rooms. We noted that staff helped people to eat in a discreet and sympathetic manner, staff sat next to the person and gave them sufficient time to take their meal. Care Homes for Older People Page 16 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. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the homes policies and procedures relating to the management of complaints and allegations of abuse. Staff have received training in adult protection and complaints management. Some staff are booked to attend adult protection training with the local authority as an addition to the training given by the provider. Prior to the recent improvements in the service there were a large number of complaints and safeguarding issues. These numbers have now decreased and there have been the usual amount of complaints expected for a home of this size. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. We spoke to three residents who assured us that all small issues were dealt with immediately. They said they could not find anything to complain about because of this. Complaints that are received are recorded. This record of complaints showed that all incidents are taken seriously and investigated thoroughly. 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. Residents live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean and free from odours. The furniture and general decor provides residents with a comfortable homely environment. A great deal of upgrading has taken place. In the past year the provider has redecorated both dining rooms, the first-floor lounge and corridor, all bathrooms, some bedrooms and the kitchen. These areas have also been provided with new flooring. Some redecoration of bedrooms is still ongoing as and when they are needed. The result of the redecoration is that residents now live in a bright, fresh and clean environment. Staff told us that the home is nicer to work in and the recently refitted bathrooms make it easier for them to care for residents. Staff are also working on improvements in the garden. They are aiming to provide raised beds for residents to use and several sitting areas where residents and relatives can relax. Staff are carrying out this work mostly in their own time, which is a measure of their commitment to the home and the residents. The housekeeper confirmed that the domestic staff have received training in infection control and control of hazardous substances. She said that the domestic team work well and are supported by the manager to carry out their work to a high standard. Care Homes for Older People Page 18 of 26 Evidence: Residents told us that the home was warm and comfortable. We noted that bedrooms were very individual and well personalised. The laundry was clean and well organised. The laundry is fitted with machines that cope with soiled and infected linen to control the risk of infection. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. Evidence: The home was adequately staffed on the day of inspection and enough staff were scheduled to be on duty in the near future. The manager confirmed that over 50 of staff had achieved NVQ level 2. Staff were up to date with essential training. The manager has a training overview to ensure that lapses do not occur. Each staff member has a training and development plan which is discussed during individual supervision. We spoke to five members of staff who confirmed that a lot of training has taken place. They felt this was useful and enabled them to improve their practice. Staff have also received training in subjects relating to care of the elderly and, in some cases, areas of special interest. This includes dementia care, care planning and management of challenging behaviour. The manager reported that she plans to develop the individual skills of nurses in areas such as palliative care and intravenous cannulation. Four staff recruitment files were examined. These were for four staff on duty, Care Homes for Older People Page 20 of 26 Evidence: including one nurse . All contained good information. Thorough background checks had been carried out before employment. Residents were protected through checking of criminal records information for all employees. The registration status of nurses had also been checked. 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. Residents live in a safe and secure home that is well-managed. Evidence: The home is run by an experienced manager. She has not yet applied to the Care Quality Commission (CQC) for registration, however she is about to do so. The manager has made a lot of positive changes to the home since she was appointed. All of the management systems have been reviewed and records are now easily obtained. The manager has shown good leadership and this has led to a general overall improvement in the service. The staff told us that they are clear about the direction the manager would wish the home to go and they feel supported in their everyday work. Residents and relatives told us that there has been a huge improvement in the care they receive at the home. Residents said that the manager is always seen around the home and spends time talking to them. Relatives told us that the manager is very involved in the day-to-day running of the service and they feel this has contributed to the improvements. One relative told us that he feels as though he visits his relative in HER home rather than A home. Care Homes for Older People Page 22 of 26 Evidence: The home does have quality monitoring systems in place. These include seeking the views of residents and their relatives. Residents and relatives meetings are held regularly. These are not well attended but the manager plans to combine them with a social event in an attempt to attract better attendance. Quality assurance questionnaires have been sent to residents and their relatives and the results of these have just been received by the provider. They are being collated and will then be given to the home manager. The manager ensures that staff receive regular formal supervision. She has a planned programme of this that lasts throughout the year. Supervision is used to give staff an opportunity to contribute to the running of the service and address any educational needs they may have. Residents money is managed by the provider. Money is held in a central account with electronic records. Individual records show each residents income and expenditure. These are balanced every week and audited monthly. The cash is held as one amount therefore we were unable to count individual amounts. Health and safety checks and tests were up-to-date. All risks, including those relating to the environment were assessed and documented. Health and safety meetings are held in the home regularly. There were no obvious trip hazards and all hazardous substances were locked away. Fire exits were clear and fire safety checks were up to date. 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 1 2 12 31 Ensure that social care is delivered in person centred way. Records of social activities should reflect this. The manager should seek registration with CQC. 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. 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 26 of 26 - 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. 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