Care Home: Sunnymede Nursing Home

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What the care home does well Residents feel they are treated with respect and that privacy and dignity are promoted. This respect extends to the way staff their family. Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. The home is well organised and managed by an effective, stable management team that promotes the views and interests of the residents. There is a robust training programme linking the learning needs of the staff to the assessed needs of the residents. All of the residents and visitors spoken with during the inspection commented positively on all aspects of the home. What has improved since the last inspection? A gas safety inspection was carried out and there is a relevant certificate. The manager and the deputy manager have attended update sessions in load handling and general Health and Safety matters respectively. A policy for the disposal of unclaimed property has been be written. In general the home returns valuables to the family. All resident valuables and unclaimed property would be recorded in a ledger. What the care home could do better: There is only one requirement, that regulation 26 visits and reports are completed each month by the provider or delegated person. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sunnymede Nursing Home 4 Vandyke Avenue Keynsham Bath & N E Somerset BS31 2UH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrew Pollard     Date: 3 1 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Sunnymede Nursing Home 4 Vandyke Avenue Keynsham Bath & N E Somerset BS31 2UH 01179863157 01179862232 bernice@charltoncare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Charlton Care Homes Ltd care home 41 Number of places (if applicable): Under 65 Over 65 41 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accomodated is 41 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Sunnymede is registered to provide nursing care for up to 41 older people. At present the home exercises a voluntary limit of 31 residents. The home is a converted older property partially extended and set in well-maintained gardens with a pleasant location. The home offers accommodation over 3 floors, access being provided by stair lift and shaft lift. The home is situated within ? mile of the centre of Keynsham and many local amenities. Local venues are best accessed by car because of the gradient of local roads. The cost per week to reside at Sunnymede Nursing Home ranges between #471.00 and #609.00. Fees are reviewed annually and if care needs increase. This weekly fee does not include provision for items such as hairdressing, chiropody, dental, ophthalmic, or audiology services. Care Homes for Older People Page 4 of 29 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 was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted one day. Following the previous inspection a small number of requirements were made, there are no outstanding requirements. The following methods of evidence gathering has been used in the production of this report; observation, discussion with residents, relatives and staff, tour of the home and sampling policies, records and care plans. Surveys were returned from residents and relatives. Information from these has been collated and are detailed throughout the report. Staff and resident interactions were seen to be friendly and caring upholding the dignity of the residents. A comment from the survey said, It is a happy place to live with nice staff to look after me Care Homes for Older People Page 6 of 29 General feedback was given to the manager on the day of inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out 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. Prospective clients and their families are given relevant information in written or verbal form about the home. Contracts and terms and conditions of services are provided to all residents. The assessment procedure is clearly written and a thorough assessment of prospective residents needs is carried out. Evidence: A statement of purpose and a home guide is made available at the initial stage of enquiry to prospective residents. This provides useful information of the services available and includes the terms and conditions. These documents are updated annually. The home operates a robust admission procedure and maintains a checklist to ensure Care Homes for Older People Page 10 of 29 Evidence: the smooth running of the initial period for residents in their new home. The preadmission assessments are comprehensive, covering activities of daily living, a full health screen and personal history background. The prospective resident and relatives are involved in the pre-assessment and all information is used to determine the suitability of the placement. Where possible the manager had obtained assessments and care plans from other professionals involved for example, social workers and hospital staff. A months trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. All the residents surveys returned stated that they had received adequate information to help them decide if Sunnymede was somewhere they would like to live. Visits to the home are encouraged either for the day or perhaps for lunch dependent on their wishes. All residents however funded are give written terms and conditions and contracts. Residents are referred to the Primary Care Trust for assessment of funding under the Registered Nurse Contribution or Continuing Health Care funding. Care Homes for Older People Page 11 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. Care plans detail residents care needs and are clearly written and give good directions to staff. The staff provide appropriate personal and nursing care to maintains residents health and well being and dignity. Proper arrangements are in place for residents to access primary healthcare services. The staff properly store, administer and record medication on behalf of residents. Evidence: From the pre-admission assessments the manager and the registered nurses are able to develop a set of care plans based on identified needs. During the first months trial period the residents plans are reviewed and updated. The manager has developed system in the home whereby a care review meeting will Care Homes for Older People Page 12 of 29 Evidence: be arranged every six months for each resident, involving their relatives and key worker. The meeting will be used to discuss and evaluate their care plans and will give the opportunity to raise any issues or concerns. Several residents files were looked at in detail, including assessments, care plans personal history profiles and risk assessments. The records showed consistency and were comprehensive and up to date. The staff are writing care plans in a more person centred way and seeking to lessen the influence of the medical care model where possible. Some families are encouraged to take time together to discuss their wishes and then pass the information on to the home so that a care plan could be devised. Regular evaluation of residents care plans was taking place. A comment from a resident survey said, Everyone looks after us very well all of the time. Risk assessments were in place with detailed information to ensure safe procedures for example, manual handling, the correct use of bed rails and how to reduce the risk of falls. Health Care needs in files and included continence, nutritional, Waterlow and pain assessments. Each resident was referred to a GP on admission to the home and an initial first visit set up. Doctors conduct six weekly visits to the home or will visit on request. General Practitioner and Para medical visits and their outcomes were documented. The GPs have previously returned comments that indicated their satisfaction with the home. The residents surveys indicated that one person said, they always get the medical care they need, twelve people said usually and one, sometimes. The same outcomes were recorded for the question, Do you receive the care and support you need Written comments included, it is a happy place to live with nice staff who look after everyone. All the residents and relatives spoken with said, They thought the home was very good. They spoke highly of the staff saying they were, Very friendly and kind. Policies and procedures for receiving, storing, administering and disposing of medications are in place. There were photographs of each resident on their medication charts to help ensure that medication was dispensed to the correct person. The administration charts were legible up to date and in order. Proper arrangements are in place for the storage and recording of controlled drugs and drug disposal. The manager is to enquire with the Commission Pharmacist if de-naturing kits are required for all CD tablet and liquid disposals. From time to time the pharmacist makes visits to monitor the drug procedures and review medication charts. The manager and deputy are link nurses with the Dorothy House Hospice and oversee end of life care planning. The staff make every effort to establish residents wishes Care Homes for Older People Page 13 of 29 Evidence: concerning palliative care and any provision residents and their families would wish for when developing end of life plans. The home has adopted The Liverpool Integrated Care Pathway using a comprehensive assessment tool for people who require palliative care. It was suggested that the end of life documents and plans be reviewed to ensure they reflect the Mental Capacity determinations where issues around treatment, hospital admission and resuscitation are pertinent. The process is sensitively completed with residents and their families significant others. Care Homes for Older People Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of social and recreational activities is arranged that seek to enhance the quality of life for the residents. Residents families are involved and informed of issues related to their relatives and are able to maintain close contact with families and friends. The menu provides a balanced diet for residents. Evidence: The activities coordinator continues to provide a varied programme of activities for the residents. The Pool Activity Level assessment and activity process is in operation to enhance the quality of life for residents with dementia. In conjunction with the residents the activities coordinator develops a monthly timetable of events. A copy of this is placed in communal areas throughout the home, to ensure that all residents and visitors are aware of the planned activities. She is a well established member of staff who is knowledgeable of the residents needs and wishes. The coordinator is responsible for documenting a record of any activities the residents have taken part in. Individuals have records of their social and activity choices and record of participation Care Homes for Older People Page 15 of 29 Evidence: in their files. Two residents surveyed said they would like to go on more trips out Personal history profiles of the residents are usually completed with them and the activities coordinator, information obtained included details of the residents work history, hobbies or interests and memories which assists in identifying topics of conversation and encouraging reminiscence with individual residents. The profiles enable staff to recognise the person as an individual and helps to develop a person centred approach. A summer fete and Bar B Q have taken place this summer. There are annual fund raising events that Sunnymede organise and all proceeds go to the residents funds. The grounds staff have done a good job in the gardens and the flower boarders were pretty and well stocked and the lawns had been cut. A holistic therapist visits the home to offer simple massage to residents A music therapist and cognitive therapist visit the home every month. The session is tailored for all residents to participate in but has been particularly engaging for residents with dementia. Residents continue to enjoy trips to the local Brass Mill, horse world for lunch and out shopping in the local high street. It is intended to arrange a programme of summer outings in the coming weeks. Various entertainers visit the home including, zoo lab, Phil the music man, cupids, the hula lady and a local history presenter. Survey comments included, The home provides a caring and happy environment and They help people have a well rounded life with excellent food, good entertainment and lovely surroundings. Residents are supported to satisfy their religious preferences. Several denominations visit the home for individual communion and every four weeks an interdenominational group visits the home to provide a service that represents various individual faiths. There are no residents with other faith backgrounds. The level of privacy in the residents lounge when visiting can be restricted due to the television and general activity within it. A quiet room is available on the top floor but due to its location is rarely used but allows residents to receive guests without having to go to their bedrooms. The home is welcoming to families and friends and relatives are invited to many social activities and their views and opinions are valued. The home has three weekly menu rotas. The menus consist of a varied, balanced choice of traditional home cooked meals. Each day residents have a choice of two meals and in addition to this omelet, fish or ham is also made available on a daily Care Homes for Older People Page 16 of 29 Evidence: basis. Special diets are available for diabetics or those requiring a soft or pureed diet. No resident currently requires any culturally specific diet. In resident surveys two people said they would like wider food choices and three others said the food was very good. Fruit bowls are available to residents in lounges. The cooks visits residents regularly to gain feedback on the food served and take requests from the menu plan for the day ahead. The kitchen is small and not well laid out but was clean and organised. An extraction fan is installed to help reduce high temperatures experienced on sunny days. Food hygiene training is up to date for all staff. Risk assessments were in place and up to date. An Environmental Health Officer recently carried out an inspection and wrote a list of minor contraventions all of which have been dealt with. 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. There are robust and comprehensive policies in place to protect residents investigate complaints or manage allegations of abuse. There are good arrangements in place for staff training and awareness of safeguarding matters. Evidence: A copy of the complaints procedure is on display in the main foyer and is part of the information provided to people on admission, The complaints policy and procedure is detailed and contains all the required information. Residents and relatives consulted indicated people knew how to complain. There have been three complaints received since the last inspection two years ago and all have been properly managed and resolved to the satisfaction of the complainants The home has written procedures for adult protection, whistle blowing, management of aggression, abuse, bullying and management of money and valuables. The Local Authority No Secrets document was available. The home promotes staff training and education in the safeguarding of vulnerable adults on induction and by regular updates. A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of Care Homes for Older People Page 18 of 29 Evidence: safeguarding adults from abuse. The General Social Care Council code of practice has been distributed to the care staff. There have been no allegations of abuse. The home holds or manages residents personal money if requested and proper records and ledgers are kept. 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. The standard of furnishing and decor is good for the benefit of residents. The home provides a safe and well maintained environment for the residents. The bedrooms and communal rooms and facilities are suitable for their purpose and meet the residents needs. The standard of cleanliness is good. Evidence: There is an ongoing redecoration of rooms and replacement of carpets and furniture as required. All of the work completed was of a good standard. Residents had been involved in the process by choosing colours for their walls and carpets for their rooms. The bedrooms looked homely and had evidence of personalisation. Suitable screening has been provided in shared bedrooms, which respects the privacy and dignity of the residents. Bedrooms have been provided with net curtains, roller blinds and curtains. The manager and housekeeping staff have a programme cleaning in the home to Care Homes for Older People Page 20 of 29 Evidence: maintain high standards of cleanliness and ensure continuity of cleaning throughout all areas of the home. The home was clean and smelt fresh. The housekeeping staff confirmed that standards are good and in addition domestic staff had been deployed on the weekends, which had enabled more continuity in cleaning over a seven day period. Corridors, landings and stairwells were bright and fresh. All of the bathrooms and toilets were in good order, clean and fresh. Baths have thermostatic mixer valves and the monitoring hot water temperatures takes place. Lounges and a conservatory are available and a suitable dining room with good seating and table facilities so that residents can enjoy their meal times in a congenial setting. A top floor room has been refurbished to enable residents to receive their visitors in private other than in their rooms if they wish. Stand aids, Mobile and fixed hoists are provided. There is one shaft lift a wheelchair lift and a stair lift, which together give level access to all parts of the home. Disabled accessible bath and showers are available. The home has a high number of profiling beds. The home has a range of pressure relieving equipment if needed. Residents surveys confirmed that the home is clean. 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. The recruitment procedures and records are in good order. The home is well staffed with appropriately trained and experienced staff for the number of residents. Proper training arrangements are in place for all staff for the benefit of residents. Evidence: There is a stable core staff team at Sunnymeade. There is a Registered Nurse on duty at all times. The manager ensures that staffing levels are related to the level of care required by the residents. The managers hours are supernumerary. The domestic, catering, admin and laundry staffing levels are satisfactory. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and safeguarding Adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift. A training matrix has been developed to show that all mandatory training including fire safety, food hygiene, first aid, load handling and adult protection was undertaken and Care Homes for Older People Page 22 of 29 Evidence: course dates had been organised for staff. The manager has done additional training to train staff in load handling and Ms Harding in general Health and Safety matters, both felt they were in need of updating. The staff have supervision and training opportunities. The staff spoken with took pride in the care they deliver and commented that they enjoy working at the home. The home continues to support their staff with their NVQ training. Fifty percent of the staff have completed at least level 2 qualifications. Three carers are working toward level 3. Three of the nurses are NVQ assessors. Care staff training records confirmed that training was up to date. Registered nurse training records for clinical updating were not reviewed at this inspection. The atmosphere in the home is warm and the staff and resident interactions were observed to be respectful, caring and helpful. All residents surveys agreed that staff were usually available when they needed them and listened and acted upon what the residents had to say. Residents survey comments stated that, The staff work hard to please everyone. Visitors comments included, The whole team are of a caring nature and Staff are friendly, approachable and respectful. Several relatives expressed positive views about staff and the care they receive comments included, The home is very well run, the staff look after the residents well. The home has an equal opportunities policy supporting the employment policy. The personnel records were reviewed for several staff members including new recruits. The employment records were complete and in good order. Criminal Records Bureau disclosures are carried out prior to recruitment. The provider is aware of the Commissions recommendations about repeat checks. Registered Nurse qualifications are validated annually. Staff turnover rates are low and that morale is good. Use of agency staff is minimal. 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 home is well managed and run taking into account the views and wishes of the relatives and residents and as they are able. There are good arrangements in place to maintain and service the equipment and facilities in the home. The Home protects the health and safety of residents and staff. The staff supervision and appraisal arrangements are good. Evidence: Mrs During the inspection the manager Mrs Currey was able to demonstrate good, effective leadership and management skills that relate to the aims and purposes of the home and feels fully supported and encouraged by managers within the company. Mrs Currey has a good team who work with her to ensure that high standards of care are achieved and maintained. Residents have regular contact with the manager. A resident stated, She was very nice. Another resident said, She is easy to talk to. Care Homes for Older People Page 24 of 29 Evidence: The Area Manager works with Mrs Currey and makes regular visits to the home. Monthly visits to the home to write Regulation 26 reports have not taken place recently. These visits should include interviews with staff and residents and an audit of the premises and quality of care and management provided. Residents meetings are held every 6 or 8 weeks And relative forums have taken place and which it is hoped to repeat every quarter Minutes are taken and circulated to residents and their families on the notice boards throughout the home. Staff ask residents prior to the meeting if they have any issues they would like to discuss and any information they would like to share with the group. There was a high degree of satisfaction expressed by all of the residents spoken with. Based on the comments received from residents surveys and visitors comments and through observation it is evident that residents feel the home is run well and ensure their needs are being met. The manager conducts an annual audit to assess the satisfaction of residents with regards to the service that the home provides. This information is obtained through questionnaires and completed by residents and relatives. The comments from the surveys were very positive The manager has established a formal recorded supervision procedure for all staff about every six weeks. The manager, deputy and night sister undertakes supervisions. The annual appraisal process ties in with the supervision arrangements. The outcomes of the supervision are recorded and learning needs identified. Regular staff meetings take place and the RNs meet separately which in part is for the process of peer review. Generic risk assessments have been reviewed for the resident and staff areas. These have been updated with records accordingly. Members of staff have been delegated responsibilities for aspects of Health and safety in the home and receive relevant training. The home has a system of training staff in Moving and Handling. Accident records were viewed and mostly evidenced minor injuries, follow up comments were recorded until the accident had been concluded. Padded bed rails are used to reduce the risk of falls where there is an assessed need and consent in place. There are restricted openings on windows. There are radiator covers in areas of identified risk. There is a formal fire risk assessment and fire plan. The fire logbook was up to date and in order. Drills, checks and maintenance have taken place. Fire safety training for staff is given on induction and then at intervals, as recommended by the Fire Officer. Care Homes for Older People Page 25 of 29 Evidence: There was a system for monitoring the risk of Legionella disease. A record of hot water outlet temperatures is maintained. The gas appliances have been serviced. The electrical installation safety certificate was up to date. The various types of lifts had been serviced and there were load test certificates for the hoists. Monthly equipment checks, including bed rails, wheelchairs, beds and commodes are being conducted and recorded; any repairs carried out are also documented. Sluicing and disinfector facilities are in place. Care Homes for Older People Page 26 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 27 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 31 26 The provider must visit the home once a month, interview residents staff and visitors and inspect the premisis and the record of events.The provider will write a report about the conduct of the home To ensure the proper management of the home for the benefit of the residents. 31/08/2009 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI 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. 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