Care Home: Sunrise of Fleet Limited

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What the care home does well Peoples needs are known before they move to Sunrise and so they can be as certain as possible that the service wil be suitable for them. Their care plan is individual and detailed. Staff know residents well and communicate with them effectively. The following comment was made "Staff are very observant and can tell when a resident is not happy or unwell." Residents do a lot of different activities that they have chosen and enjoy. One resident said "the activities keep us active, body and mind." Sunrise is well maintained and provides a clean, comfortable and safe environment to live in. Residents and their relatives are confident concerns or complaints will be taken seriously. The manager ensures that there are enough staff on duty to make sure that people are offered the right amount of support. Staff are well trained and there are good systems to check them before they work in the home. This helps to keep people safe and ensure staff can meet their needs. There are various ways the service obtain the views of residents and people with an interest in how the service is run. What has improved since the last inspection? A programme of training had been developed to ensure staff receive up to date training relevant to their role. Staff moral has improved, staff feel part of a team and enjoy their job. What the care home could do better: The manager needs to submit her application to register with us to show she is the right person to manage the service. Records of supervisions need to be recorded to show that they have happened. The manager should make sure the improvements she has identified are carefully planned. This will help to ensure they happen Key inspection report Care homes for older people Name: Address: Sunrise of Fleet Limited Reminiscence Neighbourhood Church Road Fleet Hampshire GU51 4NB     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: Tracey Horne     Date: 2 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Sunrise of Fleet Limited Reminiscence Neighbourhood Church Road Fleet Hampshire GU51 4NB 01252617657 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): fleet.rc@sunriseseniorliving.com Sunrise Operations Fleet Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 28. The registered person may provide the following category/ies of service only: Care home only (PC) - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Sunrise Of Fleet is a purpose built care home offering support to twenty eight older people or older people who have dementia. The home is one of the services offered by Sunrise on the same site and is situated on the third floor of the building. Two lifts are provided to reach the unit. Care Homes for Older People Page 4 of 27 Over 65 0 28 28 0 Brief description of the care home Bedrooms are single with en suite facilities and for people who wish to share there are suites that have two bedrooms and a shared lounge. The communal areas include a kitchen, lounge and dining room. In addition, the wide corridors are furnished with numerous alcoves and areas where people may sit or use the memorabilia scattered throughout the home. There is a small patio area that service users may use freely and they may also use the ground floor garden that is shared with the sheltered housing scheme. Sunrise is located a few minutes walk from the town centre. The current range of fees are available from the service upon request. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of the inspection was to assess how well the service is doing in meeting the key National Minimum Standards (NMS) and Regulations. The findings of this report are based on several different sources of evidence. These included: An Annual Quality Assurance Assessment (AQAA) was returned to us. The AQAA is a self assessment that has been completed by the manager. It focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We sent out surveys to five residents, ten staff, ten relatives and six health and social care professionals. We received feedback from one resident, five staff, one relative and one health and social care professional. We considered information received about the service since the last Annual Service Care Homes for Older People Page 6 of 27 Review (ASR) which we carried out in September 2008. We looked at what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. A visit to the service by a Regulatory Inspector. This took place on 24 September 2009 between 1000 and 1530. We looked at documentation relating to five residents. We spoke with the person managing the home at that time, three staff members and one person who was visiting a relative. We also spent time in communal areas observing interactions between staff and residents. We spent time looking at records such as pre admission assessments, care plans, medication records, staff recruitment and training files and records of complaints and compliments. Care Homes for Older People Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 27 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 9 of 27 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 10 of 27 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 given accurate information about the service and their needs are known before they move in. This helps them make a choice about whether the service will be suitable for them. People can be as sure as possible that the service will be able to meet their needs. The service provides intermediate care when it has capacity. Evidence: The AQAA states that seventeen residents have been admitted in the last twelve months. Comprehensive pre admission assessments are completed by a qualified nurse. Risk assessments for mobility, moving and handling, falls, nutrician and skin integrity are completed. We looked at the records of five residents who had been admitted recently. They all showed that the comprehensive assessments had been completed prior to admission. The individuals relatives or representatives were involved in the process to gather as much information about the person as possible. Such as individuals past occupation and life history, preferred routines, Care Homes for Older People Page 11 of 27 Evidence: religion/spirituality, interests and dietary requirements. The assessments also identified any potential risks, such as a history of falls, and what steps would need to be taken to minimise them on admission, such as specialist equipment or the need for two staff to provide support when transferring. Five staff responded to our survey, two ticked always and three usually to being given information about peoples needs. We aslo spoke to two members of staff who also agreed with this. One relative who responded to our survey on their relatives behalf and one resident ticked yes to receiving a contract and they received enough information about the home before moving in which enabled them to decide if it was the right place for them. We spoke with one relative who confirmed that they also felt that the home meets the needs of the residents, not just their relative, as they have observed during their visits, which are almost every day. As identified at the previous inspection, all admissions have a months trial period before the placement is reviewed and made permanent, records seen showed that this is still the case. The manager confirmed the service has two vacancies and would only provide intermediate care if there was accommodation, equipment and staff available to meet the short term needs of an individual. Care Homes for Older People Page 12 of 27 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. Residents who are able are involved in the development and review of their care plans and their health care needs are met. The homes processes of storing and handling medication protect residents. Residents privacy and dignity is respected. Evidence: The AQAA states that care plans are reviewed each month or sooner if needed and staff receive training to administer medication. We looked at five residents care plans, these gave detailed information and guidance about residents needs and how they should be met. They identified what individuals could do for themselves and whet they needed help with. They gave clear guidance to enable staff to support residents whilst maintaining their independence. Relatives or representatives of the individuals concerned had completed and signed sections of the care plans, which shows they are involved with and agree the content. Separate health care records were kept on residents files of anything relating to health care needs. Each plan included risk assessments and contained evidence that it was regularly reviewed. The manager confirmed that residents families were invited to attend review meetings, subject to the residents agreement. We spoke with two members of staff who confirmed they Care Homes for Older People Page 13 of 27 Evidence: got the information they needed from the care plan and from the daily handover and daily records. One healthcare professional agreed that staff demonstrate a clear understanding of the care needs of residents and that the management take appropriate decisions when they can no longer manage individuals needs. Daily records showed that residents had access to health care services such as Doctor, opticians, chiropodists and dentists. G.Ps visit the home regularly to see anyone with minor health issues. One relative and staff confirmed residents can see the doctor whenever they wished. One service users responded to our survey and agreed that they received care, support and medical support as they need and made the following comments Care for individuals needs, treat residents with respect and staff are understanding, patient and calm when dealing with situations arising from residents who have problems with memory loss and confusion. One relative who responded to our survey on their relatives behalf agreed to receiving the care and support their relative needs. They really care and nothing is too much trouble. Since my relative has been living here they have put on weight which is a good thing, the staff monitor this. They agreed the service always make sure medical care is sought when needed and explained the staff are very vigilant at noticing changes in behaviour which my be a result of a medical problem. All staff surveyed and talked to agreed they receive training that gives them enough knowledge about healthcare and medication. The way in which they are informed about the people they support works well. They are very confident they have the support, experience and knowledge to meet the different needs of people who live at the service. They stated the home provides good end of life care, Provides excellent care and service for the elderly. Medication is kept in a locked trolley in a locked room when not in use. Staff confirmed that only staff who have completed the three day training give out medication, in accordance with the homes procedure. We looked at some medication administration records (MAR) sheets, which had been completed correctly. A member of staff explained medication and MAR sheets are checked weekly as part of the services auditing systems and confirmed that currently no resident manages their own medication. A general practitioner stated that the home communicates clearly and works in partnership with them and that residents medication is appropriately managed. One relative said that staff are friendly and respectful and always respond if anyone is feeling unwell. Residents dignity and privacy is maintained by staff who are discrete when providing personal care. Comments received from an external health professional indicated that individuals health care needs are met by the home and that residents privacy and dignity is respected Care Homes for Older People Page 14 of 27 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. Residents are supported to live their lives in the way they wish. Residents are offered choice in all aspects of their daily living. Relatives involvement is encouraged and there is a wide range of activities provided. Evidence: The previous inspection report identified that the service provided excellent outcomes through the quality of individuals daily lives within the home. We saw evidence during our visit of this continuing for people who live there. The five residents who were case tracked had life histories, completed by themselves and their families prior to admission. This information was used to ensure activities and experiences were offered that would meet their needs. Records of activities that residents had participated in were seen, and stated if the resident enjoyed it or not, this information is used when planning future activities. Each record seen included a special care sensory profile, which included information about what the resident likes/dislikes to eat, smell, touch, for example one record showed a resident loves flowers. Other areas included information about behaviours and communication such as words and gestures individuals use to express themselves. Staff addressed residents in their preferred manner, one relative said this is always the case, staff are very respectful. A planned weekly programme of short activities is in place. This is appropriate for people Care Homes for Older People Page 15 of 27 Evidence: who have dementia and who may not be able to concentrate for long periods or in large groups. There was opportunity for staff to spend time with individual residents. Staff were observed talking with residents and playing throw and catch with an inflatable beach ball. One member of said they thought the variety of activities provided were very good. Offers choices and promotes independence. One resident said that the staff help residents to participate in activities and encourage residents to try something new which builds confidence. One relative who responded to our survey on their relatives behalf agreed that the home always arrange activities that are stimulating, and that their relative usually likes the meals. The environment is arranged into a number of reminiscence areas where residents may sit and put on makeup or jewellery, write letters or type them, spend time looking after a baby or just walk round touching the sensory pictures throughout the unit. The home has a specialist relaxation room called a Snoozelem. Residents said they felt able to make choices about how they spent their day. When we arrived at the service, some residents were having breakfast, they said, and staff confirmed this is their choice and one resident asked for a piece of toast, which staff made and said the resident often has a snack mid morning. One resident who responded to our survey agreed they enjoy taking part in the activities. Staff were heard informing residents of the activities on offer for the day, which included a religious service. Staff provided reassurance to residents by reminding them of this on several occasions and provided support to escort residents to where the service was being held. One relative told us they, and other members of their family visit regularly and are made to feel welcome. Staff are consistently helpful, friendly and polite. Main meals are provided from a central kitchen situated in the sheltered housing scheme. As mentioned, staff can make light meals and hot drinks from the kitchen in the home. The menu plan showed a wide range of food choices with hot meals available for lunch and evening meal. Residents were shown the menu and the two plated options of main meal so that they could see and choose which they preferred. We observed lunch time meal, which was very relaxed and unhurried. All residents chose to eat in the dining room. The manager said this is encouraged but residents can eat wherever they like. Hot and cold desserts were brought to residents at each table so they could choose. There were several to choose from. Bowls were used for the main meal where residents had difficulty with flat plates to help them maintain their dignity. Staff supported and encouraged some residents to eat their meals. Residents said the food is good and they like the choices. Staff confirmed there is always plenty of choice and quantity if residents want more. One relative said the food is very good and their relative has benefited by putting on some weight Care Homes for Older People Page 16 of 27 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. A robust complaints procedure ensures that people can be confident their complaints will be taken seriously and that appropriate action will be taken. Policy and procedures, together with the training provided for staff, ensures that residents are protected against the risk of abuse. Evidence: The AQAA sates two complaints have been received in the last twelve months, both were upheld. The home has a policy and procedure for recording and dealing with complaints. Copies are given to residents and their families on admission. The complaints record showed that the last complaint received was in March 2009 and was dealt with satisfactorily. All of the staff surveyed and spoken to agreed to knowing what to do if someone has concerns about the home. One relative who responded to our survey on their relatives behalf was aware of the complaints procedure and who to speak to if they were not happy and that staff usually listen to and act upon what they say. One relative said they know how to, but have never needed to make a complaint, but are confident staff would take action to resolve any concerns. The home had a policy and procedure in relation to the protection of vulnerable adults. We advised that this is reviewed to ensure it complies with the requirements of Hampshire County Councils latest Safeguarding procedure. The staff training records showed that staff receive training in recognising and responding to suspected abuse. Care Homes for Older People Page 17 of 27 Evidence: This was confirmed by staff spoken with, who demonstrated knowledge of the procedures. The annual quality assurance assessment confirmed there have been no safeguarding referrals and investigations. All of the staff we spoke to agree the service ensured their CRB and references were carried out before they started work, which protects vulnerable people. Care Homes for Older People Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean, suitably furnished home is provided for residents, which meets their needs. Evidence: The previous inspection report identified that the service provided excellent outcomes through the quality of individuals daily lives within the home. We saw evidence during our visit of this continuing for people who live there. The home has been designed to meet the needs of residents who have dementia and has been sensitively furnished. Corridors are light and spacious and provide numerous alcoves with seating so that residents may move freely around the home. Every area is designed to stimulate and provide people with opportunities to revisit stages of their lives. Bedrooms are unfurnished until the resident has decided what belongings they wish to bring. The home then provides any other furniture that is needed. Each room has a number and the name of the person living there and, if required, something that helps the person recognise the room, for example a photo board or a familiar painting. There are two communal bathrooms. There is a lounge, dining room and kitchen. Radiators are covered and all hot water outlets have thermostatic control valves fitted to protect residents from the risk of accidental burns or scalds. There is a small outside area that residents may access freely. The laundry is situated off one of the corridors and has a washing machine that has a temperature programme to clean soiled linen. The manager said residents can do their Care Homes for Older People Page 19 of 27 Evidence: own washing if they prefer. The home employs cleaners who ensure every bedroom is cleaned thoroughly each week in addition to the daily cleaning. One resident preferred to clean their own room, staff said that they have cleaning products in their room. A risk assessment was in place regarding using and storage of cleaning chemicals. Staff were seen wearing personal protective clothing when cleaning. All potentially hazardous cleaning substances were stored appropriately. Residents and staff said the home is always clean. One relative who responded to our survey on their relatives behalf agreed the service is always fresh and clean. Care Homes for Older People Page 20 of 27 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. Residents feel that a sufficient number and skill mix of staff are on duty to meet their individual and group needs. Recruitment practices ensure residents safety Evidence: Five staff responded too our survey, two ticked always and three usually when asked if there are enough staff to meet individuals needs. One relative who responded to our survey on their relatives behalf agreed the staff are always available when needed. One relative said that there are enough staff to meet residents needs, especially at busy times when residents need support with eating and personal care. Residents arent kept waiting for staff to assist them. The manager confirmed that there were six staff on duty at the time of our visit. Two staff members cover the night duty. During the visit, staff were observed spending time with residents. The manager said that staffing levels are adjusted to reflect changes in the number of residents and/or individual needs. We saw training records for the same four members of staff, which included moving and handling, medication, fire safety, abuse awareness, dementia, inductions and National Vocational Qualifications (NVQ). The manager confirmed that out of thirty staff, thirteen have NVQ level 2 or above and more staff are due to start working toward obtaining the qualification. The manager said that a training programme ensures staff receive training when needed. All staff will receive training in food hygiene in October and November. Care Homes for Older People Page 21 of 27 Evidence: Staff files seen included a personal development plan that identifies training needs. We saw that pre-employment checks had been carried out for four members of staff who had been recruited since the last inspection. This included application forms, two written references and evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. This demonstrates that residents are protected by the homes procedures. Three staff ticked very well and two mostly to induction covering everything they needed to know. All agreed they have been given enough training that is relevant to their role and helps them to understand individuals needs and keeps them up to date with new ways of working. The following comments were made training has improved and is now efficient and relevant. We have more training now that a training programme is in place which makes sure we get updated when necessary. Comments received from three residents relatives and an external health professional showed that they feel that care staff have the right skills and experience to look after people properly. One relative said all the care staff appear to be well selected and trained to look after the residents. The AQAA states that staff supervision could be improved. The manager said that staff are receiving supervisions. We looked at the records of the four staff case tracked, not all records seen reflected that. The manager said they are aware of this and are working to ensure records are up to date. Staff who responded to our survey agreed to feeling they have the right support, experience and knowledge to meeting the different needs of people. Care Homes for Older People Page 22 of 27 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 experienced in running a similar service, but is yet to register with us. The health, safety and welfare of residents and staff are promoted and protected. Systems are in place to monitor the quality of the service and to ensure residents needs and wishes are taken into consideration Evidence: There has been a change in manager since the last ASR. The current manager was appointed in May 2009 but has not yet applied to register with us. We have written to the provider about this. Staff and a relative said the home is managed well by the manager who is very approachable. The AQAA stated that monthly visits by the service providers are undertaken and there is an annual quality service audit in place, in order to maintain and to monitor the effectiveness of care provided. We saw written reports of the service providers monthly visits and compliments file containing letters and thank you cards from residents families. Relatives are invited to attend meetings with the resident and staff Care Homes for Older People Page 23 of 27 Evidence: to discuss, and where necessary to re assess the individuals needs. Residents care plans are reviewed on a regular basis with the residents, members of staff who are the individuals key worker and relatives. This ensures care plans provide staff with information that is up to date and maintains continuity of care. The home also holds a residents council meeting once a month, which gives residents, their families, staff the opportunity to communicate openly. The service sends satisfaction surveys to residents and their families on an annual basis to formally seek their views. The manager confirmed that residents expenses are paid for by the home and an invoice is sent to the residents relative or representative. Records of all transactions are kept. The AQAA stated that safe working practices are upheld and promoted within the home. A maintenance coordinator ensures all equipment and utilities are regularly serviced. Weekly tests were completed for fire alarms and fire doors. Fire drills are carried out at least monthly and staff have received relevant training, such as moving and handling and first aid. The manager confirmed they attend a health and safety meeting once a month to discus and issues they may have. Care Homes for Older People Page 24 of 27 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 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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