Care Home: Swallows, The

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What the care home does well The homes building and facilities are modern spacious and well maintained with good lighting and full wheelchair accessibility throughout. The home pays good attention to maintaining high hygiene standards with all areas being clean and well decorated. The manager and owner are well respected by staff and residents and the manager is qualified and committed to developing the quality of care offered to residents. Care planning is good and residents feel that they are being asked about what they want to do and are helped to do the things they want to. All residents staff and relatives who participated in the inspection said that the manager and staff are excellent and listen to residents. Many referred to the Swallows as their home. The home has a commitment to training staff and staff feel that they trust the homes management and are well supported to do their work. The support and information offered to residents and their families when moving to the home is good and new residents are made to feel very welcome. One relative commented that her mum improved very quickly after moving in and felt the safe and comfortable in the home. What has improved since the last inspection? The registered provider a manager have put in place an effective annual quality audit system and now consult very well with residents and relatives about the development needs of the home. Residents have been assessed about their wishes and abilities to manage their own medication and have asked residents and families to participate in care planning and reviews. The home has continued to provide good training for staff and a number of NVQ qualified staff has increased to 80%. mental health and dementia training is now included in the homes training profile. Maintenance and decoration of the home has continued to be of a high standard and one of the rooms previously shared is now used solely for one resident. The home has not yet made a final decision on whether this is permanently sustainable. What the care home could do better: The registered provider and manager must update the local authorities contracts regarding the fees charged for the cost of care and ensure that residents are given a copy so that they can understand their rights and charges paid on their behalf. More specific information about the sorts of activities and the times for activities for residents with dementia care needs should be included in their care plans. this may help to ensure that residents are able to participate in activities at times when they feel best able to do so.Liquid medication should be checked using a graduated container so that there is less chance of any mistakes being made. The owner should consider replacing the carpet in the hallway just outside of the medication storage room. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Swallows, The 318 Brownhill Road Catford London SE6 1AX     The quality rating for this care home is:   three star excellent 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: Sean Healy     Date: 1 2 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 30 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 30 Information about the care home Name of care home: Address: Swallows, The 318 Brownhill Road Catford London SE6 1AX 02084613391 02084611200 SwallowsRCH@aol.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) : Mrs Susan Wilde,Mr Alan Wilde care home 19 Number of places (if applicable): Under 65 Over 65 0 19 dementia old age, not falling within any other category Additional conditions: 19 0 The maximum number of service users who can be accommodated is: 19 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home The Swallows is a private care home managed by the same proprietors since opening in 1984. It is a large Victorian house situated between Lee and Catford, within walking distance of shops and public transport. It is registered for 19 older people and twelve of these may have dementia. The home is no longer registered for those who are physically disabled. There are 13 single rooms and 3 shared rooms. It is centrally heated and attractively decorated. Washing facilities are available in all bedrooms and there is a 24-hour nurse call system. There are two lounges, dining areas and a conservatory. There is a garden with a patio area for use in good weather. Residents are encouraged to bring in personal items of furniture and mementos to personalise Care Homes for Older People Page 4 of 30 Brief description of the care home their bedrooms. Bathrooms and toilets have aids and adaptations available. Visitors can be entertained in all of the communal areas and in private bedrooms. The home can provide information about their service through the service users guide and statement of purpose. There is also a folder with responses from a questionnaires completed by various health professional that visit the home. There is information on the notice board that a copy of the last CSCI inspection report is available in the information folder as well as a copy in resident rooms. Fees are set at between #485.00 and 550.00 per week and the reason for the difference is explained as higher levels of personal care support needed. There are additional charges for toiletries, hairdressing and newspapers. The homes email address is: swallowsrch@aol.com Care Homes for Older People Page 5 of 30 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 last key inspection took place on the 11/7/07 with an Annual Service Review taking place on the 10/7/08. The quality rating for this service is 3 Star. This means that the people who use this service experience excellent quality outcomes. This represents an improvement in the Star rating for this home since the last inspection. The inspection was unannounced, and took place on a one-day site visit on the 11th July 2009 and ended on the 12th July 2009 after receipt of relevant information regarding health and safety. The registered manager facilitated the inspection supported by the deputy manager. Care Homes for Older People Page 6 of 30 The inspection included a tour of the home and examination of records on care plans of four residents and building maintenance records and three staff training and recruitment records. Observations were made of staff working with residents in the living room/dining room area and while doing one to one activities. Four residents spoke with the inspector and four others provided written responses to the inspection questionaires. Two staff were interviewed and three others provided written comments in response to inspection questionaires. Two visiting relatives also gave their views on how the home is run. The home had completed an Annual Quality Assurance Assessment which was also used to provide information for the inspection. At the time of this inspection there was one resident vacancy. What the care home does well: What has improved since the last inspection? What they could do better: The registered provider and manager must update the local authorities contracts regarding the fees charged for the cost of care and ensure that residents are given a copy so that they can understand their rights and charges paid on their behalf. More specific information about the sorts of activities and the times for activities for residents with dementia care needs should be included in their care plans. this may help to ensure that residents are able to participate in activities at times when they feel best able to do so. Care Homes for Older People Page 8 of 30 Liquid medication should be checked using a graduated container so that there is less chance of any mistakes being made. The owner should consider replacing the carpet in the hallway just outside of the medication storage room. 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 9 of 30 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 30 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. Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents have their care needs fully assessed before moving in and have had a chance to view the home to be sure that it is suitable. Residents have written contracts but but these need to be updated to fully reflect fees and who pays them. Intermediate care is not provided Evidence: Are fully inspected four residents files regarding care assessments in care plans and also looked at five other residents care assessments. all of these residents had care assessment in place and had a care review within the last 12 months. The registered manager pointed out that a number of residents had not had involvement from social services in carrying out their reviews over the last three years. There was a letter on file showing that the home has prompted social services and have acted responsibly in Care Homes for Older People Page 11 of 30 Evidence: asking them for their involvement. Assessed care needs include help with old age issues care of dementia personal care support including bathing and toileting and dressing. Two family members interviewed said they had they had been asked for information about their relatives before moving into the home. All of the residents have a contract or statement of terms and conditions provided by the local authority who placed them. There is one privately funded resident who also has a full contract showing fees he pays and rights and responsibilities. However there is a need to update the local authority funded residents statement of terms and conditions regarding fees and to ensure all residents have a copy. (Refer to Requirement OP2) Care Homes for Older People Page 12 of 30 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. This judgement has been made using available evidence including a visit to this service. Residents benefit from comprehensive and up to date care plans their health needs are meet and they are treated with dignity and respect by the staff and management. Evidence: Examination of four residents care plans showed a clear planning and recording is happening for each resident. There is a Standex care planning system in place which now includes sections for recording dates of care reviews every month showing details of all the social and leisure interests. This enables residents to have a fuller and more personnel service offered. As at the last inspection the manager felt that the new sections in the care plans detailed above have been helpful and the home continues to develop life history records for residents so that staff will be able to know them better and have more meaningful conversations about past experiences. Four files showed that care plans Care Homes for Older People Page 13 of 30 Evidence: were up to date and detailed residents needs showing how these should be met. The care plans contain risk assessments and sections on weight nutrition and skin care. Residents who need it have an individual plan for monitoring their weight. Some residents receive a visit from the GP every two weeks and the GP will also see other residents who need it. The home liaises with other health professionals such as district nurse opticians dentist chiropodist and the tissue viability nurse. The district nurse currently visits the home twice weekly. Previous comments from the GP and District nurse show the home provides them with good information and manages health care needs of residents very well. The home provides support for eleven people with dementia care needs. Care plans have various sections to complete to ensure that mental health and behavioural issues are identified and actions and objectives are monitored and recorded. There is a supportive routine within the home that whilst flexible supports residents that have difficulties with memory and cognition. It is recommended in addition to the existing care plans and activities offered that there be clearer written support plans for people with dementia showing when they like to do activities and how they are offered exercise and mentally stimulating activities. (Refer to Recommendations OP7) Residents and relatives are offered the opportunity to participate in the review of their care plans but the manager says that not as many as she would like take up this opportunity. It is recommended that relatives and residents be reminded of the opportunity to be involved in their care planning and reviews. (Refer to Recommendation DO7) As at the last inspection the manager has drawn up an information and guidance sheet for night staff around risk assessments and the manager checks the risks identified and quickly acts to provide a safe service for the residents. The system for managing medication was examined and the storage and administration records were well managed. Four care plans showed that residents have been asked whether they wish to manage their own medication. This met a recommendation made at the last inspection. Currently none have taken up this opportunity. It is recommended that when liquid medication is being checked that this is done using a graduated container as the current system used is not accurate. (Refer to Recommendations OP9) The interaction I saw between residents and staff showed that residents are treated with respect and in a dignified manner. This was supported by comments made by two relatives and three residents all of whom said that the manager and staff are excellent and provide extremely good care. The home discusses and records residents wishes and details with regard to their death and funeral arrangements on their care plan. Care Homes for Older People Page 14 of 30 Evidence: Comments from three residents included: Within a month of moving in my mum started to look much better and is very happy here. Care Homes for Older People Page 15 of 30 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents find their lifestyle experience in the home matches their expectation and preferences. They are able to maintain links with family and with the community. They benefit from being able to access a healthy and well balance diet. Evidence: The home has a weekly programme of activities and all care plans looked at had an individual programme of weekly activities on them. These had been worked out between the resident and their key worker. The key worker enters a record in residents diaries about the activities that resident has taken part in. Residents are able to choose whether to spend time in their rooms or in communal areas and some residents choose to live fairly independent lives and not participate in communal activities other than on special occasions. As well as trips out to the local parks and other outings discussed and agreed at residents meetings the home arrange fairly short local trips for residents e.g. short walks in the local area. Care Homes for Older People Page 16 of 30 Evidence: The home have links with the Pump House Museum and one of the staff have received training to do reminiscence work with residents. At the last inspection the home had purchased various photos and other equipment to support this work. The home has visiting entertainment on special occasions. They also have regular visits from representatives of different religions which will depend on the individual needs of the residents and at present these are from the Church of England and the Roman Catholic Churches. In the past the home have had residents following other religions and have arranged contact with their chosen churches. Four residents and two relatives said that the home does provide daily activities in the home which are enjoyable. The home offers a healthy and balanced diet with choices offered to residents. Meals are served in pleasant surroundings. The atmosphere at lunchtime was observed to be very pleasant with residents chatting and enjoying the social occasion. All residents spoken to said that they are asked about the food they prefer to eat on a daily basis and that the food provided is very good. Care Homes for Older People Page 17 of 30 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the policies around vulnerable adults and there is an appropriate complaints procedure in place. Evidence: The home have a complaints policy a copy of which is available to residents on admission and is also in a file of resident information in the conservatory. The home has investigated two complaints since the last inspection and these have been recorded in full and investigated under the homes complaints policy. The first of these concerned a resident feeling that not enough food was served on another concerned a residents who continually left her medication in her room without taking. The homes management and staff listen to residents and act on their concerns and complaints. The homes Adult protection policy was reviewed in 2008. This policy meets the requirements of the local authority Adult Protection policy and procedures. All of the staff have had adult protection training as part of their induction. There have been no adult protection issues reported since last inspection. At the last inspection the manager agreed that there is a need to be clearer about issues which may need to be reported to the CSCI and to the Adult Protection Team as Care Homes for Older People Page 18 of 30 Evidence: some residents who have dementia support needs often complain but are not clear about details such as what happened or the time of day or the people involved. It was recommended that the home identify residents who this applies to and to contact the social worker involved to agree a strategy for recording and responding to these situations. The registered manager now does this and this recommendation has now been met. It is recommended that all staff be reminded that they should never informally investigate allegations of abuse but instead should always report allegations or suspicion immediately to the homes management. Care Homes for Older People Page 19 of 30 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. This judgement has been made using available evidence including a visit to this service. The home offers a very pleasant and well-maintained environment with a choice of communal and dining areas for residents. Residents rooms are well furnished and personalised. There is a well-maintained garden that is wheelchair accessible. The home is safe comfortable and clean and hygienic to a high standard. Evidence: The home is situated in a residential street within walking distance of shops and public transport. The home has a large communal sitting room a second small sitting room and a conservatory leading on to a pleasant and well-maintained garden. There is ramp access and a paved area for wheelchairs and a grassed area. The home has two dining rooms and can provide a small dining area on the second smaller sitting room as well. Residents are able to smoke in the conservatory. The home is pleasantly decorated and well maintained throughout. There is lift access to the upper floors. There are 3-shared rooms at present. The management said they are strongly considering changing one of these to single occupancy on a permanent basis. This would increase the single occupancy rooms to more than 80 and meets a recommendation made at the last inspection. All had appropriate curtaining to ensure residents privacy. Residents rooms were pleasantly furnished and residents have Care Homes for Older People Page 20 of 30 Evidence: brought personal belongs as well as items of furniture with them to the home. The home has a CCTV monitor this is only used to monitor the exits for extra security. An occupational therapist assessment has been carried out in the past and this showed the home to have the necessary adaptations needed to provide a good quality service. The home employs a cleaner from Monday to Friday. I looked at five residents bedrooms the kitchen bathrooms dining room living room and all communal areas. All of these were very clean, warm and well ventilated. Four residents said the home is always very clean and that their rooms are very comfortable. The home is totally free of unwanted odours and is very clean fresh and in a very good state of repair. It is recommended that the carpet on the ground floor outside of the medication storage room be cleaned and or replaced. (Refer to Recommendations OP19) Care Homes for Older People Page 21 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is staffed by workers sufficiently experienced and trained to carry out their work and in sufficient number to need residents needs. The home has a recruitment policy that protects residents and staff are supported by ongoing training programme. Evidence: I examined the files of three staff regarding their recruitment and employment and interviewed two staff during the inspection. I received three written responses from staff to requests for completion of the inspection questionaires. All of the comments and answers received and records examined showed that staff have been properly screened when employed and receive a good level of supervision and training to do their jobs. The home has sufficient staff on duty to meet the needs of their residents. 16 care staff and the team manager provide the care and support residents. In addition to this there is a full-time cleaner two cooks and the registered owner also attends the home on a daily basis providing maintenance support and sometimes helping with residents transport. Staff spoken to as well as residents said that they had time to spend with Care Homes for Older People Page 22 of 30 Evidence: residents and support them with their care needs without feeling rushed or unable to give the residents the time they need. There are four staff on shift from 8 a.m. to 5 p.m. with the registered manager providing additional support during this time. Between 5 p.m. 8:30 p.m. there are three staff, and nighttime support is provided by two waking staff from 9 p.m. to 8 a.m. Normally the staff to residents ratio is one staff to five residents. Over 80 of the care staff have level 2/3 NVQ in care and some staff are exploring to options with regard to future NVQ training. The assistant manager has now completed NVQ level four in care and management. Examination of three staff files showed evidence of an appropriate recruitment policy being put into practice. These files contained two references evidence of interview CRB check details health check clearance and all of these were in place before commencement of employment. All staff had contracts of employment. The home have an induction programme that is comprehensive, a workbook is in use to support the induction programme. It was recommended that the home use an index for staff files showing recruitment information and this recommendation is now met. The home has a training programme in place and staff confirmed that they are able to access training. The home is registered with the Skills for a Care organisation and the manager has a training plan in place for all individual staff especially focusing on medication, dementia adult protection moving and handling and a range of other relevant areas. As there are some mental health issues associated with some residents who have dementia, it was recommended at the last inspection that the home consider including mental health training in its training programme. This has now been done. Staff were observed to be caring and supportive of residents. Residents and relatives interviewed said that the staff were marvellous and that care is extremely good. Care Homes for Older People Page 23 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. The homes manager is fit to be in charge is of good character and is able to fully discharge her responsibilities. The home is run in the best interests of residents and their financial interests are safeguarded. The staff are regularly supervised and health and safety is promoted. Evidence: The registered manager is very experienced and is qualified as Registered General Nurse. She has been managing the home since it opened in 1984 and is very experienced in accessing the network of healthcare available in the area. She demonstrates an open and honest approach to managing the home, and is progressive in her attitude to managing the many challenges and changes within the home. Care Homes for Older People Page 24 of 30 Evidence: The Manager has an the NVQ level 4 qualification in care and management. There is an assistant manager who helps her to manage the home who has now completed an NVQ level 4 qualification. I interviewed her and she showed a good knowledge of the standards of care required and most importantly showed a good understanding of the needs of the residents and was aware of the issues regarding the development of the home. The co-owner of the home attends the home daily and comments received from staff residents and relatives unanimously showed that the homes manager and owner are held in very high regard and are always available to listen and help when needed. There was a requirement made at the last inspection for the home to put in place an effective Annual Audit system and a development plan for the home. Tis requirement has now been met. The home completes residents surveys at least annually and has also undertaken relatives and other visitors surveys. The last of these was done in February 2009 and an action plan has been produced to address improvements suggested. The survey results are available to residents and visitors to look at and are clearly presented. The home holds residents meeting every three months and relatives are invited to these meetings is well. These are seen as a place to pass information to residents as well as hear from them and plan future events. These meetings are minuted. Residents and visitors to the home said that they are happy with the consultation by the owners about the care provided saying that they are asked about care plan reviews when they happen. All residents are responsible for their own finances and four residents spoken to confirmed this. The home provides facilities for keeping small amounts of money for residents personal spending for which good clear records and receipts are kept. Staff supervision is happening consistently now and two staff said that they meet with the manager at least every eight weeks for supervision. Three other written staff inspection surveys also supported this finding. Examination of three staff files showed that good discussion is happening between the manager and staff about their job and their development within their work. The home has an up-to-date health and safety policy which was last reviewed in 2008. The health and safety responsibilities are shared between the registered manager and the registered owner/provider. The portable appliance tests have been done and electrical and gas certificates and are still up-to-date. Fire tests are done weekly with drills taking place every few months. This includes an evacuation drill and a contingency plan in for relocating residents in the event of damage to the home. Hoists and lifts are under maintenance contract, and all were done in 2009. An annual maintenance of wheelchairs is also carried out. Health and safety issues are taken very Care Homes for Older People Page 25 of 30 Evidence: seriously by the home and excellent records are kept. Care Homes for Older People Page 26 of 30 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 30 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 2 5 The registered provider and 30/10/2009 manager must ensure that all residents have up-to-date information regarding the fees charged and who pays them. This is to ensure that residents are fully aware of their rights and obligations. 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 7 The registered provider and manager should again remind residents and their relatives at the opportunity to be involved in their care planning and reviews The registered provider and manager should in addition to the existing care plans and activities offered provide clearer written support plans for people with dementia showing when they like to do activities and how they are offered exercise and mentally stimulating activities. The registered provider and manager should ensure that when checking liquid medication that this is done using a graduated container so that measurements of medication Page 28 of 30 2 7 3 9 Care Homes for Older People particularly controlled medication is more accurate. 4 18 The registered provider and manager should ensure that all staff be reminded that they should never informally investigate allegations of abuse but instead should always report allegations or suspicion immediately to the homes management. The registered provider manager should ensure that the carpet on the ground floor outside of the medication storage room be cleaned and or replaced. (Refer to Recommendations OP19) 5 19 Care Homes for Older People Page 29 of 30 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. 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