Care Home: Sycamore House

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What the care home does well On entering the care home, the atmosphere is relaxed and friendly and we can see that staff maintain good relationships with people using the service and each other. People using the service speak highly of the staff and the care and support that they receive and they say they are satisfied with the life that they experience within the care home. Case files contain in depth information about people`s needs to make sure that staff have sufficient information to be able to support people appropriately. People are supported and enabled to access specialist services to maintain their health and wellbeing. People using the service feel that they are treated respectfully and that their privacy and dignity is upheld. Activities on offer are suited to people`s individual needs and contacts with the family and wider community are maintained. A wholesome and appealing diet is on offer and specialist diets are catered for. Although no complaints have been received, the manager and staff are open to constructive criticism and concerns if the need arises, so that they can act upon these. Staff continue to undertake compulsory and additional training and they are able to discuss people`s needs and how they support them in meeting these, to demonstrate that people using the service are supported by staff who are competent in their job roles. The manager is open and approachable and maintains good relationships with both the staff and people using the service, she is up to date with training and strives to maintain excellent standards of care. A quality assurance system is in place to make sure that the service delivery is monitored and people experience good outcomes in all areas. People are assured that their personal finances are protected and that staff deal with these appropriately. What has improved since the last inspection? The service continues to make improvements in all aspects of care delivery. What the care home could do better: Minor good practice recommendations could be implemented in regard to the medication practices, to further protected people using the service. It is recommended that the service reviews its policy on what is recorded when Criminal Records Bureau checks for staff are received so that there is clear evidence that checks have been carried out. Key inspection report Care homes for older people Name: Address: Sycamore House Sycamore House Mansfield Road Nottingham Notts NG5 3FW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karmon Hawley     Date: 2 2 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 30 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 30 Information about the care home Name of care home: Address: Sycamore House Sycamore House Mansfield Road Nottingham Notts NG5 3FW 01159565205 01159604568 n.smith@abbeyfield.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Abbeyfield Society Name of registered manager (if applicable) Mrs Norma Smith Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accomodated is 31 The registered person may provide the following categories of service, Care Home only, Code PC, to service users of the following gender, either, whose primary care needs on admission to the the home are within the following categories, Older People, not falling within any other category, Code OP Date of last inspection Brief description of the care home Sycamore House is situated on a main road, approximately two miles North of the City centre. It is well served by public transport, and is close to local shops. Sycamore House is situated on different levels, with the upper levels being accessed by stairs or a passenger lift. Residents are accommodated in single bedrooms; all communal areas of the home are accessible to residents who have limited or restricted mobility. In Care Homes for Older People Page 4 of 30 Over 65 31 0 Brief description of the care home addition there are a number of different bathing aids - including seat hoists for those people whose mobility and movement is restricted. The garden is pleasantly landscaped. The layout of the building is well planned, and the fixtures and fittings are of a high standard. There is an ongoing programme of maintenance and renewal of the fixtures and decor. There is a large conservatory, which overlooks the garden, a dining room at the front of the building and a number of smaller sitting areas throughout the building. All areas are decorated to a high standard, and are light and bright. The Manager stated that the current weekly fee range for the home is between £399.91 to £447.44. 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period. A review of all the information we have received about the home from the provider and the general public since the last inspection was considered in planning this visit and this helped decide what areas were looked at. The main method of inspection we use is called case tracking which involves selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Care Homes for Older People Page 6 of 30 The Area Manager, Manager, members of staff and people who use the service were spoken with as part of this visit. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. The provider provided sent their latest Annual Quality Assurance Assessment which is a document that outlines the services development over the last year and areas where they intend to make improvements, however we did not receive this in time to incorporate this information in this report. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Minor good practice recommendations could be implemented in regard to the medication practices, to further protected people using the service. It is recommended that the service reviews its policy on what is recorded when Care Homes for Older People Page 8 of 30 Criminal Records Bureau checks for staff are received so that there is clear evidence that checks have been carried out. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that are admitted to the home have their needs assessed prior to admission, which means staff, will be able to plan for their individual needs and know how to care for them. The service does not provide intermediate care. Evidence: The manager visits people in the community prior to admission to carry out an assessment. This is to make sure that staff are able to meet peoples needs before a decision to move into the care home is made. So that staff have as much information as possible about peoples needs, additional information is also sought from family and the social worker if involved. The manager also encourages people to visit the care home and spend some time there so that they can get a feel for what it would be like to live at the care home and Care Homes for Older People Page 11 of 30 Evidence: also get to know the staff that will be supporting them. Staff spoken with tell us that they get enough information about people before they move into the care home so that they can support them as needed. One person using the service tells us that they used to visit the care home before they made a decision to move in and this made it easier for them to make a decision as they knew what to expect and the staff that would be supporting them. The service does not offer intermediate care services. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are assured that their health, personal and social care needs are set out in a plan of care so that staff know how to support them in a way that they prefer. People using the service are treated with respect and their privacy and dignity is maintained. Evidence: The manager and deputy manager have been further developing plans of care to make sure that these are personalised and person centered in respect of the support that people may need. The files that have been completed contain in depth information in respect of peoples individual needs; they reflect peoples choices and preferences in all areas. A personal profile is also available so that staff can learn more about each person and understand what has happened in their lives and what is important to them. It also outlines what personal achievements people have made in their lives and how this made them feel. The manager said that the aim of these is to give staff more of an understanding of Care Homes for Older People Page 13 of 30 Evidence: people and reflect diversity, so that staff can appreciate people for who they are. To ensure that staff have sufficient information to support people appropriately, in depth information is in place in regard to peoples complex needs such as the support needed following a stroke, dementia care and poor mobility due to medical needs. Within a care file that has not yet been completed, plans of care are mainly task focussed and only offer brief information in respect of peoples needs, however the manager said that all outstanding files will all be completed in the next couple of months to bring them up to the same standard as the others. In depth risk assessments are in place in respect of all identified needs such as falls, the safe use of bedrails and medication to ensure that risks are managed and reduced and people remain safe. There is evidence of both plans of care and risk assessments being reviewed and updated as required so that people receive continuity of care. Staff spoken with tell us that they have access to the care plans and that sufficient information is made available for them to be able to support people appropriately; I have access to care plans, there is enough information, I can find things out about them, and I make sure I know people and their needs, I was involved in the care planning process and did some training on person centered care. I have made a point of being aware of peoples past history so that I can relate to them. Staff are also able to discuss peoples individual care and specialist needs such as diabetes mellitus and how they would recognise if anything was wrong so that they could call for assistance. To ensure that peoples medical needs are met we can see people are supported to access specialist services such as the district nurse, doctor and physiotherapist as needed. In addition to this specialist equipment is also accessed to ensure that people have the necessary aids that they need, such as walking appliances and special mattresses to promote and maintain healthy skin. Staff spoken with tell us that people using the service are supported to access services such as the GP and district nurse when needed. One person using the service confirms that they can access specialist services and that the staff helped them to get a special walking aid to make sure that they are safe Care Homes for Older People Page 14 of 30 Evidence: when mobilising. I did walk with sticks but the staff noticed I was struggling, therefore I now have a Zimmer frame which they sorted out, it is better to be safe than sorry. All staff who administer medication have been trained to do so and medication records examined show us that people using the service receive their medication as prescribed. When changes are made to medication two members of staff sign medication charts to ensure that the correct changes are made, however two members of staff do not sign handwritten entries to show that these have been checked as correct. Assessments are undertaken to see if people are able to manage their medication themselves, so that they are supported to do so if they wish. We can see that risk assessments are available within plans of care when people do this to make sure that they remain safe. Fridge temperatures are monitored to make sure that medication is stored at the correct temperature so that it works properly, however room temperatures are not recorded. Throughout our inspection we saw staff treat people with respect and consideration at all times and on speaking with staff they are able to discuss how they ensure that they maintain peoples privacy and dignity when supporting them to meet their needs. People using the service speak highly of the staff and support they offer, saying that they are polite and respectful at all times. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live a life of their choosing which meets their expectations and maintain contacts with people that are important to them. Evidence: Although there is no activity coordinator appointed, there are 6 volunteers who work at the care home and the manager is looking into recruiting someone for this position. There are a number of activities on offer for people should they wish to join in and a notice board is situated near the dining room where all this information is made available. Currently activities such as movement to music, bingo, reminiscence, trips out, singers and entertainers are made available. People using the service feel that there are sufficient activities for them to join in should they wish, I am very happy and settled, there are activities but I do not want to join in, I am happy watching the TV, I used to do exercises but I dont do them anymore as I dont want to. I sit out in the garden and go out on trips and out with my family, and there are activities but we are not really that bothered but we do enjoy the violinist when they come, but we mainly entertain ourselves. Staff feel that there are enough activities for people to do should they wish. Care Homes for Older People Page 16 of 30 Evidence: So that people can maintain contact with those that are important to them there are no restrictions on visiting and people can receive visitors in private should they wish. Family and friends can also stay for a meal at a small cost should they wish. The service has also purchased a computer with Internet access so that people can keep in touch with their families this way as well if they wish. People using the service confirm that their visitors are made welcome, can visit at any time and stay for meals and one person says that their relative comes to see them everyday. Staff confirm that visitors are welcome at anytime and there are facilities where they can make drinks should they wish, however they are always offered drinks and can ask at the kitchen for refreshments at anytime. People using the service tell us that the routine of the care home is flexible and that they can spend their time as they please, they feel that their rights and choices are maintained and that they have control over their lives; I used to go out but I am not able to now, we can do what we want to do, we usually entertain ourselves. We like sitting here for the space and watching what is going on, we can do as we please here, I usually sit here, I like it as can see who comes and goes. Staff also hold this view and tell us that it is important that people do as they wish; this is their home, they can do what they like, we ensure people have choices and their rights are upheld, it is important to make sure that they are happy, feel safe and maintain their independence; they guide us, the routine is flexible, people can do as they want, how they spend their day varies. The Church comes here, various people go and they can access the local community if they want to, some people go out to the shops or a walk, we try to make it feel like it is their home. A wholesome and nutritious menu is on offer to people using the service with choices available at each meal time and specialist diets catered for. People using the service tell us that they are happy with the menu on offer, the food is good, there is enough choice and I am particular, you can have second helpings if you want, and the food is good and there is plenty to eat and different choices. Staff also feel that the menu on offer is at a good standard and that food is plentiful. One member of staff also discussed the issue of diversity and the different foods one Care Homes for Older People Page 17 of 30 Evidence: may request due to their religion, they demonstrated a good understanding in regard to this. Care Homes for Older People Page 18 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. People using the service feel able to raise concerns and complaints and can be confident that the manager will act on them. Staff know how to safeguard people living in the home from abuse. Evidence: There is a clear complaints procedure on display in the care home and also in the service user guide, which everyone has access to. The service has received 3 complaints since the last inspection three years ago. These were in respect of missing personal items and money. Records examined show us that these were investigated and resolved as required. The manager also invited the local community police into the care home who gave people using the service a talk on keeping themselves and their belongings safe. Staff spoken with are able to discuss how they would deal with a complaint should one be received to make sure that this is resolved. They also spoke of ensuring that people using the service feel comfortable with them and able to approach staff to ensure that they can raise any concerns that they may have. People using the service tell us that they know how to make a complaint if they feel the need to, however all express that they are very happy with the service provided. Most staff have received training in the protection of vulnerable adults to make sure Care Homes for Older People Page 19 of 30 Evidence: that people using the service are protected. On speaking with staff they are able to discuss their roles and responsibilities in ensuring that people remain safe and what they would do if they thought that abuse was occurring. People using the service tell us that they feel well looked after and safe; I feel safe here, if I was unhappy I could say something and I would. Care Homes for Older People Page 20 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. The general maintenance of the care home remains at a high standard and all areas accessed are clean and tidy and a homely feel is portrayed by the comfortable furnishings. Evidence: There is a large lounge overlooking the garden available for people to use should they wish, however at present most people tend to sit in other smaller seating areas that are distributed around the care home or spend their time in their bedrooms. The garden area is very well maintained with attractive plants, shrubs and seating areas and on speaking with people using the service they tell us that they enjoy sitting out in the garden in the warmer weather. Peoples rooms are personalised with their own belongings which they may bring with them. Two people using the service tell us that they have very comfortable rooms which are kept clean and tidy. The home has two passenger lifts and appropriate equipment such as hoists, bathing aids and grab rails are available as necessary to assist those who may have need of these. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by staff who are well trained and competent in their job role. Evidence: During the inspection we saw that staff are available to support people using the service as needed. People using the service tell us that the staff are very kind and caring and that they are available to help them as needed; the staff are kind and a good help when needed, people are very kind and accommodating, they help me as needed, there are enough staff to meet my needs, and staff are very nice, you can have a laugh and a joke with them, which I enjoy. There are enough staff to help if need be but I prefer to keep my independence while I can. Staff spoken with offer differing comments, where one person feels that the staffing levels are sufficient another feels that additional staff would be beneficial as staff are sometime very busy; I enjoy my job, the team generally get on well, there are enough staff to meet peoples needs, the residents come first, they are our priority and we could do with more staff at times as some people need more help and it is hard to fit everything in, however the residents are not affected, we prioritise care and work hard. Care Homes for Older People Page 22 of 30 Evidence: So that new staff are aware of their roles and responsibilities when they first start employment they undertake an induction to introduce this to them. This is an opportunity for them to get to know the general routine of the care home and the people that they will be supporting. Staff spoken with confirm that all new staff undertake an induction and that this usually takes place within 12 weeks of starting employment. 83 of staff have now attained the National Vocational Qualification level 2 in care (a nationally recognised work and theory based qualification designed to enhance peoples knowledge and skills in caring for people) and all senior staff are undertaking level 3. Both members of staff spoken with confirm that they have undertaken the above training, I have done lots of training and have done my NVQ, it has given me more understanding about people, how to communicate and improve care, and I have done the NVQ level 2 and I am now doing level 3, it is good to have achievements and be recognised for this. Staff personnel files all contain the necessary documentation required by law such as references and proof of identity, however on looking at one long term member of staffs file we did see that a Criminal Record Bureau (a police check to see if an individual has a police caution or criminal record) check number was not in place. We therefore checked all long term staff members files and saw that in total this was the case for nine members of staff. Following the inspection and further research it transpires that the service did follow the Criminal Record Bureau guidelines at the time the aforementioned Criminal Record Bureau checks were issued. It was not appropriate to keep records of Criminal Record Bureau numbers on file, therefore the file simply stated that these had been received. Nevertheless the service has obtained the numbers for these members of staff to put on file and where these are not available new checks will be applied for. Staff spoken with confirm that they have undertaken a Criminal Record Bureau check and we can see that new staff employed undergo a through recruitment process before their employment begins. Staff files examined show us that staff have individual development plans and that they continue to undertake compulsory training such as fire and manual handling to ensure that they have the knowledge and skills to support people using the service. Staff spoken with say that they have completed all the mandatory training and that they feel supported in their training and development. Care Homes for Older People Page 23 of 30 Evidence: There are also some staff who have been trained to deliver training at the care home so that this can be done as soon as possible and staff do not have to wait for positions to become available. One member of staff spoken with confirms that they themselves are an in house trainer, which they feel is good as it makes the staff feel more comfortable, enhancing the learning process. One person using the service tells us that they feel that the staff are good at their jobs and that they are well trained. Care Homes for Older People Page 24 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. People live in a care home that is well run and managed where they are enabled to have a say about the service delivery. Evidence: The manager has been working at the service for many years and therefore has experience in managing the care home. She has undertaken the Registered Managers Award (a nationally recognised work and theory based qualification designed to enhance management skills) and is now doing the National Vocational Qualification level 4 to supplement this. She also ensures that she remains up to date with all compulsory training so that she is able to ensure that good practices are maintained at all times. We saw that the manager has good relationships with both the staff and people using the service and both spoke highly of the manager; matron is nice the place is well run, the manager is good and she is friendly you can approach her, it is well run, the staff are well trained and good at their jobs, I have no concerns, the manager is Care Homes for Older People Page 25 of 30 Evidence: really nice, I have known her through her job roles here, she is approachable, any problems you can go to her, she is a grounded person, and I get enough support from the manager she is approachable. People using the service are enabled to have a say in how the care home is run and managed by way of annual questionnaires and regular meetings. The questionnaires for this year have only just been sent out and therefore no results have been returned as yet. Nevertheless the results from the previous years questionnaires all praise the service and the support received. A compliments book is also available for people to complete should they wish and we can see that this has been used and positive comments have been entered such as, the staff are always friendly and helpful, and I just want to compliment the lovely atmosphere at the Christmas show. Many of the off duty staff brought in their children. It was a lovely family event. There are regular residents meetings should people choose to attend. We can see that at the last meeting the merger of the company with another was discussed so that people were kept informed of what was happening. Issues such as the menu and activities are also discussed at these times. One person using the service tells us that they have been to some of these meetings; however they tend to just go when they want to. The manager also carries out quality assurance audits on areas such as medication, care planning and accidents so that any issues are addressed. A new quality assurance officer has also been employed to ensure that high standards are maintained. People who may wish to can keep their money in safe keeping in the care homes safe. On checking these accounts we can see that records of all transactions are kept and these are signed by two members of staff or the person using the service if able and that receipts are available. Should people not wish to use this service they can keep money in their room and a lockable facility is provided for this. Should anyone have an advocate or a someone acting as power of attorney this is documented in peoples plans of care so that staff are aware of this. One person using the service informs us that they use the lockable facility in their room and they could lock their bedroom door if they wanted to. Care Homes for Older People Page 26 of 30 Evidence: Staff spoken with tell us that they can not access peoples money and only the manager and deputy can do so, however if they do undertake any shopping they ensure that receipts are always obtained. Staff have been trained in health and safety so that they are aware of ensuring that a safe environment is maintained for people using the service. On examining health and safety records we can see that the necessary checks and servicing of equipment, such as the lift, hoist and gas systems is taking place as required to ensure that these remain in safe working order. The fire log book shows us that the fire alarm systems are tested as required and staff are attending fire drills to ensure that they have the opportunity to practice evacuation procedures in the event of a fire. Individual risk assessments in regard to fire are within peoples plans of care to ensure that they remain as safe as possible should there be a fire in the care home. Accident records show us that there are minimal amounts of accident occurring within the care home, however when they do, staff are following the correct procedures and summoning specialist assistance and advice if needed Care Homes for Older People Page 27 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 28 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 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 9 Hand written entries on medication charts are signed by two members of staff to show that these have been checked as correct. The room temperature where medication is stored is monitored and recorded to ensure that medication remains stored within the temperatures outlined in the manufacturers guidelines. All staff members that do not have a Criminal Record Bureau check number on file undertake a recheck so that up to date information is available. 2 9 3 29 Care Homes for Older People Page 29 of 30 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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