Care Home: The Abbey Retirement Home

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What the care home does well Admission processes mean that people move into the home knowing the home should be able to meet their needs and with an understanding about the running of the home. People living at the home have their health and medical care needs met by access to health professionals. A range of activities are available for people to take part in. Abbey Retirement Home provides a homely and friendly environment for people to live in. Recruitment procedures mean the home has to the best of their ability ensured people are supported and cared for by people who are suitable to work in the care industry. People living at the home are supported and cared for by a staff team in sufficient numbers and who have the necessary skills to provide the care and support needed. The manager promotes a management style that is relaxed, supportive and involving the views of everybody at the home. What has improved since the last inspection? Improvements made to care planing processes mean that care and support is personalised and that assessments are in place with regard to the risk of falls and other risks associated with the environment. All staff have received formal training about safeguarding vulnerable adults procedures. The home notifies us of any events affecting the wellbeing of people living at the home. What the care home could do better: Assessments of peoples ability to manage their own medications must be documented and systems put in place for monitoring that people are managing their own medications successfully. A medication cabinet that complies with the Misuse of Drugs (Safe Custody) Regulations 1975 must be in place for the storage of controlled drugs. Documented monitoring of people`s involvement in activities and their responses should be made. Some areas of the environment, (the laundry facilities and some localised areas of the kitchen), may pose problems in maintaining cleanliness and good hygiene standards. The manager is going to consult with relevant professionals regarding actions to be taken to ensure the hygiene and cleanliness of these areas. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Abbey Retirement Home 348 Winchester Road Southampton Hampshire SO16 6TW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gina Pickering     Date: 0 2 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Abbey Retirement Home 348 Winchester Road Southampton Hampshire SO16 6TW 02380702671 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Heather Northover,Mr Roy Clive Northover care home 15 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 15 The registered person may provide the following category 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 category : Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) Old age, not falling within any other category (OP) Date of last inspection 15 15 0 Over 65 0 0 15 Care Homes for Older People Page 4 of 29 Brief description of the care home The Abbey Retirement Home is a registered care home providing care and accommodation for up 15 older people. It provides a service for people with mental frailty and illness associated with dementia. Natasha Sykes manages the home on behalf of the proprietors Roy and Heather Northover who are also responsible for other similar services in the area. The home is situated in a residential area, on public transport routes to both Southampton Town Centre and Shirley High Street, and within about three hundred yards of a small parade of local shops. The accommodation, comprising both single and shared rooms is arranged over two floors with a passenger lift affording access to rooms on the first floor. All parts of the home and garden are accessible to residents including those who use a wheelchair. There is a car park at the rear with spaces for about four vehicles. At the time of the inspection fees ranged between 385 and 415 British pounds per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection considered information recieved about the home since our last key inspection in April 2008. This includes information provided to us in the form of the homes Annual Quality Assurance Assessment form in which the registered manager told us how the service has developed over the past twelve months and how she proposes to continue to improved the service. We surveyed people who use the service and staff members. Unfortunately due to unforeseen circumstances we were unable to use the information provided in surveys as part of this inspection process. A visit was made to the service on 2nd April 2009. We looked at documentation relating to four people using the service. We toured the building looking at the communal areas, a sample of bedrooms, bathrooms and the laundry. We also had conversations with five people living at the home, four staff members, one of the visiting activity providers and the registered manager as well as looking at various Care Homes for Older People Page 6 of 29 documentation as part of the inspection process. 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 Care Homes for Older People Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admission processes that include the provision of relevant information mean people move into the home with an understanding about the running of the home and with confidence that the home will be able to meet their needs. Evidence: The AQAA told us people interested in moving into the home are provided with written or audio information about the services provided at the home (Statement of Purpose and Service Users Guide) and an assessment of a persons needs is completed before they move into the home. We looked at copy of the written information provided to people which included information about personal and health care provision, the environment, visiting, the complaints process, leisure activities and quality assurance processes. A copy of the latest inspection report is made available for any one to view and information about the most recent quality assurance survey that includes the views of people living at the home is made available. This means that people moving into the home have an understanding about the running of the home and how they Care Homes for Older People Page 11 of 29 Evidence: can express their views about the home and influence the day to day running of the home. The manager told us she visits all people wishing to move into the home to assess whether the home will be able to meet their needs. We looked at documents for four people living at the home., they all contained an assessment made of their needs before they moved into Abbey Retirement Home. The assessment included details about mobility, communication, personal and health care, dietary needs, mental condition and life history and information such as favourite foods, hobbies and music. For people that are social services funded the home obtains copies of the social services needs assessment; copies of these were present in peoples documents. Two people living at the home told us the manager from the home visited them before they moved into the home and that they were able to visit the home prior to moving in. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning processes and care practices at the home mean people receive the care they need in the manner they want whilst having their privacy and dignity maintained. Medication practices do not fully promote the welfare pf people who chose to manage their own medications. Evidence: The AQAA told us improvements have been made to the care planning processes resulting in care plans being more detailed and being person centred. We looked at four care plans for people living at the home. Each person has a plan of care that details their abilities, problems and needs, the aims of care and method of the care and support for areas such as personal hygiene, dressing, recreation, mobility and mental health. As well as this plan each person now has detailed information about their mental health needs, daily routines, their normal behaviours and how to manage them and risk assessments for daily activities and environmental issues including the risks of falls. This means that care staff are informed of the care and support people living at the home need and the manner in which they like to be supported in their care provision. There is also good information about how to communicate with people Care Homes for Older People Page 13 of 29 Evidence: and how to manage their differing behaviours. Examples detailed in the plans include regarding communication sometimes you have to show her what you want her to do as well as asking her verbally and regarding behaviours, can become verbally aggressive and on these occasions it is best to leave him alone for a while and he must be left to do things in his own time. Care staff told us the details provided in this personalised care planning has enabled them to better provide individualised care to people living at the home. The care planning documentation contains details of contact people have with health care professionals. This includes GPs, District Nurses, Community Psychiatric Nurses, Chiropodists, dental, optical and audiology services. We were able to track the involvement of such professionals with regard to the changing conditions of people living at the home, with the changes in care being detailed on the relevant care plan or medication administration chart. Medication polices and procedures are in place. Staff records evidence that staff receive training about the safe management and administration of medications prior to being deemed competent to administer medications. We looked at the medication administration record charts for four people living at the home. These detail the dosage and time medications are administered. For one person who administers her own creams and angina spray medication there was no indication in the care plan or MAR chart as to how this is monitored or whether an assessment had been made of her ability to manage her own medications. The registered manager agreed that processes will be put in place to document assessments of a persons ability to manage their own medications and for monitoring that the person is managing their own medication successfully. Storage of medications is in an orderly manner, but the storage facilities for controlled medications does not comply with the Misuse of Drugs (Safe Custody) Regulations 1975. The manager told us she will provide storage facilities for controlled medication that does comply with the Misuse of Drugs (Safe Custody) Regulations 1975. Care plans detail actions to be taken by staff to protect the privacy and dignity of people whilst receiving personal care, including their personal preferences in the delivery and support in personal care. All shared bedrooms have screening to protect the privacy of people. Staff were observed to knock and wait for an answer prior to entering a persons bedroom. Conversations with people living at the home did not indicate any concerns regarding the protection of their privacy and dignity. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have the opportunity to take part in meaningful activities and are supported to maintain contact with family and friends. People living at the home enjoy a varied and nutritious diet. Evidence: The AQAA told us that improvements have been made regarding the provision of information about activities such as providing an information board for displaying information about forthcoming events for people at the home to view. When we visited the home there was a notice board that had details about forthcoming activities happening at the home. The care planning processes include details about peoples life history, past work experiences and their hobbies. The manager, staff and one of the visiting activity persons told us about activities provided at the home. This includes quizzes, poetry sessions, music workshops, pampering sessions, movie evenings, visits to local coffee shops, public houses and shops. People living at the home that we had conversations indicated they are satisfied with the level of provision of activities. People living at the home expressed their enjoyment of the homes pets that include a cat, rabbit and birds. Despite the good provision of activities there is no system in place for keeping a record of activities that people living at the home have taken part in and their response to activities. When we asked the manager about how she Care Homes for Older People Page 15 of 29 Evidence: monitored the activities taken part in and peoples response to activities she acknowledged there is no system in place at the moment and told us she will nominate a member of staff to take responsibility for this. The pre admission processes provide people with information about receiving visitors at the home, and notices in the home detail people can receive visitors when they wish. There were three visitors in the home during our visit but because they were taking their relatives out of the home for a period we did not manage to have conversations with them. The visitors log book detail people receive visitors at varying times of the day. People living at the home confirmed to us they can receive visitors when they wish and they can choose where to receive their visitors. The AQAA told us the home has supported people to visit friends in the community. We discussed this statement during our visit to the home and were told by the manager that staff support people living at the home to visit friends who can no longer visit them at the home due to ill health. The religious and spiritual needs of people are detailed in their care planning assessment process. A member of the clergy visits the home on a two weekly basis and several people living at the home visit their local churches with the support of church friends. Meals at the home are prepared and cooked by the care staff employed at the home all of whom have successfully obtained food hygiene certificates. A menu diary details the meals provided to people living at the home. People have a choice of food at breakfasts and the evening meal, but the lunch is a set menu. Staff told us the menu is planned around the known likes and dislikes of people living at the home, and regular discussion is held with people to find out what meals they would like prepared. People living at the home that we had conversations with told us they enjoy the meals at the home and that an alternative meal is provided if they do not like or do not want the meal that is being provided. We observed that people are encouraged to take their lunch in the dining room but some people were taking their meals in the lounge area or their bedrooms at their own choice. Assistance at the lunch time was observed to be given with sensitivity to the needs of the individual. Any assistance that is required is detailed in the care planning process for the relevant person. During the course of the visit to the home we observed that people are enabled to make choices about their daily lives. Individual choices and preferences regarding care provision are included in the care planning processes. People were observed being able to make choices about where to eat, where to spend their time whether in the communal areas with other people or in the privacy of their own bedrooms, being able Care Homes for Older People Page 16 of 29 Evidence: to make choices about whether to join with activities taking place. Staff and the manager told us that routines at the home are flexible to allow people to make choices about their daily activities that includes choices regarding their personal hygiene routines. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place for people to express concerns and complaints about the service provided at the home. People living at the home are protected form the effects of abuse by a work force that has a good understanding about safeguarding procedures. Evidence: A complaints procedure is in place. This is detailed in the written information that is provided to people before they move into the home and is displayed in the entrance hall to the home. People living at the home that we had conversations with told us they would voice any concerns to any staff member at the home. Staff told us they would inform the manager about any concerns or complaints made about the home and they understood that this must be documented. No complaints have been received by the home or by us about the service in the past twelve months. But the manager told us that any complaints received will be documented, investigated and the outcome of the investigation and the response to the complainant will be documented. Policies and procedures are in place about the safeguarding of vulnerable adults. Since the last inspection all staff members have received formalised training about safeguarding vulnerable people, thus meeting a requirement made following the last inspection. Staff demonstrated in conversation a good understanding about safeguarding procedures and knew the correct action to take in the event of Care Homes for Older People Page 18 of 29 Evidence: suspecting an act of abuse has occurred. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 home whose environment is clean and homely, but cleanliness and hygiene of some localised areas cannot be assured. Evidence: As part of the inspection a tour was made of the environment looking at communal areas, a sample of the bedrooms, the bathing facilities, laundry, kitchen and outside areas. Indoor communal areas consist of a large lounge and a dining room. Both are furnished and decorated in a homely manner. The lounge area has a variety of seating for people to make their choice of where to sit and interest in the form of two televisions, magazines, and several pets including birds in bird cages. The two televisions are spaced apart so that the sound from either was noted not to interfere with the other which allows people a greater choice of which television programme they would like to watch. The dining room is pleasantly furnished and decorated and was observed to be used by people living at the home for periods other than meal times. One person was sitting in the dining room quietly in the morning and another person received her visitor in the dining room in the afternoon. There is level access to a pleasant garden area with seating that people can make use of in the warmer weather. Bedrooms that we looked at were clean and tidy and personalised with items such as ornaments, photographs and small items of furniture. Shared rooms have screening to Care Homes for Older People Page 20 of 29 Evidence: promote the privacy of people sharing the bedroom. The AQAA told us rooms are furnished to the request of people living at the home. One example of this is a two seater settee has been provided in one persons bedroom so she can sit next to her husband when he visits. The AQAA told us laundry facilities have been improved with the laundry being re positioned downstairs. However this means access to the laundry is through service users toilet area. Clean laundry, prior to being returned to peoples bedrooms, is stored in the upstairs boiler room in which there is also a sluicing sink. The position of the laundry and the clean laundry storage areas has the potential to pose a risk of contamination of clean laundry. The manager agreed to seek professional advice regarding procedures and practices to ensure risks of contamination and spread of infection are minimised. We looked at the kitchen which was clean and tidy. But we noted concerns with torn and lifting flooring next to the meat fridge. The meat fridge had areas of peeling lining from the fridge. This means the cleanliness of these localised areas cannot be assured. The manager told us she will seek and act on advice from the relevant professional body with regard to this concern. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment practices mean the home has ensured to the best of their ability people are supported and cared for by staff members suitable to work in the care industry. People are supported by staff in sufficient numbers and who have the skills to provide the relevant support and care. Evidence: A staff rota details which members of staff are on duty at any one time. The rota, discussion with staff members and the registered manager evidenced that four members of staff are on duty in the morning, three staff members in the afternoon and one awake staff member and one asleep staff member on duty at night time. The manager is not included on the care hours on Thursday and Friday which enables her to complete her managerial duties. The housekeeping and coking duties are included in the care hours. We have received no information to indicate the support and care of people is being compromised due to care staff having to fulfil ancillary duties. During our visit to the home we observed staff monitoring the wellbeing of people in the communal areas as well as attending to the needs of those in their bedrooms, call bells were observed to be answered promptly. Staff we spoke to told us they believe there are sufficient staff to meet the needs of people living at the home. And people living at the home told us staff are always around to attend to their needs. An on call system in which either the manager or the deputy manager is on call means that staff can seek advice or support if there are problems with meeting the needs of people at Care Homes for Older People Page 22 of 29 Evidence: the home. We looked at files for three people working at the home. This evidenced that recruitment procedures are followed to protect the wellbeing of people living at the home. This includes the receipt of two satisfactory written references and receipt of satisfactory checks against the Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults (POVA) list. Staff confirmed in discussion that the above checks had been completed prior to them commencing employment at the home. Staff files contained copies of certificates for courses attended and qualifications achieved. The AQAA told us improvements are being made in the recording of staff training. The manager shared with us a matrix she is now recording all staff training on. This means that rather than having to look in staff files at their certificates, she can look at the matrix which will tell her what training each person has completed and what training they need to update. The AQAA told us that six out of the eight care staff employed have as a minimum NVQ level 2 in care. Since the AQAA was completed a further staff member has been recruited. This means that 66 pf the care staff at Abbey Retirement Home have as a minimum Level 2 NVQ in Care which exceeds the minimum standards required. The AQAA told us that a further three staff members are due to complete NVQ level 2 or 3 in care. The manager told us these studies have been completed and the staff members are waiting for their certificates to be issued. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from management that endeavours to seek their views and run the home to improve outcomes for people living at the home. Because of some localised inadequacies of the environment of the home the health and safety of all at the home cannot always be fully assured. Evidence: The manager, Natasha Sykes, has completed the Registered Managers Award. At the last key inspection in April 2008 it was detailed she was enrolling in NVQ level 4 in care. Discussion with the manager at this inspection revealed that because of problems in identifying a reliable training source she has yet to commence the NVQ level 4 in care but is planning to enrol in the forthcoming year. Both staff and people living at the home spoke highly of her management of the home. They described the management style as relaxed, supportive and involving the views of everybody at the home. The AQAA told us the ways in which the views of people living at the home and their Care Homes for Older People Page 24 of 29 Evidence: representatives are sought. These include resident meetings, satisfaction surveys and general conversations with people. We saw copies of the last two satisfaction surveys dated August 2008 and January 2009. Collated results from these indicated a good or excellent level of satisfaction from people living at the home and their representatives with the service provided by Abbey House Retirement Home. The collated results also indicated changes being made as a result of the received information including changes to the laundering processes and alterations to the provision of activities. A safe keeping facility is available for people living at the home who wish the home to look after small amounts of their money. Each individual has their money stored in a separate wallet in a locked filing cabinet. Accurate records are kept of the income and expenditure of each persons money along with the retention of receipts for money spent. We checked the money against the records for three people living at the home which evidenced that accurate records are kept of the money held by the home for people living there. As previously stated lockable drawers are available for people in their bedrooms to store money or personal possessions if they wish. Policies and procedures are in place about health and safety in the home. Staff records detail all staff have received training about health and safety topics such as the Control of substances hazardous to health (COSHH), moving and handling, risk assessments, food hygiene and emergency aid. Since the last inspection improvements have been made in identifying and documenting risks to people living at the home in relation to falls and the environment along with detailing the action to be taken by care staff reduce any identified risks. This means the service has complied with a requirement made about risk assessments following the last key inspection in April 2008. The fire log book and relevant service certificates and staff training records indicate that fire safety checks and staff training are completed to protect the safety of all at the home. A fire risk assessment completed in March 2009 by a professional fire safety company has detailed improvements needed to reduce identified risks. The manager told us about how the home is planning to implement these improvements and told us about how some of them have already been addressed. As stated in the relevant sections of this inspection report some areas of the environment raise concerns about cleanliness and hygiene namely the laundering facilities and the condition of some of the flooring in the kitchen and the condition of one of the fridges in the kitchen. The manager has told us she will seek advice from relevant professional organisations regarding these issues and will act on the advice provided by these organisations. Care Homes for Older People Page 25 of 29 Evidence: The last key inspection in April 2008 detailed some discrepancies in the reporting to us of events affecting the welfare of people living at the home. This resulted in a requirement being made about this issue. The home has informed us in the form of regulation 37 notices about events affecting the wellbeing of people living at the home such as admissions to hospital over the past year. This means they have complied with this requirement. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Assessments of a persons ability to manage their own medications must be documented and a process must be put in place to monitor that the person is managing their own medication successfully. So the wellbeing of people managing their own medications is protected. 02/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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