Care Home: The Croft

Similar services:

• Snydale Care Home
• Abbey The
• Larchfield Manor
• Hawkhills
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well People living in the home experience a comfortable, homely and relaxed atmosphere. Well trained staff attend to people`s care needs in a relaxed and unhurried manner. People were seen to be treated with dignity and their wishes respected throughout the visit. When talking about the staff people used words like, `caring, very good and kind`. Everyone also agreed that the food is good. People have good access to community based health care services. What has improved since the last inspection? A lot of work has been put into refurbishing the home. This includes redecorating throughout and providing new furniture, floor coverings and curtains. Everyone we spoke to said that it is a real improvement for people living in the home. What the care home could do better: The main area that the management team need to work on is risk assessment. This includes updating the care plans and risk assessments for people living in the home in the light of the Mental Capacity Act 2005, especially where there are rules in place for people that restrict their freedom. It also includes updating the existing risk assessments about the environment and fire safety in the home. It also includes providing more information about the risks involved with the use of bed rails and revisiting the risks involved in people smoking. Another area to be improved is the opportunities that are offered to people in pursuing their hobbies and interests, reminiscence, entertainment and social and leisure activities, both in the home, and in the local community. To completed the refurbishment to a high level, there is still some work to do to improve the kitchen and food storage facilities. Key inspection report Care homes for older people Name: Address: The Croft 17 Snydale Road Normanton Wakefield West Yorks WF6 1NT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Caroline Mitchell     Date: 1 4 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Croft 17 Snydale Road Normanton Wakefield West Yorks WF6 1NT 01924223453 01924223453 carehomes@croftcare.eclipse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Croft Carehomes Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of users who can be accommodated is 29 The registered person may provide the following category of service only: Care Home only - Code 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, maximum number of places 29 Dementia Code DE, maximum number of places, 10 Date of last inspection Brief description of the care home The Croft continues to provide accommodation and personal care for up to 29 older people. The home also provides respite care and day care for older people. Set back in its own grounds, the home is situated in a residential area close to the centre of Normanton and all services and amenities. It is near a main bus route and situated between Wakefield and Castleford, close to the M62/M1 link roads. Care Homes for Older People Page 4 of 27 Over 65 0 29 10 0 Brief description of the care home There is a large drive with parking to the front, a large lawn to the rear and a new enclosed decked patio area with access for wheelchair users and garden furniture for the use of residents during the summer months. There is a large reception area with an office to the right, large lounge/dining room and small quiet room to the front. The accommodation is provided on two floors and there is a passenger lift and assisted bathing available. The fees were £380 per week in September 2009 and extra charges are made for Chiropody and hairdressing. Information about the fees and the service provided can be obtained from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was done on an unannounced basis, so the managers didnt know we were coming. We completed the inspection in two visits starting on 11th September and completing it on 14th September. During the inspection we looked at the written records of four people who live in the home and this included their assessments, care plans, reviews, daily and medical records. We saw three staff personnel files including peoples recruitment records, and records of their training and supervision. We saw the staff rota, menus, the homes quality assurance systems, complaints records and health and safety and fire safety records. We looked at how medicines are stored and recorded. We spoke to several people who live in the home, two visiting relatives, and the registered manager and several staff. We looked around the home and sat with people while they were having their lunchtime meal. Care Homes for Older People Page 6 of 27 We sent out surveys for people living in the home and for staff to comment on how the home is run. Several people sent these back to us and we used their comments as part of the inspection. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are 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 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. Evidence: The manager told us that she when people are referred to the home, she does a preadmission assessment and, if the home can meet their needs, she encourages people to come for tea or an evening visit before they move in. Three of the people who sent surveys back to us said that they felt that they had received enough information to Care Homes for Older People Page 10 of 27 Evidence: help them decide if this home was the right place for them before they moved in. At the inspection one person told us that they had left it up to their son to find a home for them and that their son had done a good job, as they were very satisfied with the home and with the staff. We looked at the written records for three two people who had very recently moved in. There was enough information to let the staff in the home know about peoples needs and the risks associated with their particular needs and lifestyles, although the homes assessments and care plans were not yet in place. During the course of the inspection, the care plans for the two people were developed more fully. Each of the two people had a written contract on their file. Two of the people who sent surveys back to us said that they have been given written information about the homes terms and conditions. The home does not provide intermediate care. However, there a a small number of people, who come on a regular basis, for respite care and for day care. We met one person, and they said that they really like coming to the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a plan of care that the person, or someone close to them, has been involved in making. There is room to improve these plans and the risk assessments for each person. If people cannot manage their medicine, the care home supports them with it, in a safe way. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. Evidence: In the surveys that people sent back to us four people said that they receive the care and support they need and the home also makes sure they get the medical care they need. Everyone we spoke to during the inspection said they were very happy with their care and all praised the staff. During the inspection we looked at the written records for four people who live in the home. Each person has a care plan and these have been reviewed regularly in the form of evaluations. that have been done monthly, However, there were people for whom this has not been done and a requirement is made about reviewing care plans and risk assessments. The care plans cover things like peoples needs around their Care Homes for Older People Page 12 of 27 Evidence: personal hygiene, and tell staff that they should respect peoples privacy and dignity at all times. Most of the people we met were well groomed. However, we did notice that one or two peoples finger nails and teeth needed more care, which raised the question of whether they need more support than stated in their care plans. Some of the other areas covered in the care plans include sleeping, confusion, keeping safe at home and smoking. One persons file states very clearly that they have a specific allergy and another persons that certain food do not suit them. The manager said she talk to people and their relatives regularly to make sure they are involved in the care planning process. This was confirmed by the people living in the home and the relatives we spoke to. However, there is a need for this discussion to be recorded more formally. A recommendation is made about finding ways of reflecting peoples involvement in planning their care. People had records of their medical appointments and visits and these showed that they had regular access to the health care support that they need. At the time we arrived for the inspection some district nurses were visiting one of the people living in the home. They spoke positively about the home having been refurbished and said there was good communication between the home and the district nursing service. An occupational therapist also visited someone living in the home during the course of the inspection. The people we spoke to said that their GP can visit them or they can go down the road to the GP if they want to. The care staff monitor what people eat and drink and record this in peoples day-today notes. They also monitor peoples weight, and it was noticeable that one person, whose weight was a concern when they moved in, has gained weight steadily since living in the home. This, in turn has reduced the risk of the person getting pressure sores and their risk assessments need to be updated to reflect this. There are some restrictions placed on peoples personal freedom. For instance one person has a daily allowance so that they dont buy and drink too much alcohol. In some cases the staff keep peoples cigarettes and lighters and give them to people on request, to minimise the risk of people smoking without supervision. These restrictions do not seem unreasonable in the context of the particular risks and it is clear that they are put in place with best intentions. They are noted, albeit briefly, in peoples care plans or risk assessments. However, there is a need to review these arrangements in the light of the Mental Capacity Act 2005 and a requirement is made about this. The registered person needs to make sure that, where there are restrictions to peoples freedom, these are properly documented as part of their care plans. That detailed risk assessments are in place, and that these are reviewed as part of peoples annual Care Homes for Older People Page 13 of 27 Evidence: placement review. That people have agreed to such restrictions and have signed up to written agreements, where they have the capacity to do so, and that people are referred to the local authority for assessment where there is any doubt about their capacity to make such decisions. Each person has risk assessments about a range of things relevant to them, these included falls, manual handling, and pressure sores. Other assessments talk about people wandering at night, eating and drinking, and if any special equipment is used, such as adapted cutlery. Peoples communication and relationships, sleeping, personal care, mobility, mental health profile and social profile. The risk assessments say what the hazard is, who might be harmed, whether the risk is adequately controlled and what further action is necessary. The medication is stored securely and there is a fridge for medication that needs to be kept cooler than room temperature. There is a cupboard where controlled drugs can be stored securely. We were told that no one in the home was prescribed controlled drugs. We looked at the record of controlled drug and noted that some medication needed to be returned to the chemist. The manager made sure that this was done during the course of the inspection. We looked at the monitoring information that the home keeps about accidents and noted that there were a number of instances of people being found on floor in their bedrooms at night. The majority of these incidents have not resulted in any injury to people. However, we discussed with the manager, various ways of reducing the risks of people getting out of bed and falling during the night, including the option of assistive technology. Bed rails are being used for some people and there is a need for detailed risk assessments to be done for the people using them. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person is treated as an individual and the home is responsive to their race, culture, religion, age, disability, gender and sexual orientation. The care home supports people to follow personal interests and activities, although there is room for this to be improved. People are able to keep in touch with family, friends and representatives. People have nutritious and attractive meals and snacks, at a time and place to suit them. Evidence: One of the four people who sent surveys back to us said the home, provides a homely atmosphere, welcomes visitors with a drink and staff very friendly. Another person said that staff, put themselves out to interest the people living in the home. There is a part of each persons care plan that says what activities people prefer. Various staff told us that they do some reminiscence work and other activities with people each day. We saw the programme of activities. It includes: chair exercises, Bingo, painting, card making, sing-a-long, discussion, hand massage, manicure and nail care, quiz and watching television. We noticed that on one day, after lunch, staff put on some war time songs and people had a sing-a-long, and another day people were doing a quiz. Care Homes for Older People Page 15 of 27 Evidence: Most people who sent back surveys to us indicated that there was room for improvement in the area of activities. All of the three staff members who returned surveys to us said they thought that the home could improve by providing people with more opportunities for activities. The manager showed me evidence that she is looking for ways to improve the quality of the service in this area. It is recommended that the home continue to work to improve peoples access to activities, both in the home and in the local community. Another recommendation is made that people be helped to write their Life Story with any photographs of themselves and their friends and families that can be obtained, and pictures of things like the areas that they lived in, the schools they went to, their places of work and the things that have interested them throughout their lives. One persons plan mentions that they enjoy sitting in the sun. There is a nice, decked, seating area for this and several people were taking advantage of the afternoon sunshine. There were lots of visitors throughout both afternoons. The visitors seemed very relaxed about walking in and were welcomed by staff. We sat with several people at lunchtime and chatted. Everyone said the food was good. The food did look appetising and staff were attentive to peoples choices, staff remembered what people like and dont like and there was a relaxed atmosphere. One staff member told us that people can choose of a full English breakfast everyday or a lighter breakfast. We saw staff helping people to eat their meal and this was done in a sensitive and gentle way. We saw the menu and it provides good, balanced, varied healthy choices. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: In the surveys that people sent back to us three people said they know how to make a complaint and all four said that they have someone to talk to informally, if they are not happy. We saw the written records of five complaints, some made by people living in the home and some made by their relatives. In each case the records showed that each concern was properly investigated, within reasonable timescales and that action was taken to resolve the issues. The records of staff training showed that staff have training in safeguarding people from abuse and neglect. The staff we observed treated people as individuals, with care and with courtesy. Those staff we spoke to showed a good awareness of the principles of safeguarding people. The manager told us that no issues have been dealt with through the local authoritys safeguarding procedures. We spoke at length with two visiting relatives and both said they were very happy with the home and the staff. One visiting relative told us they really liked the fact that they could pop in at any time another said that they lived across the road, and visited every day. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has had a very thorough refurbishment and is a safe and well-maintained home that is homely, clean, pleasant and hygienic. Although there is still room to improve the kitchen and food storage facilities. The home has enough space and facilities for people to lead the life they choose and to meet their needs. Their room feels like their own, it is comfortable and they feel safe when they use it. Evidence: A member of staff showed us around the home. A lot of refurbishment work has been done since the last inspection, and the home has been redecorated throughout with new carpets, curtains and new furniture provided. Everyone we spoke to said the refurbishment has been a real improvement. This included the people living in the home, their visitors, the staff and the district nurse. The kitchen has been painted. However, some of the equipment in the kitchen need to be replaced or refurbished or repaired. This includes the cooker and the fridge. At the time of the inspection there was a leak in the kitchen that was likely to have been due to a fault in the dishwasher. There is a food warmer that it not used and needs to be disposed of and replaced with work surface and storage. The way that food and kitchen equipment are stored needs to be reconsidered generally. In the food store the floor covering was ripped in places. There are also repairs needed to the walls and there are an old water heater and old sink unit that ideally, need to be removed. Care Homes for Older People Page 18 of 27 Evidence: There is also a need for more shelving to help keep stored food off of the floor. Recommendations are made about these issues. We talked with the manager about putting photos on peoples bedroom doors and pictures to help people recognise toilets and bathrooms. She said that there were already plans to do this, now that the refurbishment has been completed. There are clear pockets on the doors to put pictures in. The laundry facilities are in the basement. There are two washing machines and two tumble dryers. The current method of restricting peoples access to the basement needs to be reviewed an a recommendation is made about this. There are enough toilets and bathrooms and enough baths and showers. A staff member said the shower isnt used very often as most people prefer a bath. Seven bedrooms have en-suite facilities of a wash hand basin and a toilet. Theres one double bedroom that was not occupied at the time of the inspection. The bedrooms that we saw, were nicely decorated and furnished and people had brought in things to make their rooms more their own. All of the people who sent surveys back to us said that the home was always clean and fresh and this was the case at the time of the inspection. However, there is an issue with the smoking room, as people leave the door open, so occasionally, during the inspection the smell of cigarette smoke drifted through into the hallway. A recommendation is made about this. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty. 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. Evidence: We looked at the staffing rota and this showed that there are usually three care workers on duty in the morning and three in the afternoons and evenings. There are two waking staff at night. There is also ancillary support every day, including a cook and laundry/cleaning staff. On the first day of the inspection there were only two carers on duty, as one member of care staff was on sick leave. We were told that occasionally, one particular member of ancillary staff does some care tasks to help out, and that this is how they had managed that morning. We looked at the staff members records and noted that they have received training in some areas of caring for people, but this part of their role needs to be better reflected in their personnel records and contract. We discussed the staffing levels in the home generally, with the manager and especially staffing at key times of the day. We recommend that the way staff are deployed at key times be reviewed. Care Homes for Older People Page 20 of 27 Evidence: We looked at the personnel records for three staff. There was written records to show that the proper checks had been done before they started work in the home. This includes completing a written application, attending interview, written references and having a Criminal Records Bureau (CRB) check. People had also provided sufficient evidence of their identities. We also saw that the policies about confidentiality, equal opportunities, whistle blowing and a staff handbook had been given to staff as part of their induction, and that they had written contracts of employment, that had been updated as circumstances changed. The three staff whose files we looked at had been provided with training in all the core areas of health and safety and safeguarding people from abuse. Other training that some staff have completed included diabetes, understanding dementia and managing challenging behaviour. Some of the training sessions planned for the next few months included refreshers of the core training and other titles such as principles of care, the role of the carer, development and communication. We recommend that staff be provided with training about the Mental Capacity Act 2005 and in particular the deprivation of liberty safeguards. Most staff have completed National Vocational Qualifications (NVQ) at level 2. One senior carer came in during the inspection she had an appointment with her NVQ assessor regarding her NVQ 3 course. The manager told us that two of the senior staff are doing NVQ 3. We saw that each staff member meets with the manager regularly to talk about their work on a one to one basis. this kind of supervision is done every two months and a written record is kept. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is led and managed appropriately. The environment is safe for people and staff because appropriate health and safety practises are carried out. Although, there is room to improve the risk assessments about the building and fire safety. Evidence: We met the registered provider and the financial director, very briefly. We met the manager on day two of the inspection. The manager is a Qualified Nurse and has the qualifications; the Registered Managers Award and NVQ Level 4. The manager said that as part of the quality monitoring process, there are regular residents meetings and staff meetings, so that there are forums for people to give their opinions. Questionnaires are also given out regularly to get feedback from people. Staff training records also show that staff are provided with training in health and safety, moving and handling of loads, fire prevention, food hygiene, infection control and emergency first aid. Care Homes for Older People Page 22 of 27 Evidence: The maintenance records show regular fire alarm checks are carried out along with regular servicing of the passenger lift and hoists. We looked at the Environmental & Fire Risk Assessments and found that they are thorough, but need updating as they last reviewed in 2006 and some things have changed since then. They also need to provide more detail in the area of people smoking, in the smoking room, in their own rooms, and outside on the decking. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The registered person must 24/10/2009 make sure that peoples care plans and risk assessments are reviewed, to make sure that they; a) reflect changes in peoples needs, b) are within the Mental Capacity Act 2005, particularly in relation to restrictions of peoples personal freedom, c) provide more details about the use of bed rails. To make sure peoples care plans and risk assessments properly reflect their needs at all times and comply with the Mental Capacity Act 2005. 2 38 13 The registered person must make sure that the environmental and fire risk assessments are reviewed and updated. To make sure that people remain safe in the home. 30/10/2009 Care Homes for Older People Page 25 of 27 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 2 7 7 It is recommended that the management team find ways to better reflect peoples involvement in their care plans. It is recommended that peoples care plans are revisited to review if they need more support in the area of caring for their nails and teeth. It is recommended that people be helped to write their Life Story with photographs and pictures. It is recommended that the home continue to work to improve peoples access to activities, both in the home and in the local community. It is recommended that the kitchen and food store are reorganised and refurbished to provide more shelving, cupboard space and work surface and that the cooker, fridge and dishwasher be replaced. It is recommended that the current method used to restrict peoples access to the basement be reviewed. It is recommended that the use of the smoking room be reviewed, to make sure that the smell of cigarette smoke doesnt get into the rest of the home. It is recommended that the management team review the staffing cover, at key times to make sure that there are enough staff to help people with their personal care, when getting up in the morning and going to bed at night. It is recommended that, where staff CRB checks were obtained more than three years ago, they be renewed. It is recommended that staff be provided with training about the Mental Capacity Act 2005, and in particular the deprivation of liberty safeguards. 3 4 12 12 5 19 6 7 19 20 8 27 9 10 29 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!