Care Home: The Downes

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What the care home does well Prospective clients are properly assessed prior to admission to The Downes and information about the home is available on an audio cassette and in large print. The person living at The Downes was clearly relaxed, content and able to talk comfortably with the staff and the inspector. The manager and staff demonstrated a good understanding of the care needs of the resident, and there is an evident commitment to individualised care provision. Staff were observed to interact with the resident in a professional and caring manner. Medicines are managed appropriately. Complaints are taken seriously. The environment is comfortable, clean and safe. Staff qualifications and staffing levels are appropriate to the current care needs of the resident. The manager has several years of experience in managing a care home and is suitably qualified. What has improved since the last inspection? This was the first inspection of this recently registered Care Home. What the care home could do better: The registered provider should review the home`s Statement of Purpose and Service User Guide to ensure this document contains all the information required in Schedule 1 of the Care Homes Regulations. The registered provider should make provision for storage of medical supplies (e.g. dressings) in the medicines cupboard. The registered provider should consider how to ensure that clients will have access to a telephone for private use. The registered provider should amend the menu so that it shows the alternatives available at meals. The registered provider should ensure that all staff receive safeguarding training, and encourage attendance on the local authority training programme. Identify rooms either by name or number. In the interests of infection control it is strongly recommended that: when the washing machine is due for replacement the registered provider should provide an industrial machine, better suited to the care environment and to infection control; appropriate laundry sacks should be provided to help minimise the handling of fouled linen; the belfast sink in the laundry should be replaced with a handbasin for hand washing; and an automated sluice facility should be located in an area near to the laundry. More can be done to ensure the home adheres to a robust recruitment procedure. The registered provider has appointed a manager, who has yet to apply to be the Registered Manager with the Care Quality Commission (CQC). A system for the provision of short-term cash flow should be established. Key inspection report Care homes for older people Name: Address: The Downes The Downes Foundry Hill Hayle Cornwall TR27 4HW     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: Alan Pitts     Date: 1 3 0 4 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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 Downes The Downes Foundry Hill Hayle Cornwall TR27 4HW 01736754400 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Malcolm Victor John Burkett Name of registered manager (if applicable) Type of registration: Number of places registered: care home 7 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 accommodated is 7. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home The Downes is a small care home, which provides a comfortable and appropriate accommodation and care for up to 7 residents. The Downes was registered in 2009 as a Care Home, but has only recently become operational in February 2010. The Home is privately owned and operated by Malcolm Burkett (Care Provider). The Care Homes for Older People Page 4 of 27 Over 65 7 0 0 7 1 0 2 0 0 9 Brief description of the care home house is Victorian and of Tudor Gothic design and formed part of St Theresas convent at the turn of the last century. The home is close to local amenities and also St Michaels Hospital. Fees at The Downes in April 2010 range from GBP500 to GBP1000 per week. 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 was an unannounced inspection, which took place on the 13th April 2010. The inspector met and spoke with residents, staff, and the manager. The documentation, policies and procedures, and the environment were inspected. The Downes is a small care home, which provides a comfortable and appropriate accommodation and care for up to 7 residents. The Downes was registered in 2009 as a Care Home, but has only recently become operational in February 2010. On the day of the inspection there was one resident living at the home. The relaxed comfortable atmosphere, and the evident contentment of the resident impressed the Inspector. Nothing should detract from how highly the resident spoke about their home, the staff, and the care that they receive. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The registered provider should review the homes Statement of Purpose and Service User Guide to ensure this document contains all the information required in Schedule 1 of the Care Homes Regulations. The registered provider should make provision for storage of medical supplies (e.g. dressings) in the medicines cupboard. The registered provider should consider how to ensure that clients will have access to a telephone for private use. The registered provider should amend the menu so that it shows the alternatives available at meals. The registered provider should ensure that all staff receive safeguarding training, and encourage attendance on the local authority training programme. Identify rooms either by name or number. In the interests of infection control it is strongly recommended that: when the washing machine is due for replacement the registered provider should provide an industrial machine, better suited to the care environment and to infection control; appropriate laundry sacks should be provided to help minimise the handling of fouled linen; the belfast sink in the laundry should be replaced with a handbasin for hand washing; and an automated sluice facility should be located in an area near to the laundry. More can be done to ensure the home adheres to a robust recruitment procedure. The registered provider has appointed a manager, who has yet to apply to be the Registered Manager with the Care Quality Commission (CQC). A system for the provision of short-term cash flow should be established. Care Homes for Older People Page 7 of 27 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. The most recent admission to the home was properly assessed prior to finalising the move, and relatives visited the home. Intermediate care is not offered at The Downes. The people who are thinking about a move to The Downes are provided with good information to help inform them about their choice of home. Evidence: The manager and resident confirmed that copies of the Statement of Purpose (SOP) and Service User Guide (SUG) are given to prospective and current residents (documents that tell a person about the home). This also includes the homes Complaints Procedure. We discussed the potential benefits of offering information in alternative formats (e.g. audio-visual DVD) for people with sensory deficits. The home does have an audio cassette of the SOP, but this is less convenient to distribute. The combined SOP and SUG is well presented, but brief, and the registered provider should review this document to ensure it contains all the information required in Schedule 1 of the Care Homes Regulations. Care Homes for Older People Page 10 of 27 Evidence: As part of this inspection we looked at the assessments that were carried out prior to a person moving to The Downes. The care documentation of the person most recently admitted to the home showed that a proper pre-admission assessment had take place. Comments received at the time of the inspection were positive, and confirmed that people feel they receive the information they need. One resident confirmed that their relatives had visited for them prior to deciding to move in permanently. Residents are involved in determining their care plans. Intermediate care is not offered at The Downes. 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. Each resident has a plan of care. The care documentation shows the involvement of other health care professionals, and the resident confirmed that they receive a good standard of care and felt well looked after by staff. Medicines are handled appropriately, and the home has a relevant procedure. The resident spoke highly of the care, attention, and respect shown by the staff at The Downes. Evidence: Residents care plans and documentation were inspected. The residents health, spiritual, social and personal care needs are set out in an individual plan of care and these are being reviewed with resident and/or representative involvement. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. Daily entries in the care documentation show the involvement of other healthcare agencies as appropriate to the needs of the resident. Daily entries made by staff evidence the general health care given. Residents are registered with a GP, and professional advice is sought as needed. The residents confirmed that they have the Care Homes for Older People Page 12 of 27 Evidence: opportunity for exercise and activity. All the residents have access to support services such as a chiropodist. A medicines cupboard is provided, and fitted with a small cupboard for the storage of controlled drugs. The medicine trolley is stored in this area, though the inspector was advised that a new trolley is currently on order. The cupboard does not provide any shelving or any other facility for the storage of stock medication/dressings/etc. A Controlled Drugs register is available, but not in use at the moment. A medicine policy is in operation. Medicine Administration Records were seen to be in order. Residents and their representatives or relatives are treated with respect and their right to privacy is upheld. Staff were observed to treat people with respect and dignity at all times throughout the inspection. The residents preferred name is documented as well as their likes and dislikes. People spoken with confirmed that they are treated respectfully; their privacy and rights to make decisions are supported, and they spoke very highly of the staff and the autonomy that they are afforded. The resident confirmed that they are able to meet relatives and friends within the communal areas, in the garden, or in their own rooms. Although rooms were seen to be fitted with telephone point faceplates, the inspector was advised by the manager that a number of these are blanks and not actually connected to a telephone line. The current resident has a mobile phone for personal use. Care Homes for Older People Page 13 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. The resident at the time of the inspection said that the staff could not do enough for them, and that they were free to see visitors as they wished. They also confirmed that they have enough to do to keep themselves occupied. The resident said that they enjoyed the food that was provided, and confirmed that they were offered a choice. Evidence: The resident informed the inspector that they were able to make choices about how to spend their time, and they felt that their recreational interests were being met on an individual basis. Individual interests are recorded at initial assessment. People are able to choose where to eat e.g. dining room, lounge or in their room. Spiritual and social needs are included in the care plans. Residents have a daily paper delivered if desired. The resident was happy with the flexibility within the home and felt that it met their needs and wishes. The care documentation shows the quality of the residentsday and reflect the individual preferences of that person. Residents are able to meet relatives and friends within the communal areas, in the garden or in their own rooms. Visitors are welcomed to the home, depending on the residents wishes, which are respected at all times. Rooms are personalised with plenty of evidence of personal possessions being brought in. Bedrooms may be locked Care Homes for Older People Page 14 of 27 Evidence: to ensure residents privacy, and people are offered the option of their own key. The likes and dislikes of each resident are noted and an alternative provided if the resident is known not to like something. Residents are advised of the menu planned for the day. The resident was aware what was for lunch that day. Choice is provided at all meals, though the menu should be amended to reflect this and the options available. Food records are kept. Fresh fruit and vegetables are readily available. The resident was complimentary about the food. The dining room provides an attractive, comfortable setting that is partially laid up for people who may choose to eat there. The presentation of this room would benefit from having all tables laid and prepared. The large kitchen was seen to be clean and orderly. An Environmental health Officer inspected the kitchen in March 2010, and the inspector was advised that all work identified as needed has either been completed or will be in time for the next planned inspection in May 2010. Care Homes for Older People Page 15 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. The Care Quality Commission have not received any complaints since the home became operational in February 2010. The registered providers and staff were seen to interact well with the current resident, who confirmed that they would feel able to raise any concerns. Residents welfare is protected. Evidence: There is a complaints procedure in operation, and residents confirmed that they would feel able to express any concerns. The complaints procedure includes the current contact details for the relevant Adult Social Care Department or the Care Quality Commission, and is included in the Service User Guide. The resident said that they knew who to talk to if they had a concern, and would feel able to do so. The home are recording any complaints received, and two minor complaints were seen to have been resolved appropriately. There is a Protection of Vulnerable Adults policy and a whistle blowing policy. Contact details for adult protection agencies are included. Residents are additionally safeguarded by the small staff team and frequent contact with relatives and friends. Safeguarding training is provided for staff, but this should be encouraged. Regular staff supervision has commenced. People are, on the whole, protected by the homes recruitment procedures. Care Homes for Older People Page 16 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. Residents said that they were comfortable and very happy with their accommodation. Residents rooms were personalised and comfortably furnished. There is no lift, but there are two stairlifts to aid access between floors. The environment is clean, and homely. Evidence: The house is Victorian and of Tudor Gothic design and formed part of St Theresas Convent at the turn of the last century. Retaining many of its original features the home and gardens offer peace and tranquility. The Downes is set in over six acres of listed gardens, with delightful tiered lawns, terraces, and extensive grounds. The lawns at the rear of the building are accessible through the house or via a pathway to the side of the Chapel. Individuals may enjoy the garden alone or with the assistance of staff, who will happily help locate the orchard and kitchen garden or enjoy a stroll around the grounds. The home is set in a superb location with views of the estuary and further afield the sea. The home is close to local amenities and also St Michaels Hospital. The Downes is a residential care home that is registered to provide care for 7 people over the age of 65 years, who require care by virtue of old age. There are 6 bedrooms, one of which is registered for double occupancy for those wishing to share. Each of the bedrooms has en-suite facilities, with a hand wash basin and WC. Some Care Homes for Older People Page 17 of 27 Evidence: bedrooms have assisted baths and shower facilities. Each room is different in appearance and has its own character. Each occupied room will have a call bell for assistance when needed. People are encouraged to personalise their bedrooms and whilst suitable furniture will be provided in all bedrooms, if an individual wishes to provide their own furniture, they will be encouraged to do so. Adaptations to aid mobility such as hand rails, etc, will be put in place following an assessment of needs with the Care Manager. Bedrooms are fitted with suitable locks to ensure residents privacy. In addition to the en-suite facilities, there are two assisted bathrooms that are conveniently located near the bedrooms for easy access. Bedrooms are currently not identified in any way (by name or number), with the exception of one, known as The Bishops Room. As occupancy grows it will become increasingly important that the people living there are assisted to be able to identify their own room. Additionally, room identification is crucial to a workable fire plan. The registered provider is strongly recommended to identify rooms either by name or number. The Downes has two lounges, which currently both have televisions. It is the intention that the smaller lounge will have a small library area. Both lounges overlook the lawn and terrace and are both very individual in character. The large lounge retains many of its original Victorian features and ornate ceiling, and is furnished in a manner that is in-keeping with the age of the property. The Home boasts its own chapel, which is currently used by a local Judo Club twice a week. Hayle Chamber of Commerce also meet at the Home regularly. The inspector was assured that if people feel that any external activities impede on their home the manager and Malcolm Burkett, the registered provider, will rectify the position. The chapel can be accessed without going through the main home. The large dining room is central in the Home and people have a choice of where to take meals. The home is clean, pleasant and free from any odours. Gloves and aprons are available within the home. Hand towels and a soap dispensers are available, but not throughout the property and the registered provider should ensure that as the use of rooms expands so does the provision for infection control. The kitchen is large and predominantly finished in stainless steel. The kitchen was seen to be clean and orderly. An Environmental health Officer inspected the kitchen in March 2010, and the inspector was advised that all work identified as needed has either been completed or will be in time for the next planned inspection in May 2010. Care Homes for Older People Page 18 of 27 Evidence: The laundry facility is functional and fitted with a large domestic washing machine and two tumble dryers. Red laundry sacks are not available for fouled linen. The home does not have an automated sluice facility. The manager advised the inspector that it is intended that any sluicing be done by hand in the laundrys belfast sink. In the interests of infection control it is strongly recommended that: when the washing machine is due for replacement the registered provider should provide an industrial machine, better suited to the care environment and to infection control; appropriate laundry sacks should be provided to help minimise the handling of fouled linen; the belfast sink in the laundry should be replaced with a handbasin for hand washing; and an automated sluice facility should be located in an area near to the laundry. 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. As this is a newly operational home the training records are in their infancy, but demonstrate that staff are provided with the skills and knowledge to perform their roles, and the resident was very complimentary about the care provided. A National Training Organisation compliant induction programme is in use. On the whole the home uses a robust employment procedure to protect residents, though improvements can be made. Evidence: This is a new, small establishment with a small team of staff. Staffing levels are accurately recorded. People spoken with were complimentary about the staff and the care they provide. Staffing levels were appropriate to the care needs of the resident at the time of the inspection. Staff were observed to be caring and respectful during their interactions with each other and the resident. There is an evident rapport with the resident and a relaxed atmosphere that is the result of attention to individual needs and preferences. Staff training records are not long established, but do demonstrate a commitment to furthering the staffs skills and knowledge base. In addition to the manager there are 3 senior carers, 3 carers, 2 cooks and a site manager. Of the 6 care staff 3 have NVQ Level 2 or above (2 have NVQ Level 3 and one is doing this training), and the Care Homes for Older People Page 20 of 27 Evidence: inspector was advised that the remaining 3 care staff are currently undertaking NVQ Level 2 training. The home and residents would benefit from the continued promotion of training relevant to the role staff carry out (e.g. 1st Aid, Deprivation of Liberties, Mental capacity Act). Three staff personnel files were inspected and generally seen to be satisfactory, though improvements are needed. One file showed two references, both of which were addressed To whom it may concern rather than directly to the prospective employer. The previous employers reference was not on headed paper and gave no indication of the identity of the author. Only one file contained any proof of identity, and none of the files included a photo of the staff member. All contained a job description, but none of the files contained a contract of employment, and the manager advised the inspector that the registered provider is reluctant to issue these. The manager confirmed that the home is running a National Training Organisation compliant induction programme. 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. The inspector is of the opinion that the manager has the residents best interests at heart, and this is supported by the positive comments received from the person living there. Evidence: The manager is in day-to-day control, is appropriately qualified and has several years experience of managing a care home. An application for the position of Registered Manager has yet to be made to the Care Quality Commission. The manager has introduced a quality assurance system to ascertain the views of others, especially those that use the service. The manager is fully aware of the need to expand this as occupancy increases, and summarise and publish any feedback and findings from the surveys. The manager has no access to or involvement in budgeting for the home. The manager has no access to a petty cash system, and therefore there is no system in Care Homes for Older People Page 22 of 27 Evidence: place if a resident needs to purchase anything and does not have ready access to the amount needed. The home cannot currently provide the money or purchase the item and invoice the resident or their representative. The manager and staff do not handle any residents money, and there is a relevant policy in place. The manager is gradually adapting policies and procedures provided by an external company to reflect ownership by The Downes. The Care Quality Commission has not received any complaints about this service since it became operational in February 2010. The home records any complaints or comments made and are able to respond to feedback received. Staff supervision has commenced, and the manager assured the inspector that this would be regular and frequent with appropriately detailed records kept. The home is well maintained, clean, and safe for residents, staff, and visitors. There is relevant maintenance and safety work carried out, and the home carries appropriate insurance cover. 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 29 19 The registered provider must ensure the home adheres to a robust recruitment procedure. This is to protect residents and promote a consistently high standard of care provision. 30/04/2010 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 1 The registered provider should review the homes Statement of Purpose and Service User Guide to ensure this document contains all the information required in Schedule 1 of the Care Homes Regulations. The registered provider should make provision for storage of medical supplies (e.g. dressings) in the medicines cupboard. The registered provider should consider how to ensure that clients will have access to a telephone for private use. The registered provider should amend the menu so that it shows the alternatives available at meals. 2 9 3 4 10 15 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 5 18 The registered provider should ensure that all staff receive safeguarding training, and encourage attendance on the local authority training programme. The registered provider is strongly recommended to identify rooms either by name or number. In the interests of infection control it is strongly recommended that: when the washing machine is due for replacement the registered provider should provide an industrial machine, better suited to the care environment and to infection control; appropriate laundry sacks should be provided to help minimise the handling of fouled linen; the belfast sink in the laundry should be replaced with a handbasin for hand washing; and an automated sluice facility should be located in an area near to the laundry. The registered provider should continue with the stated intention of making a Registered Manager application to the CQC. The registered provider should establish a system for the provision of short-term cash flow when needed in the home. 6 7 22 26 8 31 9 34 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. 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