Care Home: The Gateway Rest Home

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What the care home does well There is a friendly and welcoming atmosphere in the home. The people living in the home look happy and well cared for. Each person has a care plan that contains clear information to support them in they way they prefer. People are supported well with their health needs. People are supported by the community health services and there are good relationships with the manager and staff in the home. The food in the home is attractively served and wholesome. Everyone said it is good. Staff are caring, friendly and well supported. There is a good range of staff training to provide them with the skills and confidence to support the people living in the home. The home provides a homely, safe and clean environment. There is a good staff team who have worked in the home for some time. We saw that the staff are polite and friendly to all the people in the home. The manager has worked in the home for several years and has good people skills. The home is well managed. People said they like the manager. She takes the time to listen to them. There is a good quality monitoring system to make sure that people are asked what they think and the manager is always looking to improve the service. What has improved since the last inspection? The care plans have been developed to include more health care parts and also to include the considerations to be taken under the mental capacity act. The manager listened to what the people said and now some of the health services are carried out in the home, like chiropody and the optician visits the home because that is what people wanted. The manager has also arranged for the district nurse to come into the home each week to support people with their health care and make sure that if there is a problem it is dealt with quickly. A music therapist comes to the home twice a month and people said they really enjoy this. They have a new tumble dryer. They have bought new furniture and carpets for four bedrooms and decorated them. They have decorated the lounge and are going to have a new carpet fitted. More staff have completed the national vocational qualification (NVQ) training. There is ongoing staff training and courses are provided to meet people`s individual needs. What the care home could do better: The manager said she plans to improve the statement of purpose and service user guide by adding pictures and photos to give people a better idea of the home. They are continuing to develop the occupational and physical activities in the home. The manager is also continuing to pursue employing an activities coordinator. The garden area still needs some improvement so that it is a pleasant place for people to sit. The manager has included this in the homes development plan. Key inspection report Care homes for older people Name: Address: The Gateway Rest Home 409 Folkestone Road Dover Kent CT17 9JT     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: Julie Sumner     Date: 2 1 0 8 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 Gateway Rest Home 409 Folkestone Road Dover Kent CT17 9JT 01304203650 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Ann Leonard care home 20 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: 20 The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category - OP Date of last inspection Brief description of the care home The Gateway Rest Home is a residential home registered for 20 older people although 16 people are usually in residence and use the double rooms as single. The current fees for the service at the time of the visit range from £320.00 to £390.00. Information on the homes services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User (residents) Guide. The provider does not currently have a web address and if information is required the homes telephone number is included on the previous page. Care Homes for Older People Page 4 of 27 Over 65 20 0 Brief description of the care home The home is a large two-storey property situated on the outskirts of the town of Dover. Public transport, a church, shops and a public house are within easy reach. The home comprises of 12 single bedrooms and 4 double bedrooms. All rooms are currently being used as single rooms. There is a passenger lift providing access to the first floor for those who need it. In addition to bedrooms there is a large, bright, spacious communal lounge which includes a dining area. There is a rear, hard surfaced area and a garden behind and at the side where residents can sit in the summer months. The home has dedicated parking facilities at the rear of the property. The Gateway Rest Home is owned by Mrs. Ann Leonard and managed on a daily basis by Mrs. Patricia Thompson. In addition there is a dedicated care team, a cook who works Monday to Friday, and two domestic staff. 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: The manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The AQAA was very clearly written and gave us all the information we needed to plan the inspection visit. Before we visited the home we sent some surveys out to the people living in the home and people that support them. We asked the manager to give surveys to the staff and to send out surveys to the visiting professionals. We also gave some relatives surveys so that the people living in the home could give them to their families if they wished to. We sent 8 surveys out to the people living in the home and their relatives, 8 to different health and social care professionals and 8 to the staff. We received 5 surveys from people who live in the home, none yet from social and healthcare professionals and 7 from staff which was a good response. All the comments in the surveys were positive. Care Homes for Older People Page 6 of 27 We visited the home without telling anyone we were coming so that we could see what they do on a usual day. We were in the home from 11.00 in the morning to around 4 oclock in the afternoon. We talked to 9 people living in the home at different times both in the lounge and in their bedrooms. We had lunch with the people in the dining room. We sat with two people and talked about their lifestyle and generally chatted with them. We talked to the manager and all the staff who were working that day. We had a look around in the house and outside. We looked at plans and records for supporting the people living in the home. We looked at staff records including training records. We looked at some of the policies and procedures. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The care plans have been developed to include more health care parts and also to include the considerations to be taken under the mental capacity act. The manager listened to what the people said and now some of the health services are carried out in the home, like chiropody and the optician visits the home because that is what people wanted. The manager has also arranged for the district nurse to come into the home each week to support people with their health care and make sure that if there is a problem it is dealt with quickly. A music therapist comes to the home twice a month and people said they really enjoy this. They have a new tumble dryer. They have bought new furniture and carpets for four bedrooms and decorated them. They have decorated the lounge and are going to have a new carpet fitted. More staff have completed the national vocational qualification (NVQ) training. There is ongoing staff training and courses are provided to meet peoples individual needs. Care Homes for Older People Page 8 of 27 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 9 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 10 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 home understands the importance of having sufficient information when choosing a care home and have a good assessment process. Evidence: There is a clear statement of purpose and service user guide. The manager said she intends to improve both these by adding pictures and photos to give a better idea of the home. Three new people have moved into the home in the last few months. We spoke to two of them and they told us about their experience of moving into the home. They said they had been made to feel welcome. They said the staff are really nice and the manager. One of the people explained that the staff have asked her what she likes and found out how she wants to be supported with her personal care, where she likes to sit in the lounge and what she likes to do. She also has some of her own furniture. She said she is very happy with the move here. Care Homes for Older People Page 11 of 27 Evidence: We looked at two assessments. The manager carries out a pre-assessment before people move in. She then completes a full assessment which forms the basis of the care plan. We found these very clearly written with good information. The home does not offer intermediate care. Sometimes respite care is offered as a way of people getting to know the home if they are thinking they may need residential care. Care Homes for Older People Page 12 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 staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. Evidence: We looked at four care plans. Each persons needs are identified and how they need to be supported is written in next. There are clear guidelines for staff and how many carers are needed for each task. The manager assesses the risk of people falling and how much support they need to move around the home. If they need equipment like hoists there is a risk assessment for this. This means that people are given the support they need to make sure they do not fall and that they can walk around the home independently or with some help from staff. There are also risk assessments for nutrition and skin care and guidelines for staff support needed and what is important to look out for. Each care plan says how many carers are needed to support each person with their personal care and mobility. Once a month the manager has one to one meetings with the people living in the home to make sure they are being supported in the way they wish and to see how they are and also as part of the review of the care plan. She keeps a note of this and keeps it confidential. We looked at 2 Care Homes for Older People Page 13 of 27 Evidence: notes that have been kept and could see that people are involved in what is in their care plan and have the opportunity to say what they feel about the home. Parts of the care plans have been improved. There is a new pre-assessment form, history of falls and diabetic monitoring form. There is another part to include the considerations to be taken with regard to the mental capacity act. This is to make sure people are able to say what they want and have the support they need if they do not have the capacity to make a decision. People said that staff respected their privacy and were always courteous. We saw that people are asked about their lifestyle and their preferences and these are also recorded in the plan. People looked clean and their clothes were well coordinated and suitable for the weather. Some people had nail varnish on and one person who particularly stated in the care plan that she liked to wear coordinating jewellery was wearing some on the day of the visit. A comment in one of the service user surveys said they look after me well. All the people living in the home have a GP, usually keeping the one they were registered with prior to arriving at the home. People are supported to access community health services like chiropody, the opticians and district nursing services. These can either be accessed in the community or the services come to the home. The manager refers people for additional support if they agree and if there is a need. This includes the community mental health nurse. We talked to staff about how they support people with their skin care, pain control and managing medical conditions like diabetes. They demonstrated that they are knowledgeable and confident and know when to call the district nurse or GP. Training in the specialist needs of individuals like diabetes training is provided to the staff. The manager has recently arranged for a district nurse to visit the home weekly to check on the people living in the home and also to provide some support and training to the staff. The manger was very positive about this saying that they will be able to support peoples health better and sort out any problems quickly. Medication is given by 2 staff who check each other and they both sign the medication administration record (MAR) sheet. All staff who give out medication have completed the asset training course. There are photos on the storage boxes in the medication cupboard and the same photo on the MAR sheet. All medication is given out from the original containers and have clear instructions both on the container and on the MAR sheet. We saw that staff spoke to people politely and gave them their medication making sure they took it and were gentle with one person who had been asleep. 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. The people living in the home are given choices of some activities although developing these would benefit more people. People are supported to maintain the relationships that are important to them. The meals are very good. Evidence: The manager explained that they still want to employ an activities coordinator but there has been no interest in this post. The staff and manager have asked each person living in the home how they would like to spend their time. They have gathered information about past interests and occupation in the life history part of the care plan. The staff team have supported people to continue to pursue their interests. The manager organises activities to be carried out in the home. People told us what they like to do. One person told us about his hobbies and he goes out regularly to pursue them as he did before moving into the home. Some people like to stay in their room and knit, read and watch TV. A music therapist comes to the home once a month. A gentleman comes in and plays the organ each week. The people we spoke to said they enjoy the music activities. During the afternoon the staff spend some time in the lounge doing cross words and quizzes and games of bingo or dominoes. Some people said they like to sit in the lounge and just read the paper, chat or just sit and Care Homes for Older People Page 15 of 27 Evidence: watch what is going on in the home. The manager is planning to introduce more exercises and physical activities and is looking for people to come to the home to do this. The staff record what activities each person has participated in within a section in the care plan. We looked at 2 of these records and could see that people have participated in the activities they said they like. We could see that it would be beneficial for the home to provide some more activities and the manager is planning to continue to do this. People talked about their friends and family who visit. Some people go out with their friends and have quite an active social life. Some of their visitors stay in the lounge in carry out some activities with everyone who wants to join in. Comments in surveys from relative All staff are friendly and approachable. Birthdays are always celebrated, with music. Resident is free to get up and got to bed as she pleases. Easter and Christmas celebration. And comments from a staff survey Give the residents their freedom of choice. If they want to go out they can. They have no restricted times within reason. They can stay with family and friends for a while. The vicar visits once a month and people can worship in the home if they wish. The manager explained that they will organise arrangements for different religious beliefs depending on the wishes of each person. We had lunch with the people who live in the home. Everyone was complimentary about the food. They said it is consistently good. One of the comments in the survey from a person living in the home said If meals are not to liking they always find an alternative. Some of the people living in the home prefer to eat their meals in their bedroom and some like to eat in the lounge. Everyone said they could choose and did not have to do the same thing everyday. 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. Residents complaints are taken seriously and acted upon and they are protected from abuse. Evidence: The home has a complaints procedure. Each person living in the home has a copy in their service user guide. People said that the complaints procedure is clear and they have no problems talking to the staff about anything. We looked at the complaints log with the manager. The manager told us that there had been one complaint about food and that had been sorted out on the same day. People told us they have nothing to complain about here. One of the comments in a survey received said looks after the needs of the people who use the home and makes sure the staff are all aware of any problems and work together to solve them. We talked to staff about safeguarding the people living in the home. Training in safeguarding and abuse awareness is given to all staff. Staff said there is a safeguarding procedure and both were confident about what to do if there was an incident or they suspected abuse. The contact telephone numbers are in the office for social services care management and the local social services adult protection coordinator. The home lets us know if something needs to be reported. They send us notifications. They also let the care manager know. There have been no safeguarding alerts or Care Homes for Older People Page 17 of 27 Evidence: complaints referred to us. Care Homes for Older People Page 18 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 is a pleasant, safe place to live with specialist equipment provided to meet the needs of the residents. Evidence: We walked around parts of the home and had a look around. All areas of the home looked clean and smelled fresh. The sitting room is spacious and airy and there are tables and chairs at one end for mealtimes. People said they like the sitting room it is a comfortable place to sit. We spoke to some people in their bedrooms. They said they had their furniture and ornaments the way they like them. People have TVs and telephones in their bedrooms. There are carpets throughout the home in the lounge, hallway, stairs and bedroom areas. Some of the bedrooms have recently been decorated and they have new furniture and carpets. There are pictures to make it more homely. There is a ramp down into the lounge for wheelchair access. The windows are double glazed and all the radiators have been covered. There is a maintenance sheet on the staff notice board so if anything goes wrong they can phone the appropriate person straight away and get it sorted out. Care Homes for Older People Page 19 of 27 Evidence: We spoke to some people in their bedrooms about their experiences in the home. They said they were happy with their rooms. They looked well furnished, clean and comfortable. Equipment is provided to meet individually assessed needs. The call bells have been extended to make sure they are available at all times. Bedrooms have accessible call bells also from bed and chair to assist with people who have mobility difficulties. We saw that the laundry has all the equipment needed. People said their clothes are well looked after. A new tumble dryer has been bought recently. We talked about the garden. People said they like being outside but usually if feels a bit cold so they prefer to sit in the lounge. We looked at the garden. It is accessible from a side door and has a variety of paved areas and some lawn. There are some pot plants where staff have been making it more attractive. This area still needs work to make it a pleasant place for people to sit and is included in the managers development plan. Care Homes for Older People Page 20 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. The people living in the home have confidence that the staff will support them to meet their needs. Evidence: The manager carries out a thorough recruitment process to make sure the people applying for the job are who they say they are and will work in the right manner. The manager asks for identification like a passport and 2 references from people who know the person including their previous employer. They request a Criminal records bureau (CRB) check and protection of vulnerable adults list (POVA) check to make sure they have not done anything in the past that will indicate that they are unsuitable or cannot be trusted. Staff work for a trial period of time in the home while everyone gets to know each other and the member of staff decides whether this is the right job for them. We looked at two staff files and could see that all these checks had been made. We looked at the training for the new staff. The most recent staff have had an Induction in Care incorporating the Skills for Care standards. The manager is planning to use the more up to date common induction standards for the next new member of staff. We talked to the manager and the staff during the visit and looked at the duty rota. People said they have a buzzer in their room and staff always came when they are called. We could see that staff were nearby and responsive to the people in the home. Another member of staff to support people with leisure and activities would be Care Homes for Older People Page 21 of 27 Evidence: of benefit. The manager has been trying to recruit someone since their previous activities coordinator retired and said she will continue to do so. The people living in the home told us that they were well supported by the staff and that they are all really nice. We talked about staff training with the staff. They told us that they regularly attend training that they need to do to comply with the law like health and safety training. They also told us that they have training for their specific job roles and to support the individual needs of the people living in the home like managing diabetes, including monitoring blood sugar and dementia awareness . We looked at the training matrix and some of the training certificates. We could see that staff have a range of training. The manager has also arranged for the district nurse to carry out further training in skin care and nutrition. Staff have the opportunity to study for the national vocational qualification (NVQ) at level 2 and 3. The staff said they enjoy the training. When we asked the staff what they thought was good about the home they said that everyone gets on well and there is a good atmosphere. All staff have had annual appraisals and said they had found them useful in identifying what skills they would like to develop and what they would like to study. Care Homes for Older People Page 22 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 manager has good people skills, supports staff well and understands the importance of person centred care and effective outcomes for the people living in the home. There is effective implementation of risk assessments and good maintenance to provide a safe environment for people to live in and staff to work in. Evidence: The registered manager has worked in the home for many years. She has NVQ 4 in care and management and two additional elements for the registered managers award. There is a good quality assurance system in place. The manager carries out audits monthly and different aspects of the home are assessed. We looked at some of the most recent audits and at the plan overall. The manager gives questionnaires out to the people living in the home, their families, friends and professionals who visit the home. Where needed families help individuals to fill theirs in. The manager also has one to one meetings with each person each month to find out what they think of the Care Homes for Older People Page 23 of 27 Evidence: home. The outcome of the audit and what people say in the questionnaires and meetings determines what the manager includes in the development plan for the home. The people living in the home, their families or representatives control their own monies and the home does not hold, or deal with, any money on other peoples behalf. Mandatory training has been provided and is ongoing. Staff spoken to had up to date training. Training has been provided steadily in safeguarding, dementia care, and all mandatory areas of first aid, food hygiene, moving and handling, health and safety, fire safety, and infection control. Manual handling risk assessments have been completed for all individuals. Some of the equipment has been purchased by the home and some equipment has also been supplied by the district nursing services to support with pressure areas and movement. The hot water temperatures are thermostatically controlled to keep people safe. The staff check the temperatures before a person has a bath. The dates for the servicing to maintain the home and equipment were included in the annual quality assurance assessment that was completed by the manager for us. Care Homes for Older People Page 24 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 25 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 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 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. 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