Care Home: The Kings Court Nursing Home

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What the care home does well The people live in comfortable, well maintained and clean accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. Staff communicate well with them and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. There is a programme of education and training provided for staff, which ensures that staff know how to care and support the people who live at the home. What has improved since the last inspection? The manager has reviewed and improved the way care records are written and maintained in order to make care more individual. A programme of decoration has resulted in new carpets throughout the home in the corridors, stairwells and lounges as well as in 4 bedrooms. In addition, new curtains have been provided in the lounges on the ground and first floors. New table cloths, bed linen and crockery have also been bought. Four new profile beds which enable the people to be cared for when in bed easier and for it to be safer for staff to care for them have been purchased. In addition, 3 new alternating pressure relieving mattresses together with slings and moving and handling belts have been purchased. A new fire system with magnetic fire openers which enable fire doors to be kept open for access but to close automatically in case of fire have been installed. What the care home could do better: There were no requirements or recommendations as a result of this inspection. The manager told us that he wants to further develop more person focused care. We discussed with the manager about ensuring that our new name address and telephone number was in their complaints procedure, the statement of purpose and service user`s guide. He agreed to act on this. The manager told us that he was to introduce regular supervision for all staff in the future. He also told us that he was to introduce mental capacity assessments for all people in addition to the number which had been introduced already. He also agreed to update the clinical procedures in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Kings Court Nursing Home Church Street Grantham Lincs NG31 6RR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tobias Payne     Date: 1 6 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Kings Court Nursing Home Church Street Grantham Lincs NG31 6RR 01476576928 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : kcourt88@googlemail.com Barnsdale Bros. Limited care home 29 Number of places (if applicable): Under 65 Over 65 29 0 old age, not falling within any other category physical disability Additional conditions: 0 29 Service users in the category of PD should be 40 years of age and over. Date of last inspection Brief description of the care home The Kings Court Care Home is a purpose built privately owned care home providing nursing and personal care for up to 29 people. The homes registration enables the home to accommodate older people and people who have a physical disability 40 years and above. Mr and Mrs Barnsdale (Barnsdale Bros. Ltd) are the registered providers and are actively involved in the running of the home. The registered manager Mr Phillip Barton, is a first level registered nurse and has many years experience as the manager of the home. The home is located in Grantham Town Centre. This enables people living in the home easy access to the local amenities. Care Homes for Older People Page 4 of 27 Brief description of the care home The accommodation is purpose built and consists of 23 single rooms with 3 twin bedded rooms available. A shaft lift serves the accommodation on the first floor. The home has limited parking within the grounds but additional car parking space for visitors is available in an adjacent car park belonging to the home. There is a small garden with a patio area to one side of the building with a covered canopy. Access to the building is wheelchair friendly and the registered providers have a wheelchair friendly car that enables the people to go out on trips and to attend appointments when they need to. The fees at the inspection visit on the 16/6/2009 ranged from £408 to £600 each week. Extras are for hairdressing which range from £4.50 to £12, chiropody £10 to £12, toiletries, personal newspapers and magazines. Information about the home including the statement of purpose, service users guide a copy of the last inspection report can be obtained from the manager. 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 inspection which was unannounced took place over 6 hours. The manager was present throughout the inspection visit and was given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting 2 people and tracking the care they receive through the checking of their records, discussion with them, the staff and observation of how the staff and people living in the home related to one another and the care practices in the home. We looked at a sample of care records and walked around the home to see the quality of accommodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 10 people living in the home, 5 visitors as well as 6 members of staff. An (AQAA) Annual quality assurance assessment was completed by Care Homes for Older People Page 6 of 27 the manager and sent to us before our inspection. This is a self- assessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. Where the use of we or us has been used throughout this report it refers to the Care Quality Commission. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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 coming in to the home receive information to meet their needs and support to help them make an informed choice of where to live. They are assessed before they come to the home which ensures that individual needs can be met within the home. Evidence: Since the last inspection a new brochure had been produced which described the services available in the home. There was a service users guide and statement of purpose and a copy of our last inspection report was available on request. We noticed that our new name needed to be added to the statement of purpose, service users guide and complaints procedure. The manager agreed to act on this as soon as possible. The manager told us that where a referral was made he would visit each person and make a thorough assessment of their needs involving the person and any other person involved in their care and support. Once this was done written confirmation was sent to them that based on the assessment the home could meet Care Homes for Older People Page 10 of 27 Evidence: their needs. Through case tracking we looked at records for a person who had recently been admitted to the home. We could see that a detailed pre admission assessment had taken place and that the person had received a letter confirming the home could meet their needs. We also spoke to relative of a person who had been recently admitted to the home. She commented as soon as I came to the home I was impressed with the approach and attitude of the manager and by his personal approach. Before my mother came to the home we had the opportunity of preparing her room before she came here and on the day she arrived I was phoned and informed of her arrival. Since then I have been kept fully informed and have seen her make a great improvement. The service does not offer intermediate care. 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 person had a detailed care plan giving details about their care and support. This had been produced wherever possible with the involvement of the person, their family/advocate and other relevant people. Medication was safely given by staff who knew what they were doing. Evidence: The manager told us that care records had been reviewed in order to make them more individual and contain more information about each person. We looked at 4 care records in depth. Each person had detailed care records giving details about their care and support. Each included a photograph of the person, details of their assessment at the time the person moved into the home, care plan, moving and handling and risk assessment. In addition, there was information about the person including their life history and social care, brief details of activities of daily living, medication, records of the doctor and other professionals, monthly pulse, blood pressure and weight, risk and nutritional assessments including likes and dislikes. The amount of information was in more detail and had clearer instructions about how staff could meet the needs of the Care Homes for Older People Page 12 of 27 Evidence: person. The evaluations of the way care had been given were clear and entries were signed and dated as were the care plans. The care plans were hand written and detailed the agreed aims, nursing action for each aspect of care with a separate evaluation. The manager told us that he was in the process of introducing for each person a mental capacity assessment in line with recent legislation which concerned peoples rights and choices. He also told us he was to arrange for a brief care plan to be placed in the bedrooms of each person in order to enable the person to be involved in their care. We looked at records for 2 people one of whom had complex needs. Several people were fed artificially and staff had received specific training on this subject. Where confined to bed the records showed that their position was altered to relieve pressure even though they were on an alternating pressure mattress. We also saw a person confined to bed with an overbed table, bed protection rails and drinks and books within their reach. Throughout our visit we saw staff respecting the peoples wishes and choices in the way they made contact with the people living in the home and their response. We also spoke with staff who showed good knowledge about the particular needs of the people living in the home. We heard staffing asking the people would you like a fresh cup of tea as this one seems to have gone cold and where would you like to sit. We also saw staff explaining calmly and slowly what they were going to do before for example they lifted a person using a mobile hoist. A visitor told us they will gently touch her hand if she is anxious and talk to her kindly. Throughout our visit we heard staff greeting visitors and laughing and talking with the people living in the home. Where required, people living in the home were referred to Doctors, Community Nurse, Community Psychiatric Nurse, Tissue Viability Nurse, Continence Nurse, Physiotherapist, Opticians, Dentist, Chiropodist and other specialists. The home had also had Link Nurses who specialise in various aspects of care including tissue viability, continence and palliative care and meet up with other nurses and staff from NHS Lincolnshire to promote good practise. The manager told us that they continue to work towards achieving the Gold Standard Framework for terminal care and after care which will be assessed by the Macmillan Nursing Service. Registered nurses administered medication. There was a policy and procedure for this and the manager assessed each person before they were considered safe to administer medication. Records we saw were clear and well maintained with a good audit trail. The manager told us that the people were encouraged by the staff team to self medicate but all people needed a degree of assistance in order to ensure they took their medication safely. People we spoke with were satisfied with the way staff cared for them and had Care Homes for Older People Page 13 of 27 Evidence: confidence in the staff. We saw throughout our inspection staff attended to the people in a warm, friendly and kind manner, knocking on doors before entering their bedrooms and asking whether they needed any help. The people told us the staff are simply perfect, I am very satisfied and every one is so kind and helpful. 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. People are able and supported to make their own choices about how they want to live their lives, and what they want to do. Social activities are varied and provide stimulation and interest for people living in the home. People enjoy varied and nutritious meals. Visitors are made to feel welcome and supported. Evidence: On admission to the home details were obtained about each persons interests and life history and this information was contained in their care records. There was no written activities programme. The manager told us they had considered providing a separate member of staff for activities but decided that it gave more variety if all the staff were involved. They are close to the town centre, have their own wheelchair accessible car and have regular visits by local churches, Pets as Therapy and other activities. There were DVDs and large screen television. Visitors told us that they could visit whenever they wished to do so and always found a warm and friendly welcome. The 5 visitors we spoke with had fulsome praise for the care and approach of staff. Comments included I visit my mother every day and everyone is so friendly, The staff are so kind and sensitive and understand my mothers needs and I am always kept informed and have no complaints. Care Homes for Older People Page 15 of 27 Evidence: The people living in the home were offered 3 main meals a day plus snacks. South Kesteven District Council awarded the home 5 stars (excellent) on the 23/8/2008 following an inspection, in recognition of the catering service provided. We looked at the records for food temperatures, menus and cleaning rotas and found them well maintained and up to date. Meals were served in the 2 combined lounge/dining rooms on the ground floor and first floors or in their bedrooms on a tray. Meals were taken from the kitchen in heated trolleys and served from them. The menus which were also displayed on notice boards showed us that there was a varied menu with fresh fruit and vegetables. The dining tables had clean table cloths and table mats. We saw staff were assisting those people who needed assistance in a dignified, unhurried, calm and sensitive manner. All the people we spoke with were complimentary about the food. Comments included, I like to sit with my wife at lunch time assisting her, the food meets my needs and is always well cooked and well presented, If I do not like what is on the menu the staff will go out of their way to find something to suit my needs. 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. People know how to make a complaint and feel that staff will listen to their views. The care team know how to respond to a complaint and how to act in order to protect people from abuse. They are protected from abuse by correct and safe recruitment procedures. Evidence: Each person received a copy of the complaints procedure in the service users guide and this was also in the statement of purpose and there was a complaints procedure at the entrance to the home. We noticed the details in the service users guide and statement of purpose did not contain our new name and contact phone number. The manager agreed to act on this. There was a complaints log in the reception area of the home, which allowed anyone to raise any concerns or complaints about the home. During our visit none of the people living in the home, visitors or the staff had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a person living in the home. The service had an up to date copy of Lincolnshire County Councils Adult Protection Policy and all staff received regular training. We spoke with 3 staff who confirmed that they had received this training, knew what abuse was and they showed knowledge about their role and what they would do if abuse was suspected. We and the service Care Homes for Older People Page 17 of 27 Evidence: have received no complaints or safeguarding adults issues since the last inspection. All staff were correctly recruited including a check by the Criminal Records Bureau (CRB) and during their supported induction each member of staff received information about abuse. 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. People live in clean, comfortable, safe and well maintained accommodation. The infection control policy is followed and a safe environment is maintained. Evidence: The home was well maintained throughout. The manager told us that many areas throughout the home had been redecorated with new curtains, floor coverings, pressure relieving mattresses and other improvements. During our visit we walked around the home and found all areas of the home were clean, tidy and odour free. We saw throughout our visit domestic staff cleaning all areas of the home thoroughly. People we spoke with told us they were satisfied with the decoration and cleanliness of the home. They also spoke of how they liked their bedrooms. They told us they were encouraged to bring into the home small items of furniture, television, pictures and personal items. People told us I love my room, they always keep it clean, I can make it very personal with my own pictures and ornaments and the home is always clean. One person told us that on account of an allergy the owners had provided a domestic washing machine in the laundry so that her clothes would be washed correctly and she would not be affected by the soap. There were grab rails and raised toilet seats and bathrooms and toilets were wheelchair accessible and had thermostatic valves fitted to basins and baths to Care Homes for Older People Page 19 of 27 Evidence: prevent the people from scalding. There were a variety of pressure relieving mattresses, special profiling beds which enabled the beds to be raised and lowered to help staff care for the people when in bed and ease access to the bed and a variety of mobile hoists with a variety of slings and other moving and handling equipment. We saw 2 members of staff using a mobile hoist to transfer a person to a chair. They worked quietly together, taking time to explain to the person what they were doing and making sure it was done in a sensitive and careful manner with attention to the persons dignity. They then made sure the person was comfortable before they left her. There were clear signs throughout the home which showed where toilets, bathrooms and other rooms were. The home is very close to the town centre and has a small wheelchair accessible walled garden, covered canopy where people can sit if they wish to do so. Communal areas were spacious with sufficient space for those people who use wheelchairs to move around freely. Staff had received training and knew how to use equipment properly. Separate staff were employed for domestic and laundry services. Gloves and aprons were provided and the home had clear infection control policies and alcohol hand wash dispensers at the entrance and throughout the home. There is a laundry with sluice cycles on both of the commercial washing machines. There were two commercial tumble dryers. People who were sat in the 2 combined lounge/dining rooms on the ground and first floor had their own belongings with them at side tables as well as in their bedrooms. Those in bed had over bed tables enabling them to have access to drinks, tissues, fruit, newspapers or books or the television control. Some of the people were in their bedrooms reading or watching television. One person told us I like to keep myself to myself and the staff fully respect my wishes. Some of the people were walking about the home with walking aids or moving themselves about the home using their electric wheelchairs. 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. There is a safely recruited, well-trained, supported staff team available who have the skills to meet the varying needs of the people living in the home. A wide range of inhouse training and National Vocational Qualification training is provided. Evidence: Throughout our visit people we spoke with felt the home was adequately staffed with staff who were experienced and competent to care for the people living in the home. All the comments were very positive. People we spoke with did not express any worries about the level or availability of staff. During our inspection visit we saw staff attended to the needs of the people promptly and in a calm and friendly manner. The home employs registered nurses, care assistants, domestic, laundry, catering staff and a maintenance person. The people we spoke with told us I am very satisfied, everyone is so kind and helpful. The manager told us he monitored the dependency and varying needs of the people. We examined the files for 2 new members of staff. Records were clear, detailed and showed that staff were safely recruited in accordance with the regulations. This included a check by the Criminal Records Bureau (CRB). When new staff started work at the home they received a supported induction programme during which time they Care Homes for Older People Page 21 of 27 Evidence: learnt about the policies and procedures of the home and how to provide the necessary care and support to the people living in the home. We discussed with the manager the suggestion of introducing a nationally recognised more comprehensive induction in line with Skills for Care which he agreed to consider. The duty rota showed across the 24-hour period that there were registered nurses working in the home. There continued to be a wide range of training provided. This included formal training in care to National Vocational Qualification standards (55 of the staff had achieved NVQ level 2 and 2 staff had just completed NVQ level 2). In addition there were staff who were assessors and one person who had NVQ level 3. We saw records and staff confirmed that training over the last year had included, moving and handling, fire protection, adult protection, The Mental Capacity Act 2005 and Deprivation of Liberty Safeguard and tissue viability. We spoke with 4 members of staff who told us, when I arrived in the home I received a very warm welcome and had a supported induction during which I was told about the residents and their needs, I felt able to ask any questions I was unsure about and I have felt everyone I have worked has been very supportive and If I have any concerns I can always discuss it with one of the nurses. 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. Considerable effort has been made to ensure the people and staff benefit from the positive leadership of the management team. Management record systems show that the peoples health, welfare, safety and choices are promoted. The management team ensures that the people living in the home have the opportunity to voice their views and opinions. The management uses feedback from questionnaires to make improvements. Evidence: Throughout our inspection visit no one we spoke with had any concerns about the way the home was run or managed. The manager had been in post for many years and had extensive nursing and managerial experience. Since the last inspection he had obtained a management qualification. He was assisted by a deputy manager who also was a very experienced registered nurse. The owners of the home were actively involved in the home and gave their active support. The people living in the home, visitors and staff told us they had confidence in the management. The manager told us Care Homes for Older People Page 23 of 27 Evidence: that not all staff were receiving regular supervision but he was keen to ensure all staff received this at least 6 times a year. There were policies and procedures available for staff to use when providing care, which were clear and detailed and a number had been reviewed since the last inspection. We discussed with the manager the need to review the clinical procedures used throughout the home in order to ensure practice was up to date and he agreed to do this. The manager told us that the most recent survey had recently been sent out to obtain the views of the people using the service but only one had been returned at the time of our visit. We were also told that the people and relatives had been asked to contribute to the questions in the questionnaire and residents and relatives meetings had been introduced over the last year. In addition the manager told us he was looking into how people living in the home could be involved in the staff interview process. He also told us he was looking into ways of improving the management systems in the home to help with the paperwork and running of the home. Peoples monies were well maintained, though they were encouraged to manage their own finances wherever possible. Where this was not possible they were kept securely and all transactions were recorded and receipts kept. There were no concerns about equality and diversity. The home was caring for 6 younger physically disabled people, some of whom had complex needs. During our visit we saw staff showed knowledge about the individual needs and approaches that were required. The people and visitors were very satisfied with the care and approach from the staff. Comments included, I like to keep myself independent and when I go out I ask whether a member of staff can assist me and they arrange this for me and the manager is lovely and always keen to help me. The home had detailed health and safety procedures. There were also infection control policies and staff made use of alcohol hand rub bottles throughout the home to further prevent infection. Where required risk assessments had been carried out and documented. There were a range of policies and procedures available in the home relating to fire safety and fire risk assessments. A new fire alarm system had been introduced. Care staff also received fire training as part of the homes initial training and as a regular training event. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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