Care Home: The Old Vicarage Nursing and Residential Care Centre

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What the care home does well The Old Vicarage reviews its practice regularly and is always trying to improve the service offered to the residents living there. The home tries to be flexible and the home`s management and staff team have looked at where they are now and where they want to be in the future. This helps to ensure that the home is able to respond to changing needs, which in turn enables people to maintain as much independence as possible. There is a strong commitment from everyone working at the home that helps to ensure that the quality of care is provided to as high a standard as possible. Residents are treated with respect and dignity and we found that the staff members were able to demonstrate an awareness of the diverse needs of the people they were supporting. A resident has written on a survey form; "The staff are very kind and helpful". In answer to the question, what does the home do well another resident has written, "Everything". Positive, relaxed and warm relationships were seen to exist between residents, relatives and staff members, those people that commented all said that the manager and staff members were very good. One person we spoke with said; "the staff are very nice, I have no issues". Routines within the home are flexible, this gives people some control over their lives and enables them to maintain their independence. There are opportunities for people to participate in social and other activities. A varied choice of meals are offered and the standard of catering is very good. What has improved since the last inspection? There has been a change of home ownership since the previous inspection took place; prior to this and since the change approximately two years ago there have been periods when the home has either been without a registered manager or had someone in post for a short time only. It is partly due to the fact that there has been a very settled and committed staff team at the home for a few years that this did not have a major impact on the quality of service provided to residents. The management issue has now been resolved and a new manager was appointed in September 2009 [She is in the process of registering with us]. We found during this visit that she has had a very positive impact on the home since being in post and both residents and staff members spoke very highly of her and the improvements she had introduced. A staff member has written on a survey form; "I love my job and since the new manager started she has made a great improvement". Another person has written; "The home is doing really well at the moment with the new manager in place". We have the general impression that the staff team have always tried to provide a very good quality of care but have welcomed a new manager with high standards who wants to continue to improve the service offered. For example, they have told us that improvements to the menu`s and to the quality of the food provided have been made since her appointment. Improvements to the interior facilities, including refurbishment and redecoration of some bedrooms and communal areas has taken place. This is ongoing. What the care home could do better: We consider that the Old Vicarage is an excellent service so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the high standard of care provided to the service users at the present time is maintained and where possible improved upon. Key inspection report Care homes for older people Name: Address: The Old Vicarage Nursing and Residential Care Centre Fir Tree Lane The Old Vicarage Burtonwood Warrington Cheshire WA5 4NN     The quality rating for this care home is:   three star excellent 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: Paul Ramsden     Date: 2 9 0 3 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 26 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 26 Information about the care home Name of care home: Address: The Old Vicarage Nursing and Residential Care Centre Fir Tree Lane The Old Vicarage Burtonwood Warrington Cheshire WA5 4NN 01925229944 01925229944 kmhullbutler@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cheshire Lifecare Ltd Name of registered manager (if applicable) Manager post vacant Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home is within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 35 Date of last inspection Brief description of the care home The Old Vicarage is a 35-bedded care home providing personal care with nursing. It was originally a Victorian residence, which has been converted and extended. Accommodation consists of three double bedrooms [two of which are used as single rooms] and 29 single bedrooms, 15 with en-suite facilities. There were 3 lounges, a Care Homes for Older People Page 4 of 26 Over 65 35 0 Brief description of the care home dining room, a passenger lift and stair lift and special bathing facilities. The home has a large garden with patio area. The home is situated on the edge of Burtonwood village within easy access from the M62 and M6. There is a bus stop outside the home for buses to Warrington, St. Helens and Earlestown. Weekly fees range from £382 to £423 per week. Further information about fees is available from the home manager. A copy of this report can be obtained from the home or via the Care Quality Commissions website. Care Homes for Older People Page 5 of 26 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: three star excellent 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 unannounced visit took place on the 29 March 2010 and lasted for a total of five and a half hours. Paul Ramsden, Inspector, undertook the visit on behalf of the Care Quality Commission. Any references to we or us in the report refer to the Commission. All of the key standards for older people were looked at. Feedback on the findings of the inspection was given to the home manager as the inspection progressed and via a telephone call to the home after the inspection had been finished. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed questionnaire that provides us with a lot of information about the service before we go to the home. Survey forms were also sent to the home for service users and staff members to complete in order to find out their views. Five resident and nine staff forms have been returned; the comments are generally very positive and some of Care Homes for Older People Page 6 of 26 them have been included in the report. We looked at the Annual Service Reviews [ASR] that were carried out last year and the year before [This is a review of good and excellent services that takes place between key inspections, good services only have an inspection every two years and excellent services every three years]. Following the completion of the reviews we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A number of residents and staff members were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? There has been a change of home ownership since the previous inspection took place; prior to this and since the change approximately two years ago there have been periods when the home has either been without a registered manager or had someone in post for a short time only. It is partly due to the fact that there has been a very settled and committed staff team at the home for a few years that this did not have a major impact on the quality of service provided to residents. The management issue has now been resolved and a new manager was appointed in September 2009 [She is in the process of registering with us]. We found during this visit that she has had a very positive impact on the home since being in post and both residents and staff members spoke very highly of her and the improvements she had introduced. A staff member has written on a survey form; I love my job and since the new manager started she has made a great improvement. Another person has written; The home is doing really well at the moment with the new manager in place. We have the general impression that the staff team have always tried to provide a very good quality of care but have welcomed a new manager with high standards who wants to continue to improve the service offered. For example, they have told us that improvements to the menus and to the quality of the food provided have been made since her appointment. Improvements to the interior facilities, including refurbishment and redecoration of some bedrooms and communal areas has taken place. This is ongoing. Care Homes for Older People Page 8 of 26 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 26 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 26 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. Information and opportunities to visit before moving in are available and service users are assessed before moving in to ensure their needs can be met at the home. Evidence: The home provides a range of information to both prospective and existing residents; these include a brochure and a Residents Guide. The brochure is usually given to anyone enquiring about the home and a copy of the guide is put into each bedroom for residents and their visitors to read. These documents contain all of the information required and they should provide sufficient information for anybody who is is either thinking of moving into the home or is living there. People are free to visit and look around The Old Vicarage prior to choosing to live there if they want to; they can also stay for a meal and have a trial visit before deciding. If they have any queries they can contact the manager or senior staff members. Pre-admission assessments demonstrating that the resident individual needs had Care Homes for Older People Page 11 of 26 Evidence: been assessed in an accurate and consistent way had been carried out for the people whose files were looked at. The manager carries out the assessments and will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. This provides an opportunity to make sure the home can accommodate the person and their individual needs. Where applicable copies of information provided by the Local Authority are also obtained prior to admission. This provides background information as to the reasons why a move to the home is needed and is very useful when combined with the homes own assessment. Intermediate care is not provided at The Old Vicarage. Care Homes for Older People Page 12 of 26 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 residents care plans seen provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs. Evidence: The manager is responsible for drawing up a residents initial plan of care. They are generated from the information gathered during the pre-admission assessment and the additional information gathered on admission. All of the care plans seen were of a good standard and provided the staff with all of the tools needed to identify any assessed need and how it is to be met. The care plans seen were all up to date and were written in a style that would enable someone reading it to have a good idea of what help and assistance someone needed at that time. Care plans were being reviewed, with input from the resident or their representatives and where necessary re-written on a regular basis. Staff members spoken with could show that they had a good understanding of the people they were supporting and they were able to meet their diverse needs. Care Homes for Older People Page 13 of 26 Evidence: Care staff work to a good standard in order to ensure that residents receive the care they need. One of the people we spoke with told us; The staff are very nice, I have no issues. Staff members monitor a persons health and other needs daily and there was evidence to show that people were receiving the appropriate support from GPs etc. A key worker system is in place [This is a system used in the majority of homes and involves particular staff members working more closely with certain residents]. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. They were seen to be interacting with individuals in an appropriate way, knocking on bedroom doors before entering and addressing people according to their wishes. All personal care is carried out in the privacy of a persons bedroom or one of the bathrooms. The Old Vicarage has a written policy on the receipt, administration [including self administration], safekeeping, handling, recording and disposal of medication within the home. The home uses a blister pack system dispensed by a local pharmacist. The arrangements for the administration of medicines during this inspection visit were considered to be good and the residents were being given their medication as prescribed. Every staff member who dispenses medication has received training in this area. The home manager audits the medication procedures within the home on a monthly basis. Care Homes for Older People Page 14 of 26 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. Residents are supported to maintain their independence and to make choices about their lifestyle so they have control over their lives. Evidence: Residents spoken with during the inspection confirmed that their lifestyle was flexible and that staff members respected their wishes. They were able to make choices in many areas of daily living; for example, times of rising and retiring, whether or not to join in with planned activities and where to spend time and with whom. The home employs two activities co-ordinators for a total of 15 to 20 hours per week [these are carers who work additional hours]. Their roles are to work with residents both individually and in groups. A number of activities take place within the home and on the day of our visit a bingo session was taking place. There is no pressure to join in with any activities and if someone does not wish to do so the co-ordinators will try and spend some time on a one to one basis with them. There is a residents and relatives notice board in the entrance area and meetings are held regularly [the last was held on the 10 March]. The manager also speaks with residents, their relatives and other visitors to the home as often as possible. Care Homes for Older People Page 15 of 26 Evidence: Various religious denominations conduct services in the home and residents are free to attend if they wish to do so. They are also able to attend their own church if they are able to. A hairdresser visits the home on a regular basis. Meals can be taken in the dining room or in the privacy of a residents own room. There is a four week menu that has the flexibility to meet individual needs and choices and special diets are provided if required. New menus and improvements to the quality of food provided have been implemented since the manager started working at the home. The residents were positive about the quality of the food they were eating. The home has recently been awarded four stars from Warrington Borough Councils Environmental Health Department. Care Homes for Older People Page 16 of 26 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 and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Evidence: There is a written complaints procedure for the home; this is on display in the entrance area. Information about complaints is also included in the Residents Guide. The residents that commented said that they knew who to speak to if they had any concerns and were confident that the appropriate action would be taken. The home has received one complaint since the manager took up her post in September 2009. We have not received any complaints. The home has an adult protection procedure [now called safeguarding] that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. The manager was able to demonstrate that she was fully aware of the process to be followed and that the training for staff members in this area was up to date. We have not received any safeguarding referrals. Care Homes for Older People Page 17 of 26 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 facilities and accommodation is generally of a good standard; this means that residents are living in a safe, homely, comfortable environment. Evidence: The home is located in the village of Burtonwood, close to shops and other community amenities. A passenger lift and stairlift are available to allow access to all areas of the home. A tour of the premises was undertaken; this included communal areas and a number of bedrooms. All bedrooms seen during the visit were personalised and comfortable and some contained items of furniture belonging to the individual. We think that the Old Vicarage provides an environment that can fully meet the needs of the residents that live there. A resident has written on a survey form; I am very comfortable. It is being maintained to a good standard and we did not see any hygiene or cleanliness issues. The manager explained that since being in post she has altered the cleaning rota which has improved the hygiene standards generally and has eradicated any odours. Since the change of ownership and the new managers appointment in September 2009 some improvements have been made. These include; a number of bedroom have been re-furbished, this includes new furniture and soft furnishings. The small Care Homes for Older People Page 18 of 26 Evidence: visitors lounge has been redecorated and new furniture provided. The downstairs bathroom has been re-fitted and the managers office has been moved so that she is now more accessible to residents and visitors. The manager explained that the refurbishment is still ongoing and will include the new 25 bedded dementia care unit currently being built next to the home [it is intended that the existing building and the new unit will be physically joined as the building work progresses, residents and family members are being kept fully informed]. This will need to be registered with us when it is completed so has not been looked at during this visit. Aids to help maintain independence, for example a call system and bathing aids have been provided. There are fully accessible well maintained garden areas available for residents to use. The laundry within the home is well equipped and good systems are in place for the care of peoples clothes. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by a well trained and committed staff team who work hard to improve the quality of life of the people living in the home. Evidence: We saw during the visit that the staffing levels and the skill mix of staff was fully able to meet the needs of the residents living in the home. Staff members were cheerful and friendly and were seen to be treating people with the upmost respect and dignity. The staff members spoken with were very positive about the home and told us that they thought a high quality of care was being provided. One person has written on a survey form; All of the staff are working hard to give a high standard of care to the residents. We consider that they had a good understanding of the diverse needs of the people they were supporting. Residents spoken with made a number of positive comments about the staff, these included; I like a laugh and a joke with them. The manager told us that very little agency staff were needed and this was only used to cover the nursing staff; not the care staff. The nursing staff members employed undertake continuous training as part of the professional requirement for them to do so in order for them to maintain their PIN number [they cannot practice as a nurse without maintaining this]. According to the AQAA over 50 of the care staff members are either qualified or are Care Homes for Older People Page 20 of 26 Evidence: working towards a National Vocational Qualification [NVQ] level 2 or 3 in care, a recognised qualification for people working in the care profession. The staff file seen contained all of the required information and a thorough recruitment procedure was in place for the protection of residents. The homes manager confirmed that all new staff are checked against the SOVA list and that a satisfactory CRB disclosure must be obtained before employment commences. Any gaps in the employment history are checked. The manager considers that the retention and recruitment of good quality staff members is an integral component in delivering an excellent service. The result of this is that the current team have the skills, knowledge and experience to meet the diverse needs of the residents living in the home at any one time. New staff members undertake an in-house induction followed by a thorough induction training programme, including adult protection. This meets the Skills for Care Induction Standards. We were able to see an induction record for one of the most recently appointed staff members. The Old Vicarage provides a range of training courses for staff members; this includes mandatory training such as safer handling, fire safety and adult protection as well as other courses such as continence and palliative care. The staff members spoken with confirmed that training courses were readily available and that they considered that they were well trained. The manager maintains a record so that she knows what training is due to be undertaken by each of the staff members employed. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being very well run and managed on a day to day basis, this helps to ensure that the needs of the service users are met and that there are appropriate procedures in place to maintain their safety. Evidence: The home manager is experienced and knowledgeable and was able to display a clear sense of direction and best practice. She was able to clearly demonstrate an awareness of the needs of the residents living in the home and how to manage the staff team. The home manager is a qualified nurse and also has an NVQ level 4 in management. She attends courses/training in order develop the skills to fulfill her management responsibilities. A number of positive comments about the managers capabilities were made by both residents and staff members, comments from staff include; Things have improved since she has been here, there are better routines and standards are higher. the manager is really friendly but wants things done properly, any smells have gone since she came. Care Homes for Older People Page 22 of 26 Evidence: There is is a strong and committed staff team within the home who work hard to ensure that the quality of care provided is maintained at as high a level as possible. The company has its own quality monitoring system in place to order to ascertain whether residents and relatives/representatives are happy with the standards of care being provided. Questionnaires are sent out by head office and the date of the last survey was October 2009. Small amounts of money are held for some service users; this covers the cost of items such as hairdressing. Detailed records are held of all transactions and any receipts are kept. Any accidents are recorded and the home manager regularly audits these in order to ensure that any trends, for example, a resident having a number of falls are identified and addressed. The home has a comprehensive range of policies and procedures to promote and protect both residents and staff members health and safety. The maintenance records seen demonstrated that the appropriate service contracts were in place. These included, bathing aids, the fire alarm system and the gas and electrical installations. The fire safety log book showed that fire drills and training were being carried out at the recommended intervals. There was some confusion about the frequency of the testing of the fire alarm system and emergency lighting; this was clarified and the manager confirmed that she would ensure that the system was checked weekly and the lights monthly as per the guidance from Cheshire Fire Service. Care Homes for Older People Page 23 of 26 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 26 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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