Care Home: The Pines Nursing Home

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What the care home does well The home provides nursing care for up to thirty six older people in clean, homely and comfortable environment. Residents have their own accommodation which is provided in single rooms (although one room can be used as a double for a couple if required) and there is ample communal space provided. Residents can take their meals in a pleasant dining room from a varied and nutritious menu. The home provides a good standard of care . All prospective residents are assessed prior to admission to ensure the home can meet their needs. Each individual has a care plan which identifies their health, personal and social care needs and identifies the care required to meet these needs. A good range of activities is provided with outings in the home`s minibus forming part of the programme. Full time activities coordinators arrange a programme of activities and consult with and involve the residents in the planning of these. Staff receive ongoing training and regular formal supervision, there is a staff training programme and the manager ensures that all training and practices in the home are planned on the basis of research and knowledge gained from both the internet and from health and social care authorities. Comments received both from surveys and on the day included :" Excellent home, everyone is very kind and nothing is too much trouble". " The staff work very hard to ensure that everything about this home is to our liking" " Very good home, very clean, good food . Staff spoken with said that the home is "The best home I`ve worked in`. " We all work to ensure the residents are happy, we have a lovely staff team and work together"." I work on the agency and come here sometimes if they need me, its a good home with good care". What has improved since the last inspection? The home continues to invest in new equipment and to redecorate the home. The menus and activities programmes are changed according to the suggestions given by residents. The home has recently commenced e-learning for some staff to add to the formal courses already being offered. The manager and some of the staff have undertaken training in Deprivation of Liberty safeguarding and the Mental Capacity Act to ensure that staff are aware of resident`s rights. The home has also included staff training in dignity of residents and more infection control training resulting in the home having two "dignity champions" and two infection control `champions` to ensure that residents receive a good standard of care which maintains their dignity and pride. What the care home could do better: There have been no requirements made at this inspection. There were some medications that had been incorrectly signed on administration which the manager addressed subsequent to the inspection. The provider has not undertaken any regulation 26 visits since November 2008 (Monthly visits and reports required by regulation to be undertaken by the provider or an appointed person). The Care Quality Commission will be contacting the provider directly regarding this. Key inspection report Care homes for older people Name: Address: The Pines Nursing Home Furze Hill Hove East Sussex BN3 1PA     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: Elizabeth Dudley     Date: 2 6 1 1 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 30 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 30 Information about the care home Name of care home: Address: The Pines Nursing Home Furze Hill Hove East Sussex BN3 1PA 01273820275 01273734979 janis.weir@independentage.org.uk david.lockley@independentage.org.uk The Royal United Kingdom Benificent Association care home 35 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) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 35 The registered person may provide the following category of service only : Care home only_(PC) to service users of the following gender: Either Whose primary care needs on admission to the service are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Pines provides personal and nursing care for up to thirty-six older people. It is owned by Independent Age (The Royal United Kingdom Beneficent Association). The Pines is purpose built and provides a passenger lift, enabling access for residents to all parts of the home. The home is situated in a residential area of Hove, East Sussex, and is within walking distance of the seafront and the shopping centres of Brighton and Hove that are linked by Western Road that has many shops and access to local transport including both Brighton and Hove mainline stations. The home also has access at the rear to St Annes Well Gardens, a popular local park which provides a Care Homes for Older People Page 4 of 30 Over 65 35 0 Brief description of the care home pleasant view to some service users rooms. Accommodation is provided in thirty-five single rooms, all of which have en-suite facilities, thirty of these providing en suite showers. There is one shared room for the use of a married couple or long-term friends. Communal space is provided in a lounge/conservatory, quiet lounge and large dining area, and there is a well- equipped Activities room on the first floor. There is a small, well-maintained garden that is accessible to residents. Car parking is available at the front of the home for approximately eight cars. The fees currently charged by the home as informed to the commission on the 26th November 2009, range from £532 to £876.50 per week, these do not include other services such as hairdressing and chiropody and charges for these are available from the home. Care Homes for Older People Page 5 of 30 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 key unannounced inspection took place on the 26th November 2009 and was facilitated by Mrs J Weir registered manager. The Annual quality assurance assessment (AQAA) was sent to us by the service when we asked for it. The Annual Quality Assurance Assessment ( AQAA) is a self assessment, required by regulation, that focuses on how well outcomes are being attained for people using the service. It also gave us some numerical information about the service. This was used to help inform the judgements made in this report. Other methods used to inform the judgements made included the examination of documentation required to meet regulation and ensure the smooth running of the home. These included care plans, medication records, menus, staff personnel files and training and health and safety documentation. Care Homes for Older People Page 6 of 30 Six residents and five members of staff were involved in the inspection and discussions held with them regarding how they perceived living and working in this home. Prior to the inspection the Care Quality Commission sent out fifteen surveys to residents, ten to staff and four to health and social care professionals, to gain their views of the home. Of these twelve were returned from residents, five from staff and four from health and social care professionals. All of the views given and comments made were very positive. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: There have been no requirements made at this inspection. There were some medications that had been incorrectly signed on administration which the manager addressed subsequent to the inspection. The provider has not undertaken any regulation 26 visits since November 2008 (Monthly visits and reports required by regulation to be undertaken by the provider or an appointed person). The Care Quality Commission will be contacting the provider Care Homes for Older People Page 8 of 30 directly regarding this. 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 30 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 30 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. Prospective residents receive sufficient information to enable them to make a decision over whether they wish to move into the home. The manager assesses prospective residents prior to admission to ensure that the home can meet the individuals needs and expectations. These are comprehensive and form the basis of the individuals care planning. Evidence: All residents are provided with complete information about the home prior to admission. This includes a Statement of Purpose and Service User Guide, a brochure which details the services offered by both the home and the parent company and information on the daily routines of the home. All these documents are updated at regular intervals. Terms and Conditions of Residence and a contract detailing the fees payable are Care Homes for Older People Page 11 of 30 Evidence: given to all residents, irrespective of how their care is funded, following admission. Prospective residents are invited to visit the home and may stay for lunch if they wish. The manager or a suitably qualified member of staff undertakes a preadmission assessment on prospective residents to ensure that the home will be able to meet their needs. Whilst currently prospective residents do not receive written confirmation of the homes ability to do this, the manager gave assurances that this will be commenced. The home currently admits residents for permanent and continuing care but not for intermediate or transitional care. Care Homes for Older People Page 12 of 30 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 standard of care planning ensures that the health and personal care needs are well met, and there is evidence that the home consults a range of other health care specialists in a timely manner should they have any concerns about the resident. End of life care takes into account residents wishes and staff have the expertise to ensure that residents are kept comfortable and free from pain at this time. Evidence: Four care plans were examined which showed that the standard of care planning was comprehensive and included all the information relating to the care of the individuals current and changing needs. These had been reviewed regularly and formed in consultation with the resident or their representative where possible. The current care plans used are preformatted and do not give the opportunity for detailed instruction to care staff or the opportunity to personalise the care plan. However it was evident in the daily records and some parts of the care planning that residents were being given the opportunity to direct how the care was given and that Care Homes for Older People Page 13 of 30 Evidence: personal wishes and preferences were being taken into account.The manager is considering changing the care plan format, which will assist care or nursing staff to ensure clear directions for care staff are included in the planning. A recommendation was made to the manager regarding recording the pressure of mattresses used for residents who are at risk of pressure damage. Information regarding nursing and care interventions which had taken place, such as turning and fluid charts, was present in residents rooms and were up to date and accurate. There was evidence in the care plans that the home is proactive in accessing relevant health care nurse and therapy specialists in a timely manner. Residents appeared well looked after and people nursed in bed were comfortable, with those who were able being encouraged to maintain independence according to their ability. Residents said that they were able to make their own choices regarding how they were being cared for and that call bells were answered promptly. This was also evident during this day. Surveys sent out to residents and health care professionals prior to the day were returned with positive comments being made. Examples of these from residents were Excellent home, very well looked after. Place is as near perfect as it could be. The home provides support as I need it. Comments from health care professionals included; No problems with The Pines, staff are very good and follow up all recommendations in treatment. Staff have the right skills , very well informed staff. Good staff, sensible and pleasant. Medication policies and procedures have been reviewed regularly. Some residents take responsibility for administering their own medications and there was evidence of robust policies for this and regular review of the individual residents ability to undertake this. Whilst generally medications had been signed for following administration, and the home has peer audits of this, a controlled drug had not been signed following administration, and one residents medication had been signed as administered although the tablets were on the residents bedside table a few hours later. Staff showed awareness that these incidents should not have happened and said that this was unusual and it was addressed by the manager immediately, therefore a requirement has not been made. Care Homes for Older People Page 14 of 30 Evidence: The home admits residents for continuing care, and the staff use recognised nursing tools such as the Gold Standards framework for ensuring residents comfort and quality of care at the end of their lives. Staff are familiar with the use of syringe drivers and other forms of pain control, and aware of the importance of updating their training on end of life care. Care Homes for Older People Page 15 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with a good quality of life which ensures that they are receive sufficient mental and physical activity if they wish to have this, and are encouraged to make their own decisions about their daily routines. A varied and nutritious menu is provided and food is well presented and in good quantities. All residents spoken with made very positive comments about the food provided. Evidence: The home employs two activities organisers, one of whom works on a full time basis, and a full activities programme is produced. Activities available include outings three times a week, bingo, crafts and some one to one time, residents are assisted to go shopping and a supper club takes place at intervals. There is also a trolley shop which is run by the Friends of the Pines and this enables those residents who cannot go out to purchase essentials. Comments from residents included The activities staff work very hard with outings and there are some activities almost every day. There are more than enough activities for me.Excellent range of activities. Care Homes for Older People Page 16 of 30 Evidence: There was evidence in the care plans that residents are able to have fully choice in all activities of daily living, such as preferred times of rising and retiring, and this was confirmed with residents spoken with. We can choose exactly what we do and for me thats important, because if one thing is not timed when I want it to be it throws the rest of the day out. Absolutely the staff do things at the times we request it, they really are fabulous, everything is for us and for our wishes. Menus showed a good variety of food being offered with choices at all meals. Catering staff are able to provide food to meet any special diets or preferences the residents may have. The chef stated that he frequently makes meals that are not part of that days choice if residents request this. The chef is aware of those residents who require fortified diets and ensures that this is done. The timing of both breakfast and supper meals have been determined by the residents and breakfast is served until around 10.30, therefore giving residents a chance to take their time in the mornings. Residents also discuss menus at the residents meetings. Meals were attractively presented and good quantities of food was served, staff were attending to residents who required assistance in an empathetic manner. All tables and trays were presented well and included condiments being available. Residents are offered a choice of alcoholic beverages with their lunch. A variety of fresh fruit and vegetables were used in the cooking and made available to residents. All comments from residents, both from surveys and made in person, were very positive about the meals provided: Nothing is to much trouble, if you dont like something they bring something else without a grumble, we always have a choice at meals and everything is beautifully cooked. The chef here is amazing, we get some wonderful food, its very well cooked and thought out. Lovely food, really enjoy it, give you far to much, but its so nice you just have to eat it. Catering staff have received the appropriate health and safety and catering training and the chef has attended courses in cooking for people with medical conditions and catering for the older person. The home was awarded five stars in the Environmental Health Authoritys Scores on doors initiative. Care Homes for Older People Page 17 of 30 Evidence: Care Homes for Older People Page 18 of 30 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 are confident that any complaints and concerns they may have would be dealt with in a confidential and transparent manner. Staff were aware of the importance of safeguarding those in their care. Evidence: The home has a complaints policy which is made available to residents and keeps records of complaints and minor concerns received and the actions taken to address these. During the past year there have been eleven minor complaints, eight of which were substantiated, and one adult safeguarding which was referred to social services but dealt with by the manager. Staff spoken with confirmed that they had adult safeguarding training, this is given at induction and updated yearly. Staff were aware of what constitutes an adult safeguarding issue and how to report this. The staff have also received training in the mental capacity act and in Deprivation of Liberty safeguarding. No residents have required assessing for this. Both surveys and discussion with residents showed that they were aware of how to make a formal complaint, although all said that they would discuss it with the manager first and were confident that this would be dealt with in an open and Care Homes for Older People Page 19 of 30 Evidence: transparent manner. Care Homes for Older People Page 20 of 30 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 Pines offers a pleasant, safe and well maintained home. Residents rooms are comfortable and they are able to bring in their own possessions. The standard of cleanliness is excellent and staff are aware of the necessity to minimise the spread of infection. Evidence: The home is well maintained and has communal accommodation which includes a conservatory, dining room and several other rooms which can be used by residents for the purposes of events and activities. The small but well maintained garden is accessible to all residents. Residents personal accommodation is in single rooms, one to these single rooms can be used as a double room for a couple if required. All rooms have an en suite facility and thirty of the thirty five rooms also have an shower en suite. Extra bathing facilities are available in the form of assisted bathrooms on each floor. Hot water temperatures to residents outlets are monitored on a regular basis and records showed that these were within recommended parameters. All windows above ground floor level had restricted opening for resident safety. The standard of cleanliness throughout the home was excellent and the house keeping Care Homes for Older People Page 21 of 30 Evidence: staff are commended for their work in attaining this. All staff have infection control training and there are two infection control champions within the home ( members of staff who receive training from, and liaise with the Health Protection Agency and adopt the latest infection control information into the home). Staff were wearing protective equipment such as gloves and aprons appropriately and there were adequate hand washing facilities and alcohol gel throughout the home. There are sufficient aids such as hoists and handrails throughout the home to enable residents to maximise their independence. Residents spoken with praised the standard of the laundry: My clothes always come back clean and well ironed. The staff in the laundry work very hard, everything is well ironed. Comments received about the home included: Always very clean, its well decorated and furnished and very nice to live here. The standard of cleanliness is second to none, and it always smells fresh. Clean and well decorated, nice garden which we can use in the summer. Care Homes for Older People Page 22 of 30 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 home has sufficient staff with suitable training to meet the needs of the residents in the home. Robust recruitment systems are in place which ensures that residents are safeguarded. Evidence: The duty rota and discussions with staff showed that there are generally sufficient staff to meet the needs of the residents in the home. Any shortfalls are made up with agency staff, although these are used rarely and are staff who are familiar with the home. Staff appeared busy, but not overly so, and there was a relaxed atmosphere in the home. Comments received from staff included We always have enough staff, agency staff come in sometimes but they are usually people that know the home. Cant think of any time that we have been short of staff, we always have agency if we are short suddenly, but usually its fine. We are busy all the time but there is enough time for us to look after residents at their own pace- we are not rushed. New staff participate in both a local home induction and where applicable the nationally recognised induction course Skills for Care. New staff receive mandatory health and safety training such as moving and handling and fire training prior to commencing work at the home. Care Homes for Older People Page 23 of 30 Evidence: Staff training records showed that staff have access to varied training with training sessions accessed from training consortiums, the Nursing Home Support Team and Brighton and Hove Local Authority. Registered nurses pursue their own training according to the requirements of their professional body and also take part in training offered by the home. The home encourages care staff to participate in study for the National Vocational Qualification level 2 or 3 in Care. Currently ten of the twenty three care staff have attained this. The home is aware that 50 or above of the staff should have this qualification and are working to achieve this target. Staff personnel files were examined and these included all documentation as required by regulation for the safety of residents. However the home is having difficulty in obtaining references for volunteer staff and the manager gave assurances that she would continue to pursue this. The home is aware that all volunteers are required to have the same checks as employed staff to ensure residents safety. Care Homes for Older People Page 24 of 30 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. That management systems in the home are robust ensure the safety and well being of the residents in the home. The home provides a welcoming and homely environment for residents whose views are used in forming the services provided. Evidence: The registered manager has been in post for five years, is a Registered General Nurse and has the experience and qualifications necessary for running the home. The registered manager is proactive in ensuring the home has the latest information on any health, safety or training issues by regularly accessing information from the internet or accessing this from various agencies such as the Health Protection Agency or Nursing Home Support Team. She also ensures that she participates in and keeps up to date with all the clinical and management training available. The manager has attended training in the Deprivation of Liberty Safeguarding and the Care Homes for Older People Page 25 of 30 Evidence: Mental Capacity Act, with the majority of the staff having received training in the Mental Capacity Act. The AQAA (annual quality assurance assessment ) was received when we asked for it and was comprehensive, detailing what has been happening in the home over the past year and plans for the next twelve months. Discussions with residents and staff and observation of the life of the home during the day showed that there is a relaxed and homely atmosphere, there were good interactions seen between residents and staff and visitors were welcomed. Comments from residents included Excellent home, everything here is just right, very satisfied. Nice place to live, staff are good and the management is excellent. Nothing to complain about at all, good food, nice staff and comfortable bed. Staff said that it was a good place to work Low staff turnover, pleasant home, good training and approachable management. RUKBA carries out an annual quality monitoring assessment of the services provided by the home on an annual basis and results of this are made known to the home. The manager sends out questionnaires to residents and their representatives on a six monthly basis. The results of these and the information gained from the quarterly residents meetings are used to make any changes to the services provided. Residents are involved in both choosing the menus and the activities and are enabled to have their say on all aspects of life in the home. Regular staff meetings are held and staff said that their suggestions and comments were listened to. The AQAA, and some policies and procedures examined, showed that these are updated on a regular basis. Staff receive regular formal supervision and appraisal and records of these were seen. There was no evidence of any regulation 26 visits having taken place since 17th November 2008 (monthly visits and reports required by regulation by the provider or person appointed to do this). The commission will be writing to the provider regarding this and asked to give assurances that these will be recommenced. No requirement has been made on this occasion due to the local management of the home being good. Care Homes for Older People Page 26 of 30 Evidence: The home does not keep any personal money or act as an appointee for residents. The AQAA told us that all the equipment and utilities are serviced regularly, and random certificates of service examined gave evidence of this. Regular testing of fire alarms and other security measures takes place and all staff have mandatory training at the required intervals. Risk assessments were in place throughout the home. Accident and incident forms were examined, and the home has robust systems in place to ensure that the Care Quality Commission is informed of any incidents affecting the well being of the residents in the home. Care Homes for Older People Page 27 of 30 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 28 of 30 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 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!