Care Home: The Wakefield Centre

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What the care home does well The home is caring for a number of people with high and complex needs. All of the residents, visitors and family members spoken with were very complimentary about the care and support provided by staff at the Wakefield. The care plan and healthcare records looked at were all relevant and up to date. The home monitors residents health and wellbeing very closely. All of the medication looked at was stored safely and the medical administration records were fully completed. A new, comprehensive medication administration policy and procedure has recently been issued to all units. The meals provided are of a very high standard with hot and cold meals available throughout the day. The menu is varied, appealing, nutritious and wholesome. All residents spoken with were very happy with the food. The environment is well decorated, comfortable, clean and suitable for its stated purpose. Steps have been taken to meet the varying physical and psychological needs of residents by creating a physiotherapy room, internet cafe and sensory room. The training and development of staff is given a high priority. Residents and relatives spoke highly of the competence of staff and their good communication skills. Staff commented on the good standard of training provided and on the support provided by senior staff, including the registered manager and the training manager. What has improved since the last inspection? The home has ensured that all residents have a service user guide in their rooms. The call aid systems are in reach of all residents when they are in their rooms. The home offers hot and cold drinks and snacks 24/7 to residents if requested. The complaints procedure is in each resident`s room for residents, relatives and any other visitors. The care plans detailed the preferences of residents getting up and going to bed. What the care home could do better: The daily records completed by some staff were not legible. The procedures for elimination and fluid charts were not being fully completed by all staff after assisting a resident. Staff should be aware of the need to promote dignity when escorting a resident out of the lounge for personal care. The laundry service needs to include a service for delicate clothes that should not be put in the washing machine or dryers. Key inspection report Care homes for older people Name: Address: The Wakefield Centre Ravenscourt Gardens Hammersmith London W6 0AE     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: Jackie Derbyshire     Date: 2 0 0 5 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 28 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 28 Information about the care home Name of care home: Address: The Wakefield Centre Ravenscourt Gardens Hammersmith London W6 0AE 02082227800 02082227801 carol.smit@wakefieldcentre.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ganymede Care Limited Name of registered manager (if applicable) Wynne Carol Smit Type of registration: Number of places registered: care home 146 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 146 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 are within the following categories: Physical disability - Code PD Old Age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home The Wakefield Centre provides nursing care and accommodation for 144 men and women. This includes people with dementia and younger adults with a physical disability. The home is located in a residential area of Stamford Brook, with easy Care Homes for Older People Page 4 of 28 Over 65 0 146 0 146 0 146 Brief description of the care home access to transport links, local shops and other amenities in the Chiswick High Road. The weekly fees for the home range from £659.24 - £ 2731.41, this varies depending on the care and support plan. Care Homes for Older People Page 5 of 28 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: The quality rating for this service is 3 star. This means that the people using the service receive an excellent service. Throughout this report the word we will be used as meaning the Care Quality Commission CQC.This unannounced inspection took place on the 19th May 2010 when we spent 8.00 hours visiting the home.The Compliance Inspector was accompanied by Sheila Lycholit a Compliance Inspector. We spent time talking with the registered manager, residents,relatives and visitors, the chef, the housekeeper, the financial administrator, care and nursing staff and a maintenance officer. There are currently 142 residents living at the home, 124 commissioned by local authorities and 18 private residents. There are 187 staff currently employed at the home including: nurses,care staff, kitchen staff and maintenance and housekeeping staff. We looked at the care records of 6 residents. We looked at 6 staff files including recruitment, supervision and training records. Care Homes for Older People Page 6 of 28 The CQC received 9 resident and relative surveys and 5 staff surveys, all of the information will be included throughout this report. There were 7 requirements set in 2008 that have been met. We spent time discussing the requirements with the registered manager and looking at relevant records and documentation. There is 1 new requirement and 4 good practice recommendations set from this inspection. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The daily records completed by some staff were not legible. The procedures for elimination and fluid charts were not being fully completed by all staff after assisting a resident. Staff should be aware of the need to promote dignity when escorting a resident out of the lounge for personal care. The laundry service needs to include a service for delicate clothes that should not be put in the washing machine or dryers. Care Homes for Older People Page 8 of 28 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 28 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 28 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 using the 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 provides a statement of purpose that is specific to the individual home and the resident group they care for. The care plan is a working document, reviewed regularly, involving the person and their representatives if agreed. Evidence: Comments from residents and relatives. I am happy living here, I would of course rather be in my own home but I can not look after myself any longer. I am very pleased with the excellent standard of care provided to my mother she has lived in the home since 2008. Care Homes for Older People Page 11 of 28 Evidence: I have made a lot of progress since living at the home. It is perfect. In discussion a relative who visits regularly commented that staff had responded well to her involvement in trying to ensure that her mothers needs are met. There were some initial problems which were resolved and she is now happy with the care provided. She commented on the good communication with staff, who phoned her if there were any issues regarding her mothers condition. We spent time looking at the homes statement of purpose and service user guides. Both documents were up to date and relevant. We were told by the registered manager that she is in the process of changing the documents for the new Health and Social Care Act 2008 Regulations and outcomes. We looked at the records of 6 residents and each contained a contract of terms and conditions for living at the Wakefield. We looked at the needs assessments of 6 residents that were completed prior to moving into the home and then reviewed and up dated as necessary on a monthly basis.All needs assessments were comprehensive showing what care and support each individual required and how the home was going to meet their needs. Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each residents plan; they give a comprehensive overview of their health needs and act as an indicator of change in healthcare requirements. Evidence: Comments from residents and relatives: The staff are helpful and empathetic in their duty of care. Kind caring staff. Good personal attention given to individuals needs. Well trained staff who have assisted my mother in improving her quality of life. Care Homes for Older People Page 13 of 28 Evidence: We spent time looking at the care plans of 6 residents, all 6 care plans worked in conjunction with the care needs assessments. All of the care plans outlined the specific health and social care requirements of the residents with information showing how they were going to meet their needs. Care plan records showed that they are reviewed monthly and in some instances earlier when a change occured in an individuals health or wellbeing. The health care records in all 6 residents files looked at were relevant up to date and informative. The home uses a lot of different monitoring records to monitor the health of the residents including: A Mental Ability Assessment, Malnutrition Universal Screening Tool (MUST), Waterlow and Barthel. Records looked at also included monthly weight and observation records, mobilising, medication. All of the residents have access to the GP who visits the home twice a week. All 6 residents files included information on hospital appointments, appointments with health professionals and records of a visiting optician, dentist and chiropodist. One of the residents files also included detailed records completed by the tissue viability nurse showing the frequency of dressings changed, medication used and photographs at various stages in the recovery process. An up to date copy of the homes revised medication policy and procedure, issued in May 2010 was available on the units. The guidance is comprehensive, covering all aspects of the handling of medication. Registered Nurses (RNs) confirmed that they received annually training in the handling of medication. The storage of medication was looked at on 3 units, where all medication was found to be kept in a locked walkin room, maintained at a cool temperature. The storage of controlled drugs was checked on one unit where all drugs were kept locked in a metal wall cabinet. The controlled drugs record book was fully completed. Medication administration records seen were up to date. Staff confirmed that the administration of medication is audited monthly by the Clinical Nurse Manager. The GP practice that visits the home twice a week regularly reviews residents medication. The Unit Manager for one of the units for elderly frail people stated that as a result of reviews, the unit had been able to reduce the use of medication by 30 resulting in a number of residents remaining more alert. The staff induction training records show that all staff are trained in how to treat residents with dignity at all times. On the day of this site visit a member of staff was seen to escort a resident from the lounge to assist them with personal care. Unfortunately the member of staff was carrying an incontinence pad in view of the other residents. Care Homes for Older People Page 14 of 28 Evidence: The residents files looked at all had information in place regarding what support was requested for them in the planning for dealing with increasing infirmity, terminal illness and death. The home is providing palliative care. Included in the service users guide is information for residents, relatives and other services showing what support the home can provide in the circumstances of a residents death, including their request for their wishes and beliefs being adhered to by the staff. Care Homes for Older People Page 15 of 28 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. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.Routines are flexible and residents can make choices in areas of their life. Meals are very well balanced and highly nutritional and cater for varying cultural and dietary needs of the people who use the service. Evidence: The home employs 3 Activities Co-ordinators, who see each new resident to find out their interests and to introduce them to the programme of activities provided on in each unit. The two Activities Coordinators spoken with during the inspection confirmed that they had suitable resources to provide a range of group and individual activities. The Coordinator on the ground floor dementia care unit was observed to be engaged in supporting residents orientation and had planned a variety of individual activities for the morning. Photos around the home show residents and staff taking part in outings, and parties and events held at the home. On the week of the inspection a trip had taken place to the Royal Airforce Museum, with a second group going later in the week. Another Coordinator when interviewed did not have an up to date programme for residents and gave limited information regarding training she had attended. This was later followed up by the Manager who supplied a copy of the up to date Care Homes for Older People Page 16 of 28 Evidence: programme and confirmed that the member of staff had attended relevant training. The Training Manager undertook to ensure that this member of staff received some additional support regarding her work. The home has recruited voluntary workers to provide one to one support to a number of residents, for example to escort them to the local shops and cafes. Additional facilities have been created to meet residents social and psychological needs, including an internet cafe, OT kitchen and sensory room. The Manager stated that ways of supporting residents with IT and multi media who could not physically use a keyboard were being explored, for example the use of touchscreens and other specialised equipment. A Catholic priest attends on Sundays, visiting each unit, where he gives Holy Communion. An Anglican service for Holy Communion is held every Tuesday on the ground floor. Six relatives were spoken with during the inspection, all of whom visit several times a week. Each confirmed that communication with staff was good and they were phoned when there were any issues or concerns. Relatives also said that when they phoned the home for information, the phone was answered promptly and that they were able to speak to the relevant member of staff or staff phoned them back at the earliest opportunity. Two relatives had experience of placements in other homes and compared the care provided at The Wakefield very favourably. Attractive dining areas have been created on each unit, in particular on the third floor where residents have very good views from the dining room. At lunchtime staff were observed to be supporting residents with eating by sitting next to them, engaging in conversation and assisting discretely. We sampled two choices from the lunchtime menu, which were fresh, tasty and attractively presented. The Manager states in the AQAA that improvements in residents nutrition have taken place as the result of the employment of a full-time qualified Dietician and the implementation of nutritional screening. We spent time talking to the chef who was very passionate about the food provided to the residents. The chef spends time talking to all new residents and their relatives to discuss dietry and cultural requirements. The chef has recently implemented a fast food menu for younger adults who requested snack food. The menus looked at offered good variety, were nutritionally balanced and had been put in place by the chef and the dietician. Care Homes for Older People Page 17 of 28 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 using the 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 service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of formats including other languages. Evidence: We spent time looking at the homes complaint policy and procedure. The complaint procedure is in all of the residents rooms. On each floor there is a suggestion box with forms for residents, relatives and any other visitors in the home to complete. In discussion with the registered manager we were told that the suggestions raised are taken seriously and would be discussed at the residents and relatives meetings. There have been 13 complaints raised at the home in the last 12 months, we spent time looking at the complaints and looked at all of the investigaton records. The complaints looked at were dealt with in the relevant timescale and showed the outcome of each complaint. We looked at The Thank You Book with lots of compliment letters and thank you cards from residents, relatives and other people that visit the home. The book is kept by the main office for people to look at. We spent time discussing the safeguarding procedure with the registered manager and looking at the safeguarding records. The home has had 28 safeguarding incidents Care Homes for Older People Page 18 of 28 Evidence: reported in the last 12 months. The home is reporting all incidents to the CQC and the relevant commissioning local authorities.The home has got some residents with very complex care needs, this is reflected in the number of incidents that occur at the home. Care Homes for Older People Page 19 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the 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 provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who live there. Evidence: The Wakefield is located close to public transport, with Stamford Brook tube station and bus routes nearby. The building is over five floors, with units on each floor, with lift access. The ground floor is for 31 older people with dementia; the first floor for 35 elderly frail residents; the second floor 36 younger adults; the third floor 37 elderly frail people and younger adults and the fourth floor 17 younger adults. The home has a garden accessible to the ground floor unit and balconies on the upper floors. Residents rooms and communal areas are in a good state of decoration and repair. The home has its own maintenance staff who were seen working around the building during the inspection. A number of residents rooms seen contain a considerable number of their personal possessions, including furniture, photos and items reflecting their interests. The majority of bedrooms have an en suite shower and WC and washbasin, with a few having a WC and washbasin only. Relatives and residents spoken with confirmed that Care Homes for Older People Page 20 of 28 Evidence: they were happy with the bedrooms and did not need any additional furniture or equipment. Each floor has assisted bath and shower rooms, containing suitable equipment. There is a well equipped hairdressing room, which was in use at the time of the inspection. The home was clean, with no unpleasant odours at this unannounced visit. The Manager commented that it was planned to replace some of the carpets in the corridors with hard flooring, as even with regular steam cleaning it was impossible to keep them completely odour free. All laundry is carried out on site. Two relatives in discussion commented that clothing had been lost, although one said that it usually reappeared. One relative said that she took her mothers knitwear home to wash as garments had previously been washed at too high a temperature. The Manager stated that she was aware of some problems regarding residents clothing and that steps had been taken to improve the service, including extending the hours the laundry was open and appointing a Housekeeper, who had been in post for three months. She assessed that there had been progress but would continue to look at ways of improving the service. We spent time talking to the housekeeper who is very proud of the standard of hygiene and cleanliness of the home. The housekeeper told us that the domestic and laundry staff team work extremely hard to keep the home odour free and clean for the people living there. Care Homes for Older People Page 21 of 28 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. People using the 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 service ensures that all staff receive relevant training that is focussed on delivering improved outcomes for people using the service.The service puts a high level of importance on training and staff report that they are supported through training to meet the individual needs of people using the service. Evidence: During the day, each unit is staffed by two RNs, including the Unit Manager when on duty, and 5 or 6 Health Care Assistants (HCAs). In addition there are two physiotherapy staff, three Activity Coordinators, domestic, catering , maintenance, administration and reception staff. Staff training and professional practice are supported by the Training Manager and Clinical Nurse Manager. Six staff files were looked at. All were in good order, with records showing that a sound recruitment procedure was followed, with all criminal record and identy checks undertaken. A system of regularly checking the PIN numbers of RNs is in place. Training records show that staff complete manadatory training during their induction and receive annual refresher training. A programme of additional training based on the needs of the service has been developed. This includes dementia care training Care Homes for Older People Page 22 of 28 Evidence: provided with the University of Stirling. The Manager stated that the home prefers to recruit HCAs with at least NVQ2. Staff who do not have the award are enrolled on the next available intake. The home has achieved a good percentage of NVQ qualified staff with 82 achieving level 2, 3 or 4. Staff are supported by regular supervision, staff meetings and annual appraisal. Care Homes for Older People Page 23 of 28 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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.The manager has the required qualifications and experience and is competent to run the home.The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. Evidence: The registered manager has worked in health and social care for many years, she is a qualified RGN and RMH nurse and has many years experience of managing care homes.The registered manager has a degree in Teaching Nursing and Management and has achieved the level 4 NVQ. The registered manager told us that she attends regular training and seminars and forums to ensure she is up to date with all policies and procedures for care homes that provide nursing care. We spent time looking at the quality assurance procedure in the home. There are regular self audits taking place including medication, nutrition, and care documents. Care Homes for Older People Page 24 of 28 Evidence: There was a questionnaire given to all residents and staff in March 2010, the outcome was that 22 residents questionnaires were returned and 23 of staff. We looked at the outcome of the survey and there were positive comments including a resident stating the improvement in their wellbeing since living at the Wakefield. We looked at the monthly management audit records that includes looking at random residents files and ensuring that staff are completing records appropriately. All floors have a suggestion box located by the nursing station, we were told by the registered manager that suggestions are taken seriously and will be discussed in the resident and relative meetings if required. The registered manager has recently requested an audit for the servicing of beds and mattresses, this will take place on 9th June 2010. The home has Regulation 26 visits completed on a monthly basis, the records looked at show that these visits by the provider look at all areas of the care, support, health and environment records at the home. The finances of residents are kept by the financial administrator at the home. We spent time looking at the financial transaction records of 6 residents and the balance of their finances. All records looked at were in date and the correct balance was seen on each residents record. Not all residents have their finances kept by the home as there are lockable cabinets in all rooms for residents to keep their belongings. The home liaises closely with relatives, advocates and social workers for residents that are unable to make decisions about their finances. Staff are supported by regular supervision, staff meetings and annual appraisal. The care plan records are kept with the individual, all other records are kept secure in the administration office or the homes computer system that requires a password for access. Records looked at were up to date and relevant. Care staff do need to ensure that the daily records are legible and work in conjunction with the care plan. We spent time with a maintenance officer and looking at the health and safety checks completed on a daily, weekly and monthly basis. All health and safety records show that the home does ensure that all areas of the home are safe for the people living there, the staff and other visitors. Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 17 The registered manager to ensure that all daily records are legible. To show what service the residents have been provided with, in line with the care plan. 29/08/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 7 8 All staff to use the appropriate codes on the elimination records so that they are easily understood. All staff to ensure they sign and date fluid intake records to show that the record is up to date and being used appropriately. All staff to ensure that when they are escorting a resident to assist with personal care they do so with dignity and discretion. The laundry service needs to include a service for delicate clothes that should not be put in the washing machine or dryers. 3 10 4 26 Care Homes for Older People Page 27 of 28 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. © 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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