Care Home: The White House

What the care home does well The service does well against all of the national minimum standard outcome groups for older people. The home`s outcomes for health and personal care, environment, management and administration are all particularly impressive, scoring excellent quality ratings. The care home has no deficiencies and is very well regarded by all of the service users and relatives who commented. Staff too were complimentary in their observations about the home, both as a place to work and live. Typical comments received from people who use the service, relatives and staff included: "The staff could not have been better. They communicated with us brilliantly." "The staff are very caring." "Pleasant staff with a good understanding of elderly people with confusion." "The residents` needs come first." "The home does well with its care of residents - very homely, safe atmosphere. Staff are approachable and treat residents as individuals." "I feel that the new owners really do want to make the home a better place for our residents, with not only material things but much improved care, to a very high standard." "Since Mr Carter became manager I feel that our paperwork has improved immensely, also we appear to be doing lots more training, which obviously is essential to our jobs." "Many improvements have been made in recent months mainly to do with communication and refurbishment...the new owners and manager have brought a breath of fresh air to the place. Much more to keep residents motivated and alert - well done!" "We moved my father from X. Their management and staff could learn from The White House." "The home has more than lived up to expectations - this is exceptional." What has improved since the last inspection? This was the first key inspection since the home was acquired by new registered providers in September 2009. What the care home could do better: There are no requirements or recommendations resulting from this inspection. The service is committed to a person-centred approach, which respects the individuality of each service user, and to learning about how it can improve its quality. The registered manager is working towards achieving appropriate qualifications for his role. Key inspection report Care homes for older people Name: Address: The White House The White House 76A Darlington Road Hartburn Stockton on Tees TS18 5ET     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: Stephen Ellis     Date: 2 6 0 1 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 25 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 25 Information about the care home Name of care home: Address: The White House The White House 76A Darlington Road Hartburn Stockton on Tees TS18 5ET Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Martin Antony Carter Type of registration: Number of places registered: care home 29 Stephen Metcalf, Susan Metcalf, Louise Harvey Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Older persons not falling within any other category, , Code OP. Physical Disability Code PD 3 maximum number of places 29. Date of last inspection Brief description of the care home The White House is a well established care home for older people that was purchased by new owners in September 2009. It is well located, close to local community facilities and accessible by public transport and car. All bedrooms are spacious with en suite facilities and are used as single rooms. There are 3 floors, connected by passenger lift and stairs. The home is well equipped throughout. It aims to provide person centred Care Homes for Older People Page 4 of 25 0 0 Over 65 29 3 Brief description of the care home care, respecting the unique individuality of each person who uses its service. There is a garden area to the rear, plus paved car parking area to the front. At the time of inspection in January 2010, weekly fees charged ranged from £420 to £460. However, the actual amount paid by people depends on their individual circumstances. Care Homes for Older People Page 5 of 25 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 inspection was the first key inspection of the service since its purchase by new owners in September 2009. It took place on 26th January 2010 over 6 hours. The process of the inspection included discussions with 8 people who use the service, 2 relatives and 4 staff, plus the registered manager and registered providers. Prior to the inspection, written comments had been received from 6 people who use the service and/or their relatives, plus 9 members of staff. The inspection also involved scrutiny of a selection of statutory records, including 5 service user plans of care and 2 staff files, plus a sample of medicines records. The inspector examined other documents required to be kept, including some audit reports and maintenance records. He carried out a tour of the building, sampling representative rooms and facilities. The inspector had lunch with a group of people who use the service. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 25 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 8 of 25 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 who may use the service and their representatives have the information needed to choose a home that will meet their needs. Intermediate care is not provided. Evidence: People who use the service at The White House and relatives described the admission process in very positive terms. Typical comments included: The staff could not have been better. They communicated with us brilliantly. Full information about what the home has to offer was provided, including a service users guide, terms and conditions of residence, and contracts where appropriate. Copies of the terms and conditions were stored in separate care files at the home. Prospective service users were always welcome to come for trial stays before making their minds up. Two relatives confirmed that full assessments of peoples needs were carried out before people were admitted. Detailed assessments of need were found in five plans of care examined on the day of inspection. The services and facilities provided by the home were clearly designed to Care Homes for Older People Page 9 of 25 Evidence: meet the needs of the people to be admitted, including environmental standards and in terms of staffing levels and mix of skills. Care Homes for Older People Page 10 of 25 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: People who use the service and relatives were very pleased with the standard of care and support provided, including health care. Typical comments included: The staff are very caring. Pleasant staff with a good understanding of elderly people with confusion. The residents needs come first. The home does well with its care of residents - very homely, safe atmosphere. Staff are approachable and treat residents as individuals. Five plans of care were examined and were impressive, being detailed and comprehensive, based on all the activities of daily living, person centred in approach, up to date and regularly evaluated. They included sections devoted to: Care Planning, Life Story, Daily Logs, Bathing and bed logs, Medical Health Log, Weight record, Blood Pressure record, Admission form, Dependency Assessments, Nutritional Risk Assessments, Falls risk assessments, Braden Scale Risk Assessments, Mental Health Risk Assessment, Transfer and Mobility Assessments, and Sleeping Assessments. Good use was made of written risk assessments and plans of action by Care Homes for Older People Page 11 of 25 Evidence: which risks could be minimized. People who use the service or a relative had signed their plans of care, signifying consultation and agreement. These detailed records provided evidence of consistently good care, as vouched for by service users and relatives. The service has introduced a careful handover system between staff shifts that involves the senior staff from both shifts visiting each service user in their rooms together, to confirm the verbal handover that has taken place in the office. This practice seems to be working very well and helping to promote person centred care and professional accountability. Additional care files for each service user were found to contain records concerning: admission and assessment, care plan assessment, care plans revised and superseded, daily diary sheets, health visits and appointments, medicines, contract, finance, questionnaires and any complaints. The home has involved the local Falls Prevention Team and Sensory Loss Team to provide help and guidance in meeting the needs of people who would benefit from their expertise. For example, a sensor to detect movement has been installed in one bedroom and flashing light doorbells have been fitted to the doors of two other bedrooms accommodating people who are deaf. Medicine arrangements at the home were impressive, with good storage facilities, systems and procedures. Records of administration of medicines were well maintained. Any hand-written entries are double signed by staff and quantities of medicines are clearly recorded on the medicine administration record sheets. There are good arrangements for the disposal of unwanted medicines, again with good records. Staff responsible for medicines have completed Safe Handling of Medicines training. There are good policies and procedures in place and very good auditing arrangements, including monthly management checks and continual oversight by a medicines champion who is a senior member of staff within the home. People who wish to self-medicate may do so, subject to risk assessment, and each person has a lockable drawer in their bedroom to use for this purpose if required. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet peoples individual expectations. Evidence: People living at The White House were very positive in their comments about being treated with respect for their privacy and dignity. For example, staff always knocked on bedroom doors before entering and two deaf service users have had flashing light doorbells fitted to their bedroom doors for this purpose. Good quality, safe locks are fitted to bedroom doors, respecting peoples privacy and choice. All bedrooms also have a lockable drawer. People said they were free to spend their time as they wished. Their interests and needs were discussed and recorded so that staff at the home could try to satisfy them by respecting their lifestyle choices. They could could get up and go to bed when they liked and could pursue individual activities and interests. They could join in group activities and social events if they wanted to, and there was a part time activities coordinator to ensure a varied and stimulating programme from which people could choose. This included visiting entertainers, zoo lab (visits from unusual animals to see and hold), Wii games using consoles and large, flat screen television (e.g. bowling or water skiing), baking, quizzes, bingo, recall and reminiscence, and Care Homes for Older People Page 13 of 25 Evidence: armchair exercises. There is also a visiting hairdresser. Several people said they liked getting their own paper each day. Some people said they liked to go out for walks or outings with friends or family, and several did that while the inspector was there. Others said they enjoyed the activities in the home, or watching television and reading books. The home has a good supply of books, including audio versions, and also receives a visiting library service. Some people like to attend religious services conducted at the home. Again, peoples wishes in this area are respected. The home benefits from the involvement of one particular service user who acts as an assistant activities organiser. It also holds regular consultation meetings with service users and displays the minutes of these meetings on the notice board. The home publishes a monthly newsletter to keep people informed of significant events. It has 4 delightful budgerigars in the Conservatory lounge and a fish tank in the dining room. People living at the home take an active interest in their activities and welfare. The home is planning to develop a potting shed and greenhouse in the garden, plus an animal corner (e.g. rabbits and guinee pigs) as a result of consultations with people using the service. A visiting therapy dog is proving to be very popular. Peoples bedrooms were found to be personalised with ornaments and photographs belonging to the occupant. Some people had telephones in their bedrooms. Relatives said they were always made welcome when they visited. They could visit at any reasonable time. They described the staff as being very helpful, supportive and good at communicating, both with them and their relatives living at the home. There are good community links. A varied, appetising menu is supplied. Everyone spoken to on the day said that the meals were good or very good. The inspector enjoyed his meal with service users at lunchtime. Meals are usually taken in the homes well equipped and attractively decorated dining room, although people may eat their meals in their own rooms if they prefer. The home carries out nutritional assessments so that it can ensure people receive nourishing and appetising meals of their choice. The kitchen was noted to be well equipped, clean and well organised. The Environmental Health Officer will be visiting to carry out an assessment to award a quality rating for hygiene standards. Care Homes for Older People Page 14 of 25 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 who use the service are able to express their concerns and have access to a robust, effective complaints procedure, and are protected from abuse. Evidence: People living at The White House and relatives said that they were confident in approaching staff or management with any concern or complaint. They knew they would be listened to and taken seriously, with appropriate action taken wherever possible. The complaints procedure is displayed throughout the home and in the service users guide. They all described a friendly, enabling environment, where staff were genuinely concerned about their safety and welfare. An examination of staff files showed that good recruitment practices are followed, with careful checks and references being obtained. Each member of staff has had an enhanced criminal record bureau (CRB) check before starting employment, to confirm they are suitable to work in positions of trust with vulnerable adults. They go through careful induction and mandatory training, including safeguarding awareness, so that they can operate safely and protect people from abuse or neglect. Staff members confirmed that they had completed such training and were confident about reporting any suspicions of ill treatment, including whistle-blowing. The provider has a comprehensive policy concerning equality and diversity, both for service users and staff, which helps promote anti-discriminatory practice within the home. Good arrangements were observed for looking after small sums of service users money within the home, including individual accounts, double signatures, receipts and balance records, so that Care Homes for Older People Page 15 of 25 Evidence: people could have ready access to such money for various purchases they wished to make. Regular audits of such accounts and records are carried out routinely by management. Care Homes for Older People Page 16 of 25 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. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: A very high standard of provision is evident throughout the building. The home has been extensively upgraded since it was acquired by the new owners in September 2009. To date, 10 bedrooms, lounge, main hall, dining room and office have been refurbished. New, flat screen televisions have been installed in the lounge and conservatory, including a 50 model in the well equipped and comfortable conservatory. A new tumble dryer has been installed in the Laundry. A full time maintenance officer has been employed. A comprehensive cleaning rota has been implemented. The home is recruiting dedicated laundry staff. Spacious, well equipped accommodation is provided on each of the three floors. Corridors are wide and supplied with handrails. All bedrooms are lockable, spacious singles with en suite toilets and wash hand basins. The type of lock has been chosen for its safety and ease of use. Rooms are well designed and well furnished. Heating is supplied via guarded radiators and can be controlled within each room to suit individual requirements. There are attractive lounges and dining room on the ground floor. The home is very well lit, both by daylight and artificial lighting of good domestic quality. Communal toilets, bathrooms and shower rooms are spacious, well equipped and adapted, with Care Homes for Older People Page 17 of 25 Evidence: attractive decor. These are present across the home and are well positioned. There is a vertical passenger lift plus stairs to each floor. Throughout the building there are attractive pieces of furniture, ornaments, flowers and plants, and pictures on walls. Windows are well decorated with drapes and curtains. Colours are coordinated. People who use the service and relatives said that they liked the building very much and were impressed with the quality of the furnishings and facilities. Everyone commented very positively about the quality and atmosphere within the home. The home was fresh and clean throughout and well maintained. Equipment and facilities are being maintained and serviced according to schedules. Liquid soap and paper towels are supplied in all communal toilets and bathrooms and staff use alcohol gel for hand hygiene. Such gel is supplied in the entrance hall for visitors use. Infection control training is provided for staff. The homes Laundry is well equipped and well organised. Care Homes for Older People Page 18 of 25 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: On the day of inspection there were 22 people using the service. During the day between 8 am and 9 pm there are typically 4 members of care staff deployed, including a senior carer. At night, there are 2 care staff, including a senior. The home employs a part time activities coordinator (20 hours). In addition, there are catering staff (7.30 am to 6 pm) and domestic staff (8 am to 3 pm) in sufficient numbers for the needs of the home. The home is in the process of recruiting dedicated laundry staff. The full time manager is dedicated to management duties and the deputy manager also has some dedicated management time. There is an administrator and separate maintenance officer. There are good recruitment procedures operating, with careful checks (including enhanced criminal record bureau checks) and references being sought on prospective employees. All staff undergo induction and mandatory training, in line with Skills for Care guidance. Over 80 of permanent care staff have achieved National Vocational Qualifications (NVQ) in Care at level 2 or above,which is commendable, with the remainder working towards the award. There is on-going staff training and development, including dementia awareness, moving and handling, food hygiene, safeguarding and infection control. Staff training is based on training needs Care Homes for Older People Page 19 of 25 Evidence: assessments carried out at regular intervals (e.g. during staff supervision and appraisal sessions). Staff members confirmed the arrangements for recruitment, induction and training. They also said that they enjoyed working at the home, felt well supported and valued for their contribution to positive outcomes for people using the service. Service users and relatives were very positive in their comments about the caring practices of staff and the very good communication. Care Homes for Older People Page 20 of 25 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 management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a competent management team. Evidence: The registered manager at The White House is well experienced in caring for older people and he is working towards his qualifications in Care, Management and Leadership at National Vocational Qualifications (NVQ) level 4. He hopes to complete these during 2010. The management approach of the home creates an open, positive and inclusive atmosphere, as revealed in numerous positive comments from service users, relatives and staff. This approach is consistent with the registered providers philosophy of care, which is person-centred, and can be found in the homes statement of purpose and service users guide. Typical comments received included: I feel that the new owners really do want to make the home a better place for our residents, with not only material things but much improved care, to a very high standard. Since Mr Carter became manager I feel that our paperwork has improved Care Homes for Older People Page 21 of 25 Evidence: immensely, also we appear to be doing lots more training, which obviously is essential to our jobs. Many improvements have been made in recent months mainly to do with communication and refurbishment...the new owners and manager have brought a breath of fresh air to the place. Much more to keep residents motivated and alert well done! We moved my father from X. Their management and staff could learn from The White House. The home has more than lived up to expectations - this is exceptional. There are very good quality assurance systems operating, including monthly visits by the registered providers representative (regulation 26 visits), use and yearly analysis of written quality surveys completed by service users, their representatives and other stakeholders, such as visiting health and social care professionals. For example, The White House tries to complete 4 relatives surveys per month. The provider publishes summaries of such feedback. The manager welcomes face to face discussion of issues of concern with all stakeholders, either individually or in small groups. Regular meetings are held with service users about all matters of interest affecting their lives at the home. The manager carries out regular audits of all aspects of the service and is assisted in this task by the owners who visit frequently. The home has a medicines champion who helps promote safe practice. All policies and procedures are kept under review, as are staff training needs, in the light of statutory requirements and best practice guidance. The policies and procedures are closely interwoven with the homes quality assurance system. There are robust policies and procedures in place for the safekeeping of service users personal monies and valuables. Small sums of personal monies are stored securely in individual accounts, along with receipts and records of transactions. Double signatures are used against each transaction, for added protection. The manager is aiming to ensure that each member of care staff receives an annual appraisal and six, one-to-one supervision sessions each year. There was evidence of appraisals and supervision in staff files. There are very good health and safety policies and procedures for safe working practices in the home. These are reinforced by good staff training in health and safety issues, as confirmed in staff files and comments received from staff and management. Health and Safety issues are routinely discussed in staff meetings and monitored through management audits. There are monthly health and safety summary reports and monthly management reviews. Members of care staff carry out daily health and safety checks plus quality assurance checks using checklists. Maintenance records are kept and a sample confirmed that the home is well maintained with servicing scheduled at regular intervals. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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). 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