Care Home: Thomas Henshaw Court

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What the care home does well During the visit staff told us how much they liked working in Thomas Henshaw and demonstrated a warm and caring attitude. Examples were seen throughout the visit were the service had recognised and dealt with people`s changing health care needs. People living in the service told us that the staff were "fantastic", "can`t do enough for you" and "could not ask for better". Staff have regular supervision to maintain their skills. Training is in place that supports them to develop new skills and meet people`s individual needs. The Service has several different areas that individuals can choose to sit in. Bedrooms are called flats. This is because each bedroom is sufficient to support a seating area, bedroom area, kitchenette and ensuite bathroom. People living in the service and their relatives were particularly impressive with the amount of personal space available. They were also sure that it helped maintain people`s independence. There are a variety of good practice examples in the service that show how the service makes sure that people living in the home views are used to influence the service. This includes regular activities that prompte independence, a robust complaints process, surveys, meetings and good communication amongst the staff team. All people moving into the service are offered the opportunity to decide if the service can meet their needs. Information about the service is updated regularly with copies available in the main office. What has improved since the last inspection? The manager told us that she believes that the choices of activities has increased. People living in the service thought that the activities were always good but there was a better range in place. Environment has been updated with new bathroom designed to meet some dementia care needs refurbished and there are plans for another bathroom to refurbished. Regular audits (checks) are in place in several practice areas of the service to maintain quality. The service has been able to increase the means of communication with people who live in the service and their families. What the care home could do better: The service meet all regulations and no requirements were made following this visit. Some good practice recommendations were made. The information within the home known as the statement of purpose is in need of updating in order that it supplies clear, accurate information about the services availiable. Care plans are in place but are not person centred and are a complicated system that means that format is not easily accessible the people living in the service. Also with in health and personal care are medications. People living in the service receive the medications prescribed by the medical profession. Some of the records such as riskassessments for self-medicating people were not sufficient to reduce any identified risks. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thomas Henshaw Court 105 Norwood Road Southport Merseyside PR8 6EL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Garrity     Date: 2 3 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Thomas Henshaw Court 105 Norwood Road Southport Merseyside PR8 6EL 01704533317 01704534616 cathy.sutton@anchor.org.uk 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) : Anchor Trust care home 43 Number of places (if applicable): Under 65 Over 65 43 physical disability Additional conditions: 9 Service users to include up to 43 in the category of Physical Disability (E) Service users to include up to 9 in the category of Physical Disability Date of last inspection Brief description of the care home Thomas Henshaw Court is a purpose built care home registered to provide support to people with an age related condition. It is also able to support 9 people under retirement age. The service is owned and maintained by Anchor Trust, who also owns a variety of care services including other care homes. Accommodation is provided in 42 self-contained flats, all of which have an en-suite bathroom and a kitchenette. The current scale of charges at the home are from 389 pounds up to 445 pounds per week, with additional charges for hairdressing, chiropody, newspapers, beautician services. There is also a third party charge of 30 pounds for people funded by Social Services. Third party top up are used to bring the fees paid for by social services up to the services standard fee and can not be paid by the person living in the service or social services. Care Homes for Older People Page 4 of 27 Brief description of the care home Thomas Henshaws has information about its services available in the main office of the service and copy given to all people considering living in the service. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 visit was carried out over a period of one day. We (the commission) arrived at the home at 09:30 and left at 19:30. We spoke with 10 people who live in the home, 3 visitor, 6 staff, deputy manager and the manager. We completed the inspection by a visit to Thomas Henshaw, a review took place of many of the records available in the home and our offices. These included individuals care records, staff rota, staff files, maintenance records, menus, questionnaires, medications and information sent to us by the manager. The service sent us self audit known as an AQAA, which contains information about how the service will increase its quality. This visit included discussions with people who Care Homes for Older People Page 6 of 27 live in the home, visitors, staff and management. We also received information from Social Services and this information is included within this report. The arrangements for equality and diversity were discussed during the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with their choices. What the care home does well: What has improved since the last inspection? What they could do better: The service meet all regulations and no requirements were made following this visit. Some good practice recommendations were made. The information within the home known as the statement of purpose is in need of updating in order that it supplies clear, accurate information about the services availiable. Care plans are in place but are not person centred and are a complicated system that means that format is not easily accessible the people living in the service. Also with in health and personal care are medications. People living in the service receive the medications prescribed by the medical profession. Some of the records such as risk Care Homes for Older People Page 8 of 27 assessments for self-medicating people were not sufficient to reduce any identified risks. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Everyone wishing to move into the service has the oppertunity to decide if Thomas Henshaws staff can meet their needs. Evidence: The AQAA for the service told us that, All service users have a pre-admission assessment prior to admission. Prospective clients and their families, friends or representative are encouraged to visit the home. All pre-admission assessments are carried out by staff qualified to do so. We looked at the records of people who have come to live in the service and noticed that all had their needs looked at (a preadmission assessment) before they moved in. People living in the service told us I came to look around. We were all invited to stay to lunch. The room they offered me was so nice and the staff so kind it seemed perfect. Once a person has moved in to the service the staff team do a longer assessment that Care Homes for Older People Page 11 of 27 Evidence: looks a little more closely at their needs. We looked at these assessments and all had been completed. The assessments did give staff the opportunity to look at peoples personal preferences and choices both food and interests. This space was not very large and did not support staff to fully explore these areas with people who live in the service. The manager described to us how they make sure that once someone moves in the staff try to understand their personal choices and aim to meet their needs. All people moving into the home are provided with information known as a statement of purpose (what services the home will provide) and a service user guide (how these services will be provided). We looked at this information and noticed that the manager was reviewing this in order to update them. We discussed with the manager the need to make clear within the service users guide the criteria for admission to the service and the arrangements for emergency admissions. The information also needed to make clear the diversity of needs that the service caters for. Thomas Henshaws was originally registered for people with a visual impairment. In recent years they have registered the service for people with an age related condition. As a result the service is registered to support younger people as well as people with an age related condition. The arrangements for meeting the diversity of peoples needs are not detailed in the statement of purpose or the service users guide. The information shown to us was available in different formats such as Braille or tape upon request. The staff working in the service told us that they explain all information to people living in the home when they move in. During our visit we observed staff communicating with people living in the service using a variety of means. People living in the home told us that they were shown information and that staff spent time communicating with them about the contents of any information. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people living in the service are met. People living in the service are supported to maintain their independence and have their dignity needs met. Evidence: We spoke to people living in the service who told us staff are absolutely fantastic they understand what we need and could not live anywhere better, its a great home. Relatives told us that they are faultless never have any concerns, they treat everyone here with such respect and dignity its so nice to see and understand that they are treated very well. Several staff have undertaken training to become dignity champions with the intention of making the maintenance of dignity and independence a priority of the service. We looked at the care records of people who live in the service. All external professionals such as district nurses and doctors are appropriately contacted if changes in peoples health occur. Care plans are written when people move into the home and Care Homes for Older People Page 13 of 27 Evidence: updated as peoples needs change. People who live in the home are encouraged to read and sign care plans when they are written. When we looked at the care plans we noticed that they were available in the main office and were very large. Staff told us that they found the care records were too long, difficult to read, not easy to get right or keep up to date and dont read them very often they are too big to spend the time on. People living in the service told us, us I can ask to see my plan, staff asked me to sign it ages ago and Staff would discuss it with me if I wanted. They keep them in the office so I cant just peek at it, The system for care records and plans is long, the records shown were mainly up to date and gave an overview of the actions needed to meet the needs of people living in the service. We looked at the management of medications the service has a variety of checks (audits) in place that are done to make sure that medications are managed correctly. We noticed that when issues had been identified such as a medication not being signed for the management team addressed these. People living in the service are offered support to manage their own medications to maintain their independence. We looked at the assessment of risk and the plan to manage the risk safely for people managing their own medications. One person had a risk assessment that did not detail the medications they managed or explain what the staff needed to do to maintain the persons safely fully. Another person managed an external preparation and there was no risk assessment in place for this. On reviewing the medication records we noted that in all but one case people received their medications correctly. In the one case the persons antibiotics had not been given correctly. Medications were correctly stored and staff had all received training in giving out medications. There were examples of good practice including photographs of the people to who the medications were to be given and policies and procedures that are kept up to date. Several of the staff in the service have received training in becoming dignity champions. The intention of this training is to maintain the dignity and independence of people living in the service. Observations through the day showed that staff respected the people that they supported, spoke in an appropriate manner, using humor and banter as appropriate. Several people in the service are visually and hearing impaired. Staff observed communicated with people with these needs in a manner that maintained their independence. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run in a manner to maintain peoples independence and provide them with a daily routine that meets their needs. Evidence: The AQAA from the home told us that, there is a Full time activity coordinator, who is trained to drive the bus. A varied range of activities on offer, e.g. Themed meals, crafts, preserve making, bingo, dominoes, swimming, bowls, horse riding, mystery tour, meals out, karaoke, cheese and wine and theatre trips. When we looked we noticed that there was a variety of activities available. Some people have been on holiday, others are undertaking a computer training course and daily group activities are available in the home. There is some budget allocated to activities from Anchor who own the service and fund raising adds substantial amounts to this fund. People who live in the service use some of their activities to fund raise such as handmade cards and homemade preserves. A notice board is available that shows some of the weekly programme. This is on a board that is cluttered with other items and is difficult to clearly determine what is on Care Homes for Older People Page 15 of 27 Evidence: offer. The service also makes loud speaker announcements to people who live in the service and staff sign to those who need it what is available each day. People spoken with told us, there are lots of different things to do and its easily the best home I have ever seen. I can pretty much have my own life as I want. Family members spoken with, we get involved with lots of stuff. There is always some party or celebration happening. It feels like a really up beat place to visit. Menus are regularly changed a copy is included in service users guide. Choices are offered at each meal. Staff also go round and discuss the meals with people so they can be aware of what is on offer. There is a weekly menu printed available in the dining room and a Braille menu is also available. These are not suitable for people with dementia needs and the service is considering putting in place picture menus. Meals do not indicate special diets such as soft diets, or diabetic there are people living in the service who have these needs. All people spoken with are aware that there is a choice and that they can also ask for certain vegetables and anything that is not on the menu. Each person has a small kitchen in their living area and can access drinks and snacks as they see fit. Clear instructions are available for anyone needing a food supplement and staff monitor peoples weights in order to make sure that they are eating a diet that meets their needs. All people spoken with said food is great, always something I like to eat, cooks are excellent and not a single problem with the food its always very good. The service encourages involvement from the families including surveys, comments on the service both positive and negative, involvement in activities and events. Relatives are welcomed to visit Thomas Henshaws. Relatives spoken with said, its a great place. Its like coming to visit her in a flat with lots of other stuff going on, cant wish for anywhere better. Theres stuff to join in if wanted. We are always made very welcome by the staff and can stay and have a meal if we want. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the service believe that any concerns they have will be dealt with. Evidence: We looked at the arrangements that the service had for recognising and dealing with concerns. The AQAA for the service told us Listen to all complaints and deal with them according to Anchor policy .Encourage feedback from service users and families. Customer service team within Anchor have been set up and are proactive in assisting with dealing with complaints. Records in the service showed that the manager treats all complaints seriously. There have been 12 concerns raised with the service. There were logs that showed what these concerns were and what actions had been taken to address the concerns. People living in the home told us, I know who Id complain to or tell anything I was upset about, Staff try hard to make sure everything is right. Ive never had a worry but if I did Id tell them. Im sure they would make it right. Information regarding how to raise concerns both in writing and informally is available in the home. Staff are aware that they need to discuss all concerns with the manager or whoever is in charge of the service at the time. We spoke with relatives who told us, they have a complaints procedure I think. Id never have any issue with the home. I would talk to the manager if I thought there was a problem. Staff receive training in recognising and dealing with serious concerns known as Care Homes for Older People Page 17 of 27 Evidence: safeguarding or abuse issues. Training is on-going to keep staff up to date and also as part of their induction when they start working in Thomas Henshaws. Staff records recorded that staff had also been updated in this training. Staff spoke with were not aware of what actions needed to be taken if an allegation was made. They would have taken some inappropriate action such as discussing the matter with the person making the allegation or the person accused. These actions could mean that is the matter needed a police investigation this may not be able to take place. There was a policy and procedure in the service that encouraged staff to report their concerns and advised the manager to contact a representative of Anchor who owns the home. The policy did not give staff guidance on how allegations of this nature should be dealt with, such as the home can not investigate until Social Services has agreed this. Staff were very clear that they would be able to recognise and report any concerns including more serious safeguarding issues. They told us that they had not had any allegations of this nature made against Thomas Henshaws. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a comfortable, clean and well maintained home to live in. Evidence: The service is purpose built and has been adapted to meet the different needs of the people who live there. Handrails have tabs on them that indicate people with sight issues that there is an exit nearby. There are specialised bathing areas in the service. One bathroom has been recently refurbished and adaptations made to support people with dementia needs. There is also a lounge, dinning room kitchen and laundry facilities. Personal space for the people who live is a large bedroom/sitting area, kitchenette and ensuite bathrooms. People living in the home told us that bedrooms known as flats are fantastic, lots of space. Can bring in all my things. The suite is my own as is the bed. Bedrooms seen had been personalised by the people living in them. The AQAA for the home told us that, Home Improvement programme on going. All issues of concern re-cleanliness are addressed in a timely manner to prevent unpleasant smells permeating through the home. When we looked around the home we noticed that the service is well maintained. There are cleaning schedules to help staff maintain the cleanliness of the main areas of the home such as kitchens and Care Homes for Older People Page 19 of 27 Evidence: peoples own bedrooms. When we visited the service there was a pandemic alert for swine flu. The service had developed a plan of how it would deal with such an event. An outbreak of an infection had been alerted to us and the manager had put into place a plan that helped prevent any further infection from spreading. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for employing and training staff are effective in maintaining the safety and meeting the needs of people who live in Thomas Henshaws. Evidence: People living in the service and their relatives told us, its a fantastic home, the staff are really good, nothing is too much for them and I cant fault any of the staff all are without exception very good. Observations during the visit showed that staff were very able to communicate well with people living in the service and light-hearted banter was used to have a laugh and a joke. We looked at how staff were recruited. When we looked at staff records we noticed that staffing files for people recruited when the home was owned by a different organisation were not always fully up to date. In one case we could only locate one reference. There was a log available that showed two references had been received and the second appears to have been lost. All but one staff member had been checked including references and a police check before they started working. Relevant checks on staffs past experience assist in making sure that they are suitable to work with people living in the home. Thomas Henshaws has seven volunteers who help with activities. All of these had, had Care Homes for Older People Page 21 of 27 Evidence: a CRB check and references taken. This action makes sure that people living in the service are protected from people who may not be suitable to support them. The AQAA for the service told us that, training was in place for staff. It did not detail what training staff had had in the last 12 months or what training was planned for care staff in the future. There was a plan to provide training for the activities co-ordinator, house keepers and bank staff. We looked at the training in place in the service and noticed that staff were up to date in key training such as moving and handling, infection control and safeguarding of adults. They had also received training specific to peoples needs and several staff were undertaking National Vocational Qualifications (a qualification for staff working in care services). A training plan was in place that highlighted what training staff had done and when renewals of training were due. Staff spoken with told us that they had received lots of different training in the last 12 months and that they were able to identify if they needed further training. All staff had records that showed that they received an induction that covered the needs of the people they support. Particular training such as medications was available to staff depending on their job role. Staff spoken with found that the induction was of benefit when they first started working in Thomas Henshaws. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective management arrangements mke sure that care practices promote peoples rights and best interests. Evidence: The manager and deputy manager was in charge at the time of this visit. Both demonstrated that they were keen to provide a good level of service and in managing the service in the best interests of the people living and working there. The manager is registered with us. Both the manager and the deputy told us of the levels of supervision and support that they received from Anchor. They were clear that they were given opportunities to develop their own personal skills. The providers representative makes regular visits to the service both to support the management team and to look at the quality of the service. Staff spoke with told us great manager and deputy, could not ask for more support and best manager I have worked for, she really keeps us on the ball. People living in the service told us all the staff are great. But if you need to see the manager shes always happy to chat. Visitors to the Care Homes for Older People Page 23 of 27 Evidence: service told us that they found all the staff approachable and felt that the manager and the deputy take time to listen to their views. In recent months the manager has made sure that relatives are included in the ways that the service runs and have been asked to give feedback on the service provided. The service has a quality assurance system in place that seeks and acts on the views of people living in the service. This covers a variety of areas such as housekeeping, personal care, staff attitudes and meals. As a result of opinions on the last surveys the manager put into place a series of meeting for people who live in the home in relation to the quality of the food. The last few meetings discussed these at length and put into place suggested actions. The service has a number of tools to check on the quality of the service including reviews of medication, care plans and staff meetings. People living in the home told us that the service is run to meet their needs and that there opportunities for them to discuss what they want the service to offer. We looked at how peoples personal monies were managed. Some people take their own funds and a lockable space is provided in their bedrooms to help them keep this money secure. Other people the home minds their money for them. Peoples funds are readily available for them to access as they would wish. Records are available that shows any deductions or income as such people living in the service are kept informed as to what funds they have available. Staff receive regular training in all aspects of health and safety management. Regular checks such as electrics, gas and fire equipment is in place to help maintain the safety of people living in the service. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The sop needs to include a full admission criteria and any arrangements for emergency admissions. Additionally the diversity of needs of people living in the service needs to be clearly detailed including what arrangements are in place to meet individual needs. Consideration should be made to make care plans person centred, user friendly and available in formats that meet the needs of people living in the service. Risk assessments for people who are self medicating need to be reviewed and updated. Where individuals manage their own medications staff need to have full instructions regarding any potential risks and how to minimise these. 2 7 3 9 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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