Care Home: Truscott Manor

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What the care home does well The residents are cared for in a very dedicated and respectful manner in wellmaintained and comfortable surroundings. Residents were relaxed and all spoken to stated that they are treated with care and respect. Activities provided in the home are varied and suit the individual needs of the residents. The residents stated that they enjoy these activities and have choice on whether to join in. Staff said they are well supported and that their training provides a good knowledge base to meet residents needs appropriately. The quality of the documentation in the home is in good order, up to date and readily available. The home has a dedicated cleaning staff, who ensure the home is clean, hygienic and fresh smelling throughout. Gold Standard Framework training for staff ensures they have knowledge to positively manage `end of life` care in the home. End of live care assessments seen are comprehensive and include all aspects of residents needs and preferences Comments from residents included: `I think it`s very nice here. They are very efficient and know what their doing` `They are like a family and are so lovely` `Its the most peaceful place and we would recommend it to anybody` `The room is warm and cosy and we have lots of pictures and personal belongings around to make us feel at home.` The expert by experience said `My experience at Truscott Manor was very positive. From what I could see it was well staffed, well equipped, had a nice ambience and staff and residents all seemed happy to be there. The residents and relative that I spoke to all said they were very happy with Truscott Manor... the staff, the care and all other aspects of their life at the home.` What has improved since the last inspection? Since the last inspection, several aspects of the home have been improved upon; Care plan documents contain more comprehensive information about the residents needs and preferences Some areas of the home have been re-furbished and new furniture purchased including two new sluice and washing machines. The fire escape has recently been repaired in line with the Fire Department recommendations. Pot holes in the drive way were being filled and made good on the day of the visit. What the care home could do better: The home needs to continue to develop on identified areas of improvement, outlined in their AQAA. The refurbishment plans for the home need to continue to ensure the home is safe and comfortable for the people who live and work there. A requirement was made following the visit, to ensure all staff are up to date with their refresher training in respect of fire safety, infection control and dementia care. Key inspection report Care homes for older people Name: Address: Truscott Manor Lewes Road East Grinstead West Sussex RH19 3SU     The quality rating for this care home is:   two star good 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: Beth Tye     Date: 2 1 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 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) 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 28 Information about the care home Name of care home: Address: Truscott Manor Lewes Road East Grinstead West Sussex RH19 3SU 01342314458 01342317240 info@truscott.wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Frannan International Limited care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 41 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Truscott Manor is a care home able to provide nursing care and accommodation for 41 people in the category of older people. Frannan International Ltd is the registered provider and the Responsible Individual on behalf of the company is Mrs N. Kassam. The home is located in a rural setting in extensive grounds on the outskirts of East Grinstead, shops and other amenities are a short drive away. Private accommodation is on two floors, a passenger lift is available but does not serve all rooms. Communal accommodation is available on the ground floor. The majority of the homes bedrooms are single and 19 have en-suite facilities. Care Homes for Older People Page 4 of 28 Over 65 41 0 Brief description of the care home The fees currently being charged by the home are from #545 to #775 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: two star good 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 service has been rated as two stars, which is a Good quality rating. The site visit was undertaken by Ms Beth Tye, as part of the inspection process. It took place on 21st July 2009 between 10.30 and 3.15pm. The inspector was accompanied by an expert by experience Mr Nigel Ryan. During the visit Mr Ryan spoke to several residents, staff and a relative to gain an insight into how the home is run. Mr Ryans findings have been included in the body of this report. The registered manager facilitated the inspection during the visit. An Annual Audit Questionnaire Assessment had been completed by the manager and forwarded to the Commission prior to the visit. All documents required on the day were made available. 16 comment cards were received from residents, many filled out with the aid of relatives who added their own comments. Four were received from professionals. Care Homes for Older People Page 6 of 28 These comments were all positive. Comments from residents, families and professionals elicited by the homes own quality assurance systems were seen in the home and these were also very positive. We looked at four residents care plans, daily recording, health charts and medicine administration charts. We spoke to a relative and five residents, all spoke very highly of the home and the care offered, which they said was delivered in a respectful manner. They also stated that the activities were appropriate. The atmosphere in the home was very relaxed and sociable. Many of the residents were sitting in the lounge socialising. Others were seen in their rooms listening to music, reading, watching television or with visitors. This report is compiled using information as described above and also information held on file at the Commission. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? Since the last inspection, several aspects of the home have been improved upon; Care plan documents contain more comprehensive information about the residents needs and preferences Some areas of the home have been re-furbished and new furniture purchased including two new sluice and washing machines. The fire escape has recently been repaired in line with the Fire Department recommendations. Pot holes in the drive way were being filled and made good on the day of the visit. Care Homes for Older People Page 8 of 28 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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. Residents are assessed prior to admission. All residents are provided with up to date information about the service. The Quality of this outcome area is good. Evidence: The manager or her deputy assess all the residents prior to their admission to the home. All residents spoken with had the Statement of Purpose and Service Users Guide in their rooms and the complaints procedure was included in the Statement of Purpose and Service Users Guide and displayed on the notice board in the hall. All the residents had contracts that gave up-to-date information about the service and responsibilities for this. The home provides respite care but not inter-mediate care. Care Homes for Older People Page 11 of 28 Evidence: The expert by experience gained feedback from relatives and residents about the admissions process which confirmed people are able to visit the home prior to admission. One relative had looked at three care homes before choosing Truscott Manor four years ago, following a visit. Two residents who have been at Truscott Manor for a year were recommended by a friend. Their nephew and his wife visited it before a decision was made. 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. All residents have care plan in place, ensuring healthcare needs are met appropriately by staff in the home. Risk assessments and reviews for residents are recorded on files. Medication procedures are adhered to and staff have received medication training as part of their induction. This promotes good practice when dealing with medication. The quality of this outcome area is excellent. This judgement was made from available evidence including a visit to the service. Evidence: Four care plans looked at during the visit and all contained detailed information relating to health and personal care needs of residents. Staff stated this information informed them of individual needs and how to respond to them appropriately. In relation to health and personal care needs, observation and feedback from residents reflected that they are treated with respect by staff, and their privacy and dignity is upheld. The inspector found that since the last inspection care plans had been updated with Care Homes for Older People Page 13 of 28 Evidence: more detailed information relating to health and social care needs of individuals. There are clear objectives and actions for each identified need recorded so staff can be clear about their roles and appropriate responses to residents. All plans had been reviewed on a monthly basis and changes recorded in detail. There were risk assessments in place identifying hazards to residents alongside action plans to inform staff how to minimise and manage risk areas. Staff handover at each of the shift changes during the day ensures each staff member is fully aware of the immediate needs of each resident. This information is transferred to daily records in the care plans. All daily care records seen were up to date and in good order. Any specialist health needs are referred to community-based professionals. These include physiotherapists, dentist, optician, chiropodist and community nurses. Correspondence held in individual files supported this. Examination of records, feedback and discussion with the residents and their relatives confirmed good practice is maintained in the home and residents are treated with dignity and respect. The homes medication procedures ensure safe practice with the handling, administration, storage and disposal of medicines. Nursing staff who administer the medicines to the residents have been assessed as competent to undertake the procedure. On examining MAR charts they were accurate and there were no gaps noted in recording of administration of medicines. Where appropriate care plans include comprehensive information in line with the Gold Standards end of life framework and Liverpool Care pathways scheme. This provides residents and their families an opportunity to discuss and plan interventions for residents in respect of palliative care. Training undertaken by staff ensures they have the opportunity for reflective practice and extensive reviews around end of life care. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Truscott Manor are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate and residents are encouraged to maintain contact with all their friends and family, wherever possible. The food is of a good standard and offers a choice of menu. Evidence: An on-going programme of activities are organised at the home, offering stimulation to those residents who are less able to explore interests outside the home. Life stories, including hobbies and preferences of individuals are detailed on care plans to ensure the activities provided are in line with personal interests and needs. The home has a part time activities co-ordinator in post who organises an on going activities plan. This includes; reminiscence work, art therapy, games, quizzes, music and skittles. Sufficient staff resources are provided to allow time for one to one activities and stimulation. One staff member said often in the afternoon we are able to spend time with the residents which means we all get to know them well and understand them better. The expert by experience spoke to residents about the activities and reported Two Care Homes for Older People Page 15 of 28 Evidence: residents were very complimentary about the range of activities on offer and showed me the programme for July that they had. They did both go to the Summer Party on 4th July, which they enjoyed because there was live music and singing. The couple are used to pets so they appreciate the Pat a Dog project monthly visits. The home maintenance man had also fitted a bird table to their window. Another resident said they look forward to the physiotherapist who visits on Tuesdays, the hairdresser on Thursdays and the masseuse who comes in occasionally. Both resdients commented on the lovely view of the grounds backing onto Ashurst Park that they had from their window. They stated that their nephew and his wife visits regularly too and commented on the pleasant nature of the staff at the home. Religious and cultural needs are identified as part of the care planning process. Communion is held on a regular basis and the home has a songs of praise evening once a month. An activities plan is on display in the home and residents are provided with a copy, to enable them to plan their time. On the whole, routines are flexible to meet residents needs. Residents confirmed that they can choose what they want to do as far as social events, routines and also what times they go to bed and get up in the morning. Flexibility enables individuals to have choice and express a preference in their daily lives. Residents and relatives confirmed that the visiting arrangements for the home are open and visitors can come and go as they please and are made welcome by the staff. Feedback forms confirmed relatives felt welcomed and involved by the home. During the visit staff were observed interacting with the residents. They knocked on doors prior to entering, knelt down to their level to converse with them and offered choice where possible. Staff were seen throughout the day being respectful, kind and sensitive to residents needs. The expert by experience reported The general feeling was that there was a good rapport between the staff and residents. The residents and relative spoken with had nothing but praise for the staff and their care and attentive nature. Throughout the inspection I noted all the staff I encountered had a warm and friendly demeanour. Residents and relatives have the opportunity to attend meetings within the home, so they can comment on how they view the home and contribute to decision-making. Care Homes for Older People Page 16 of 28 Evidence: The menu offered at Truscott Manor offers a wide range of balanced, home cooked food. The cook is experienced and qualified to fulfil her role. When spoken with during the visit it was clear she was familiar with dietary requirements of the residents. The menu offered at the home takes in to account the preferences of residents and specialist dietary needs, all of which are recorded on daily records and care plans. This promotes choice for the residents and provides an opportunity for them to eat what they prefer. The expert by experience reported My impression whilst sat in the dining area was that the residents that were dining were relaxed and comfortable. They seemed happy with their meals and were talking and interacting with each other across tables. My impression overall was that staff during the mealtime appeared very competent and caring. There were lots of warm smiles and willingness to assist where appropriate 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. The home has provided residents with information in respect of complaints. Residents and their families are aware of their rights and how to complain. All staff have completed training on adult abuse awareness. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: The complaints procedure was displayed in the hallway with the Visitors Book and included in the Statement of Purpose and Service Users Guide. The complaints log detailed three complaints in the past year, all of which have been resolved within appropriate timescales. Two residents told the inspector if there was anything they were unhappy with anything, they would tell the staff or manager. The staff confirmed that they had completed Adult Protection Training in the home and in addition had covered this area in their National Vocational Qualification and induction. The staff files seen contained the relevant documentation, including Criminal Records Bureau enhanced checks and relevant references. This demonstrates the home has a Care Homes for Older People Page 18 of 28 Evidence: robust employment procedure which protects the welfare of the residents. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable environment and have access to safe and comfortable indoor and outdoor communal facilities. Standards of hygiene and cleanliness are good throughout the home. Records and feedback demonstrate that staff have completed infection control and fire training but refresher courses are overdue. A requirement was made to ensure this is undertaken (see Staffing section) The quality of this outcome area is adequate. This judgement was made from available evidence including a visit to the service. Evidence: The inspector walked around the home and examined specialist equipment to ensure residents are safe and enjoy surroundings. Although some areas of the home are worn and would benefit from redecoration and re-carpeting. The home is clean, fresh smelling and well presented throughout. The on going maintenance plans for the premises include new carpeting and redecoration of communal areas. Records demonstrate that staff have all completed health and safety and infection control training. This needs to be updated and the manager is in the process of arranging refresher courses for staff this year. Staff awareness will promote residents Care Homes for Older People Page 20 of 28 Evidence: safety and the risk of infection is minimized and where possible eliminated. Hand gel is available in dispensers on all corridors. Health and safety signs are displayed throughout the building, offering guidance to staff, residents and visitors about safety procedures. The indoor communal areas, garden and bedrooms are safe and well arranged to maximise independence without compromising a sense of freedom. Outdoor garden furniture was well placed to encourage the residents to move in and out of the secure rear garden. Residents bedrooms are decorated prior to each new admission. They are furnished and arranged to accommodate the needs of residents. The double rooms have screens to protect residents using the wash hand basins and promote privacy and dignity. Radiators are guarded and thermostatic valves in place to restrict water temperatures to safe levels and protect residents from burns and scalds. Provision of a bath-slide, grab rails and raised seating in toilets provide individuals with limited mobility more independence. A call bell is provided in every room so staff are aware and can attend an emergency situation should it arise. The home has environmental risk assessments in place and there are two on site maintenance workers who complete any work required on a daily basis. This ensures the home is kept safe and free from hazards. Records showed all fire, health and safety checks are regularly undertaken and up to date. All equipment is regularly serviced and certificates held on file. Fire training for staff has been undertaken but records indicated refresher training was overdue for some staff. The manager stated this will be included in the mandatory staff refresher training organised for later in the year. On the day of the visit the home was having potholes filled in the driveway, this had been identified as a potential hazard to people using and visiting the home. The Registered Provider and management continue to improve the facilities for residents and an on going maintenance plan for the home is in place. 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. The staff numbers are sufficient to meet the assessed needs of residents. Recruitment procedures and record keeping are robust to ensure that residents are in safe hands at all times. Staff training includes specialist areas to meet residents assessed needs. Some staff training is overdue and a requirement has been made to ensure staff undertake refresher courses as needed, at the earliest opportunity. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service. Evidence: The inspector observed that the staffing rota, examined in conjunction with care plans, showed that the staffing levels do ensure residents needs can be met at all times. The inspector observed that staff spent quality time with residents and treated them with dignity and respect. Staff were observed responding and communicating appropriately to residents in line with their levels of understanding and ability. The home does not use agency staff and existing staff cover staff absences when required. The inspector observed that domestic and catering roles are staffed separately. Staff members, who were spoken with in private, said I like working here, the residents receive an excellent standard of care All the staff spoken with were clear Care Homes for Older People Page 22 of 28 Evidence: about their role and responsibilities within the home. Over 50 of the care staff have now obtained training in National Vocational Qualification level 2 and 3, to ensure they have the skills and knowledge to do their job in a professional manner. The inspector examined four staff records to ensure consistency of recruitment procedures. Records showed that staff had only been employed following a Protection of Vulnerable Adults check and Criminal Records Bureau clearance. All records were up to date, contained relevant information and were in good order. The staff on duty confirmed that training has been provided in addition to mandatory training staff had completed specialist training appropriate to residents needs. These included Dementia Care, Palliative care and Mental Capacity. Staff records seen on the day confirmed that although staff had completed a comprehensive induction, specialist and mandatory training and National Vocational training (levels 2 & 3) some staff were overdue for refresher courses. These included fire training, infection control and dementia care. A requirement has been made in respect of this. The manager, when spoken to, was aware of this and is in the process of implementing training days to ensure all staff are up to date. 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. Residents and staff benefit from the leadership and management approach within the home. Overall the residents welfare is a priority within the home, and this is supported by efficient administration systems. The quality of this outcome area is good. This judgement was made from available evidence including a visit to the service Evidence: The manager has completed the Registered Managers Award and keeps herself up to date with changing legislation and training. This compliments her years of experience managing Truscott Manor. The Quality Assurance System for this year has been completed and was available in the entrance hall for all visitors, relatives and residents representatives to view. Staff, residents and their families are consulted through meetings to ensure their views are included and implemented in any decision made on the way the home is Care Homes for Older People Page 24 of 28 Evidence: run. Staff feedback reflected that the management provides a clear sense of leadership and direction. Staff spoken to stated if there are problems the manager is always around to deal with it And that the management is supportive. This enables staff to seek guidance when needed to ensure residents needs are met appropriately. Residents are encouraged to manage their own finances or if this is not viable and a representative of the resident take on the responsibilities for this. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Good moving and handling practise was observed that minimises risks to residents health safety and welfare. Policies and procedures were in place and had been updated recently. 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 30 18 The registered person shall ensure staff recieve appropriate training for the work they are to perform Records show that some staff are in need of refresher courses in areas such as fire training, dementia care and infection control. 30/10/2009 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 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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