Care Home: Tyneview Nursing Home

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What the care home does well The home has a pleasant atmosphere and visitors are made welcome when visiting their friends or relatives. The residents were positive about how it feels to live in the home and one said they felt "safe and happy about the care" another said "I looked at lots of other homes before choosing this one and I am pleased that I did". There is a competent, committed Manager in post, and all of her staff team work hard to make sure that people living in the home have their nursing and medical needs met. They work well with outside agencies to make sure that the residents have good access to specialist advisor`s. The staff in the home are well trained and skilled in the roles they undertake and they are supervised regularly to make sure that they remain confident and competent. The food being served is good, nutritious and well presented. The staff have a good understanding of the nutritional needs of the residents and the people living in the home were very complementary about the food they are served. Social profiles are being used to make sure that people are being supported to live active and fulfilled lives according to their conditions and choices. What has improved since the last inspection? Eleven requirements have been met since the last full inspection. There is now a comprehensive quality assurance programme being used by the home to make sure that it is run in the best interests of the people living in the home. There has been a significant amount of redecoration and refurbishment carried out as part of a planned programme this makes sure the environment remains safe and comfortable for the people living there. The residents are being made aware of the choice of meals and further improvements are being made to make it available in other formats, which are readily available and easy to see and understand. The dining room has been refurbished and adapted utensils are now available for people to use. This is to ensure they retain their rights to choice and independence. The residents privacy and dignity is being maintained by removing publicly displayed notices which include residents names and storing personal continence items more discreetly. There is now appropriate bathing facilities for the number of residents adequate numbers, which can meet their needs. The shower areas have been significantly improved. There is an activities co-ordinatir who workswith the staff to make sure that activities and social care plans continue to be developed and interests recorded. This will make sure a person centered approach to social care is in place. Care plans and records of care are now completed in enough detail to show how the residents and representatives are involved in making decisions about the care and their lives. The records also now contain detailed information when the residents refuse care or are resistant due to their condition. The wishes and feelings of the resident are taken into account when planning care. The registered provider visits the home at least once a month and prepares a report of the visit in line with the regulation. What the care home could do better: Two requirements were made as a result of this inspection. These were that the bedrooms must be redecorated, furnished and equipped taking into account the needs and views of the occupant. This will make sure that they are pleasant and comfortable places for the residents the live. The second was that the adaptations provided in toilets, bathrooms and bedrooms must be reviewed as part of the refurbishment programme. This will ensure that residents are supported to live their lives as independently as possible. Three recommendations were made. It is recommended that the improvements made to the way that the residents are supported to live active and fulfilled lives be continued and developed further as planned. Further improvements are needed to the way that the residents are informed about the meals available. And it is recommended that improvements could be made in the documentation of complaint to make it easier to use the information as part of the quality assurance process. Key inspection report Care homes for older people Name: Address: Tyneview Nursing Home Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF     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: Suzanne McKean     Date: 1 8 1 2 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 29 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 29 Information about the care home Name of care home: Address: Tyneview Nursing Home Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF 01914772835 P/F01914772835 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Beverley Anne Tarplee,Mr Martin Lang care home 36 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 who can be accommodated is: 36 The registered person may provide the following category of service only: Care Home with Nursing, Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category, Code OP, maximum number of places 36 Date of last inspection Brief description of the care home This home is registered as a care home providing nursing and personal care for older people. It is a building that has been converted to its present purpose as a care home. There are three main floors with some further changes of level within these. The home is built on rising ground and the main entrance is at first floor level. It has a passenger lift giving access to all floors. It is situated in an urban setting close to a busy road junction and is accessible by Care Homes for Older People Page 4 of 29 Over 65 36 0 2 3 1 2 2 0 0 8 Brief description of the care home public transport with several major bus routes running by the home. There are no grounds that can be used as recreational space but it has a small outside area at the front of the building for residents to sit. There is an ample car parking. There are a local facilities, such as pubs and shops, within walking distance of the home and it is a short drive to the town centre. The home is elevated position provides views of the River Tyne and Newcastle to the North and West. The home charges fees of £424 per week with the nursing care element of the care fees being provided in addition to this when applicable. Care Homes for Older People Page 5 of 29 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Summary: This is an overview of what the inspector found during the inspection. How the inspection we carried out:- Before the visit we looked at, the information we have received since the last visit. How the service dealt with any complaints and concerns or protection of vulnerable Care Homes for Older People Page 6 of 29 adult issues since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. Used surveys to find out the views of residents their relatives or representatives and professionals who visit the home. The visit: An unannounced visit was made on 17th December 2009 and a second planned visit was carried out on 18th December 2009 , the total time of the visits was eight hours. During the visit we: Talked with people who use the service, the staff and the manager. A number of visitors were present during the visit and six were spoken to in private. Looked at information about the people who use the service and how well their needs are met. Looked at the records which must be kept. Checked the staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building and parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the Manager what we found. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Eleven requirements have been met since the last full inspection. There is now a comprehensive quality assurance programme being used by the home to make sure that it is run in the best interests of the people living in the home. There has been a significant amount of redecoration and refurbishment carried out as part of a planned programme this makes sure the environment remains safe and comfortable for the people living there. The residents are being made aware of the choice of meals and further improvements are being made to make it available in other formats, which are readily available and easy to see and understand. The dining room has been refurbished and adapted utensils are now available for people to use. This is to ensure they retain their rights to choice and independence. The residents privacy and dignity is being maintained by removing publicly displayed notices which include residents names and storing personal continence items more discreetly. There is now appropriate bathing facilities for the number of residents adequate numbers, which can meet their needs. The shower areas have been significantly improved. There is an activities co-ordinatir who workswith the staff to make sure that activities and social care plans continue to be developed and interests recorded. This will make sure a person centered approach to social care is in place. Care plans and records of care are now completed in enough detail to show how the residents and representatives are involved in making decisions about the care and their Care Homes for Older People Page 8 of 29 lives. The records also now contain detailed information when the residents refuse care or are resistant due to their condition. The wishes and feelings of the resident are taken into account when planning care. The registered provider visits the home at least once a month and prepares a report of the visit in line with the regulation. 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 29 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 29 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. Good admission assessments and information gathered before the placement makes sure that the home is prepared for the person moving in and that the person can be confident their needs will be met. Evidence: The home uses an assessment document, which is designed to give a way of recording information about the needs of the people who are considering moving into the home or staying for a short period. The tool assists the staff to find out about all of the aspects of peoples lives and needs. The manager is confident that it gives her the information she needs to make the judgment about offering a place. The manager has shown in the past that she is careful when offering a place to make sure that they can not only meet their needs but that she has considered the residents already in the home. Care Homes for Older People Page 11 of 29 Evidence: Potential permanent residents can visit the home and spend time in the communal areas prior to making the decision to move in but those spoken to on the day had relied on their relatives to make the choice for them. During the inspection a visitor explained that he had looked at a number of homes when looking for a place for his relative and was very happy that they had chosen Tyneview. Care Homes for Older People Page 12 of 29 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. People living in the home have their health and personal care needs met and care plans are in place to show how the care this is achieved. Evidence: Each person living in the home has an individual care plan which is developed from the detailed assessment and added to throughout their stay. These care plans show how the personal and health care needs of the resident are to be met. The staff spoken to were knowledgeable about the contents of the care plans. They were able to describe the needs of the residents and were clear about the way that they had to record the care given and the need to report any relevant issues to senior staff. Care plans are in place around both the physical needs and the social care needs of the people living in the home. Necessary risk assessments are completed for a selection of areas including falls, nutrition and deterioration in skin condition. These were being reviewed and the reviews were up to date. The care plans are comprehensive in there level of detail, including the information Care Homes for Older People Page 13 of 29 Evidence: about moving and assisting and the instructions about how staff should support the individual. There is now clear direction to the staff on how to carry out the procedure. Food and fluid charts which were being kept for individual residents are up to date and are completed in sufficient detail to ensure that they are useful as part of the care planning process. The residents are having their personal hygiene needs met to a good standard. Residents are supported to access NHS services and facilities as and when they need to. The care plans showed that the specialist advisors are used for individual people living in the home and their advice is followed. The residents and their representatives are supported to take part in making decisions but comments from relatives suggest that this could be improved to make it more effective and formal. Residents said that they felt well cared for by the staff and an example of this was they look after our care and wellbeing in the best possible way. Relatives and residents returned surveys were very positive a example of the was that a relative said I think that the staff at the home do a good job for all concerned, another said the staff are friendly and approachable. They treat my relative with care and consideration. The Manager is caring and responds to any needs. I am very pleased with the recent modernisation. Residents were dressed for the activities they were undertaking and looked comfortable and tidy. A number of residents were positive about the care they were being given and were very complementary about the staff. The staff were being kind and polite although pressure to achieved the tasks due to being short staffed made them have to work hard and leaving them little time for more relaxed conversation with the residents. The residents are encouraged to maintain contact with their families, friends and visitors and can use either their own rooms or the communal areas. The home manages the administration of prescribed medication appropriately. There are appropriate systems in place to arrange for the ordering of the residents medication and the records were up to date and in good order. The home has a contract for the disposal of the medication which is no longer required and the records of this were in place. Controlled drugs are managed appropriately. Specific routes of administration are followed and any omissions or changes to the way that the medications are given are recorded. Care Homes for Older People Page 14 of 29 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. Residents are supported to live in active and fulfilled way in line with their choices, abilities and condition , and are involved in decision making in their everyday lives. Evidence: Residents have the choice to spend time either in their own rooms or in the communal lounges and during the visits a number of them were in their bedrooms spending time watching television, reading or listening to the radio. There is a more formal social programme now in place, and on the day of the visit a number of residents were involved in a game of Bingo. Others were spending time in their rooms or in the communal areas watching television or spending time with their visitors. There is now an activities person employed, and the activity programme is being developed further. The manager told us that because the residents do not all like to participate in group activities they try to provide one to one activities and this was confirmed by the activities co-ordintor. The staff have been working on improving the information in the care plans about Care Homes for Older People Page 15 of 29 Evidence: peoples previous life histories, and there is now an individual personal profile of each resident so that an individualised social plan can be developed. This will assist the introduction of a more person centered approach to the way residents spend their lives. Residents spoken to said that their families are always welcomed and others said they regularly go out with their family. There is a small patio/garden area to the side of the home. This benefits the residents as their it is the only outdoor area for people to enjoy in the better weather. There is a three-week menu, which offers choice and variety. The meal time was calm and residents were enjoying the meal time experience. Most of the residents took their meals in the dining room but a number chose to eat in their own rooms and they were supported to do so. Lunchtime was a busy time but pleasant time. Several people need help to eat their food and the staff sat with them and assisted in a sensitive manner. There is good flexibility in the meal times and the breakfast is available over a period of time allowing for residents to rise at the time they prefer. The main meal is served in the evening and this is effective as a number of the residents have large breakfasts. Cold and hot drinks were readily available throughout the day. There is now information in the home to tell the residents and the staff about the food being served although there are plans to improve this further. This would not only inform them but give a good topic of conversation through the day. Care Homes for Older People Page 16 of 29 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. Good procedures are in place to protect residents from risk of harm and enable their concerns to be effectively dealt with. Evidence: The home has a complaints policy and procedure, which is displayed and given to everyone when they come into the home. All of the people spoken to said they knew who to complain to although they pointed out that there was little to complain about. Records show that the complaints made have been dealt with at home level since the last visit to the home. These records are detailed and show the outcome of the investigation and the level of satisfaction of the complainant. Further improvements could be made in the documentation of complaints to make it easier to use the information as part of the quality assurance process. All of the staff have received Safeguarding Adults training either in house or by attending training with Gateshead Council. The registered manager has recently attended training on the Mental Capacity Act. Staff had an understanding of what constitutes abuse and would be able to use the procedures if necessary. There has been no safeguarding alerts since the last Care Homes for Older People Page 17 of 29 Evidence: inspection but the Manager and senior staff understand the process and are confident that they could deal with an issue if it arises. Care Homes for Older People Page 18 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers the residents a clean, safe, comfortable and pleasant environment to live in. Evidence: Tyneview is a converted building with bedrooms over four floors and the main communal lounges and dining rooms on the lower two floors. There are impressive views of the Tyne from the main lounges. There is a smaller communal area overlooking the car park although few people use this. This is currently used by the hairdresser although there are plans to improve this to make it a tea room as part of the programme of re-decoration. There is access to all areas via stairs and passenger lifts. Signs are posted on each floor level so that people can find their way around the home. There are no gardens or grounds that could be realistically used as an amenity area for people living in the home, however there is now a small area of private garden at the side of the home for people to use in the better weather. A loop system is available in the lower lounge, which helps those with hearing problems hear the television, which is at the far end of the lounge. Care Homes for Older People Page 19 of 29 Evidence: There are adequate numbers of toilet and bathing facilities however not all can be used for people needing assistance. The bathroom on the top floor is not in use, Some floor coverings in toilet areas have been renewed but there is remaining work to be carried out. There have been significant improvements to the two showers (which are on different floors. These have been re-tiled and new plumbing fitted, these are now pleasant showers which offer pleasant, private places for residents to have personal care. Two new shower chairs have also been purchased. the bathrooms are clean and tidy and these areas along with the showers rooms give the people living in the home a pleasant comfortable place to enjoy the experience of bathing. The toilet facilities have been redecorated and new toilet seats have been provided. The aids and adaptations in the toilets are being reviewed as part of the refurbishment programme. All of the bedrooms are for single use, none have an en-suite facility, although some bedrooms are in small clusters with a toilet and unassisted bath sited close to two bedrooms. People have brought small items of furniture and keepsakes with them making the rooms individualised. They reflect their previous lifestyles and religious beliefs. Many of the bedrooms are cluttered with the personal items of residents but were clean and organised according to the choices of individual occupant. The furniture and bedding in several of the rooms is becoming tired and worn with bedding becoming faded and thin. Many of the bedrooms are due redecoration as there is damage to walls and paintwork. Some furniture is damaged and needs replacing. This is part of the next phase of the refurbishment programme. The laundry has adequate facilities, and the area was generally well organised and the area was being used as it was planned with clean to dirty areas identified. There was a liquid soap and paper towels in this area so staff can wash their hands effectively. The sluices were being kept closed and clinical waste is being managed satisfactorily. Items for disposal was being double bagged to prevent odour and allow staff to carry it safely from where care is being given to the yellow bag. Wheelchairs and other care items were clean and there is a process to have them cleaned. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected by a good recruitment and selection procedures and staff are supported through training to make them able to fulfill the role they undertake. Evidence: The home benefits from a stable staff team, many of who have worked in the home for some considerable time. The registered manager is generally supernumerary but does work clinically one shift a week. During the site visit the staffing included two qualified nurses, four carers, domestics, cook, kitchen assistant, handyman and an activities co-ordinator. Four staff files showed that job descriptions and roles are clear and each file had an application form completed. There was evidence of Criminal Record Bureau checks, of Vulnerable Adult checks, and proof of identity. A training programme is in place. This provides an overview of training achieved and required. Staff said that they have done or been offered training. Records show that all have had comprehensive training in Infection Control, and have had refresher training in Moving and Assisting and Health and Safety and fire safety. Care Homes for Older People Page 21 of 29 Evidence: Specialist training includes resuscitation, care of the syringe driver and palliative care. The home has a policy for recruitment and selection on staff. This is being followed. Staff records were held safely to maintain confidentiality with limited access to these and the supervision records. Advice was given to chase up a reference for one person who had submitted two personal referees, which had been returned, and one professional reference which had not yet been returned. Care Homes for Older People Page 22 of 29 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. While management and administration of the home is adequate, support for the manager is lacking. The absence of an effective quality assurance process affects the running of the home and quality of care delivered to people using the service. Evidence: The manager is a registered nurse and has many years experience both as a nurse and as a manager. The manager is registered with the Commission for Social Care Inspection. She is aware of the need to keep up to date with current best practice and tries to make sure all staff are knowledgeable and trained to care for the people who are using the service. The manager does not hold or have detailed information regarding the homes budgets and this makes it difficult for her to plan the purchases needed or any changes needed to the home. She is confident that she can obtain finances for equipment she needs to Care Homes for Older People Page 23 of 29 Evidence: meet the needs of the residents but cannot plan ahead for changes which can be predicted. The Manager has introduced a quality assurance programme and has carried out both resident/relatives and visiting professional surveys. The manager also spends time talking to individual residents about their views and those spoken to confirmed tis. The surveys and comments on the day from people living in the home were very positive about the staff and the care provision. A number were complementary about the changes made to the building decoration and particularly the lounges and dining room. Records relating to peoples monies were checked. Accounts are held individually. Receipts are kept for all expenditure. Three amounts of money were checked and were correct. Residents have free hairdressing (except for perms) as it is paid for by the home. Supervision records are very detailed and everyone receives supervision six times a year. Maintenance records for day-to-day safety were in place including recording of water temperatures, checking window restrictors and general health and safety checks for the safety of staff .the people who live in the home and any visitor. These checks are carried out by the maintenance person/handyman. Staff have completed fire training, infection control, moving and handling and health and safety in line with good practice guidance. Accidents are recorded and the manager carries out audits to track trends and look at when accidents occur to prevent them happening again. She has also introduced a monthly Quality Indicator Reports as a way of reviewing the home and as part of the quality assurance process. Audits have been carried out for medicines and pressure ulcer care, this will feed into the quality assurance process. Surveys are used as a way of getting the views of the residents this is to be repeated annually and has recently been carried out although these are being ananlysed and the action plan developed. The quality assurance process, however there is no formal process in place to make sure that the home is operating in the best interest of the residents taking into Care Homes for Older People Page 24 of 29 Evidence: account their views. Although it is acknowledged that the registered provider visits the home regularly there is no record of the visit and the issues that were looked at or the process undertaken. There must be a visit at least once a month in line with Regulation 26 of the Care Homes Regulations 2001, and the content of this visit is clearly identified. Care Homes for Older People Page 25 of 29 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 29 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 22 23 The adaptations provided in toilets, bathrooms and bedrooms must be reviewed as part of the refurbishment programme. This will ensure that residents are supported to live their lives as independently as possible. 01/06/2010 2 24 23 The bedrooms must be 01/08/2010 redecorated, furnished and equipped taking into account the needs and views of the occupant. This will make sure that they are pleasant and comfortable places for the residents the live. Care Homes for Older People Page 27 of 29 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 12 It is recommended that the improvements made to the way that the residents are supported to live active and fulfilled lives be continued and developed further as planned. It is recommended that the improvements to the way that the residents are informed about the meals available are continued as planned. It is recommended that improvements could be made in the documentation of complaint to make it easier to use the information as part of the quality assurance process. 2 15 3 16 Care Homes for Older People Page 28 of 29 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. 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