Care Home: Wavertree House

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What the care home does well The relaxed, homely and welcoming atmosphere has evolved over many years and reflects the commitment and dedication of the management team and the close professional relationships that have developed between service users and the support staff. Staff are evidently valued and supported by the managers and they are clearly held in high regard not only by members of staff but service users and their relatives as well. Effective systems are in place for the admission and ongoing care of service users. High quality individual care plans developed from comprehensive pre admission assessments ensure that the care and support needs of residents are met in a structured and consistent manner. Communication and consultation with service users` family members is effective with relatives having the opportunity to partake in individual assessment, care planning and reviewing processes, as appropriate. Appropriate recreational and leisure activities are provided and service users benefit from menus that are balanced and nutritious, reflecting their individual likes and preferences. Following robust personal and environmental risk asssessments, all necessary specialist equipment and adaptations are provided in a pleasant environment that is comfortable, well maintained and decorated and furnished to a high standard. What has improved since the last inspection? There were no requirements or recommendations made following the previous inspection. What the care home could do better: There were no requirements made as a result of this inspection. However some concerns were raised regarding staff training and the unsettled situation concerning the management of the service. Therefore, in the best interests of service users and staff, it is important that the necessary changes within the management structure should be carried out both swiftly and sensitively. It is also recommended that a review of staff training should be carried out and consideration given to more effective methods of training. Key inspection report Care homes for older people Name: Address: Wavertree House Somerhill Road Hove East Sussex BN3 1RN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 0 5 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Wavertree House Somerhill Road Hove East Sussex BN3 1RN 01273262200 01273262230 maxine.miles@rnib.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: RNIB care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Sensory Impairment (SI) Date of last inspection Brief description of the care home Wavertree House is a care home run by the Royal National Institute of the Blind (RNIB). The home is registered to care for up to forty-four people with sensory impairments. The property is situated in a residential area of Hove and is very close to local transport, parks, the seafront and shopping areas. Accommodation comprises of thirty-three studios, seven one-bedroom flats and two 2-person flats. All contain en suite facilities and self-contained kitchenettes. The larger flats situated in the older wing also have entry halls and lounges. All flats have their own front door. The building comprises of two areas; the older wing with seven flats and the new purpose built premises, which contain the studios, flats and a guest flat. Accommodation is presented over three floors, which are all served by lifts. Communal areas within the Care Homes for Older People Page 4 of 30 Over 65 0 44 Brief description of the care home home include a large dining area, a commercial kitchen, separate laundry area, an assisted bath on each floor, therapeutic spa, a library, a dedicated activities room, lounges, a reception and large lobby and a minibus for transport. Residents also have the use of a pleasant rear courtyard garden. The current fees for this home range from £595.54 - £677.49. Additional fees are payable for hairdressing and chiropody. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. This unannounced inspection took place over five and a half hours, between 10:00 and 15:30, in February 2010. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was very good. On the day of the inspection there were thirty nine service users living at the home. The inspection process involved observation of working practices, examination of the homes records and discussion with five service users, two service usersrelatives, three members of staff and the Acting Assistant Manager (AAM). Communal areas throughout the home were seen and several service users bedrooms were viewed. Care Homes for Older People Page 6 of 30 The focus of the inspection was on the quality of life for people who live at the home. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 30 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 30 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 30 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. Documentation, including a comprehensive Service Users Guide and Statement of Purpose, ensures that prospective service users have sufficient information about the home and the services provided and know that it is able to meet their individual care and support needs. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Evidence: Comprehensive and detailed information regarding the home has been produced and is made available to all prospective service users in the form of the Statement of Purpose and Service User Guide. The Statement of Purpose provides a brief introduction and overview of Wavertree House, including the organisational, management and staffing structure. It contains details of service users rights and responsibilities. It also includes details of the Care Homes for Older People Page 11 of 30 Evidence: homes admission criteria, complaints procedure, facilities and activities available. However it was noted and discussed with the acting assistant manager,(AAM), that the document has evidently not been reviewed or updated since February 2008. Consequently information, including the management structure and contact details for the CQC is both out of date and inaccurate. The Service User Guide is well presented and comprehensive covering most aspects of life in the home. It provides answers to a range of typical and frequently asked questions, service users may have when moving to the home. These include: What services can I expect to be provided and what extras will I have to pay for? and What if my neeeds change once Ive moved in? The AAM confirmed that the Service User Guide is made available in various formats, including print, CD, tape and Braille, as required. As with the Statement of Purpose, it was noted that the contact details for the CQC are inaccurate and should be updated. Both documents are accessible within the home and are provided to any interested parties. There is a clear admissions criteria in accordance with the homes aims and objectives. As well as being invited to visit the home to look around and meet with existing service users and staff, prospective service users have the opportunity to stop overnight or occasionally for a weekend stay before moving in. A thorough pre admission assessment process ensures that prospective service users are suitable for Wavertree House. In addition to establishing whether the individuals care and support needs can be met within the home, the AAM also stressed the importance of ensuring compatibility with existing service users. Each service user is issued with a formal contract, including a statement of terms and conditions of residency. Assesment records and contracts that were viewed were found to have been signed by both the service user, or their representative, and the manager, on behalf of the organisation. Relevant documentation relating to the two most recent admissions to the home was inspected and found to be comprehensive, up to date and well maintained. The AAM confirmed that new service users undergo a flexible trial period at the home, followed by a thorough placement review, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and Care Homes for Older People Page 12 of 30 Evidence: support needs are able to be met. Care Homes for Older People Page 13 of 30 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. Comprehensive, high quality care plans enable staff to meet the assessed support needs of service users in a structured and consistent manner. Systems for consultation and participation are effective. Service users are protected by the homes medication policies and procedures. They are are treated with respect and encouraged and enabled to make decisions about their day to day living. Evidence: High quality, person centred, care plans have been developed and implemented for each service user. Individual plans that were viewed were found to contain a personal profile, daily progress sheets and personal and environmental risk assessments, including medication management and fire evacuation. Nutitional risk assessments were also in place for each service user and included a monthly record of the individuals weight and any associated nutritional concerns. All such assessments were noted to have been recently reviewed, on 28 January 2010. Care Homes for Older People Page 14 of 30 Evidence: The AAM confirmed that service users and, where appropriate, a relative or representative continue to be directly involved in regular care plan reviews. It was evident from plans that were examined that reviews are appropriately recorded and plans, including risk assessments, are amended appropriately to reflect changing needs or circumstances. Information recorded includes who was present at the review and details of issues discussed and agreed goals. A care plan agreement in respect of each service user was found to have been signed by the individual, or their relative or representative, to acknowledge that they have been consulted about the plan and confirm that they agree with the actions documented. Individuals are clearly enabled and supported to make decisions about many aspects of their life and are made aware of and understand the reasons for specific action being taken. Service users continue, as much as is practicable to be enabled and supported to participate in all aspects of life in the home. The AAM confirmed that close and effective working relationships between service users and their key worker ensured that any subtle change in an individuals mood or behaviour can be identified and addressed at an early stage. Independence and individuality continue to be encouraged and promoted within the home and are clearly reflected in the personalising of service users rooms, the choice of bedclothes and colour schemes and individual preferences for menus and activities. Documentary evidence was in place to demonstrate that the health and emotional care needs of service users continue to be met within the home. Care plans provide clear guidance to staff on the health needs of service users. Records showed that there is regular input from health care professionals where needed. Individual care plans that were examined were found to contain detailed information, clearly developed through close consultation with and direct involvement of service users and their relatives. All service users are registered with local GPs and have access to other health care professionals, including psychologists and occupational therapists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The manager confirmed that all staff responsible for Care Homes for Older People Page 15 of 30 Evidence: administering medication have received appropriate training and are individually assessed and authorised to do so. This was confirmed through discussions with staff and supported by training records examined. Following several notifications received by the CQC since the previous inspection, relating to errors in administering medicines, the AAM confirmed that medication management and healthcare and clinical procedures and policies have been reviewed and updated to reflect good practice guidance. These changes have evidently been reinforced through revised staff training, supervision and regular meetings. Additional measures recently introduced also include an annual competency assessment for all staff repsonsible for the control of medication. As part of this assessment process, staff must evidently complete a questionnaire and sign a policy agreement, confirming that they have read and understood relevant policies and procedures. Care Homes for Older People Page 16 of 30 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. Service users are enabled and supported to maintain contact with family and friends as they wish. They benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: As previously documented and in accordance with their personal care plan, service users are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, service users were observed being supported in a sensitive, professional and respectful manner by members of staff. The AAM confirmed that, where appropriate, service users family links continue to be supported. Visiting to the home is unrestricted and service users relatives and friends are made welcome at any reasonable time. As part of the inspection process, several service users relatives were spoken with and all expressed a high level of satisfaction with the home and the care and support provided: She is so happy there and that is very important to me. Care Homes for Older People Page 17 of 30 Evidence: The staff are so kind and cant do enough to help. Im always made very welcome. Its a great comfort to know that she is so settled here and being looked after so well. A part time activities coordinator is employed for four sessions a week. There is a planned activities programme in place, relating to service users expressed preferences and abilities and this is made available in selected formats and also posted weekly on the activities notice board. Regular volunteers visit the home to help with social activities, transport and outings as well as befriending and one to one time. A daily menu is displayed in large print on the talking notice board outside the dining room. The varied, balanced and nutritious menu reflects seasonal variations and is based on service users identified likes and preferences. As previously documented, nutritional screening forms part of the initial assessment process. The AAM confirmed that good quality fresh produce is sought from local suppliers. An alternative to the main meal is always available. Food surveys are completed 6-monthly and menus are regularly reviewed and discussed at service user meetings. The experienced chef and his assistants have eviedently developed good and effective communication with service users and this was supported by positive comments received: The food here is very good and the chef knows what we all like and what we dont. They let you know what is on the menu and there is always a choice. Three full meals a day are provided and service users are able to access hot and cold drinks and snacks throughout the day and night. Provision is also made for service users to be able to make drinks independently in their flats or they are available in the communal lounge at specific times during the day. The main meals of the day are served in the bright and spacious dining room. During the inspection, I joined three service users for an enjoyable lucnch, in pleasant surroundings and in very good company. Care Homes for Older People Page 18 of 30 Evidence: Care Homes for Older People Page 19 of 30 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 open and inclusive atmosphere within the home enables service users, staff and visitors to feel able to express any concerns, confident that they will be listened to. Service users are safeguarded from abuse through robust policies, procedures and relevant staff training. Evidence: A clear,concise and accessible complaints procedure has been developed for the benefit of service users, their relatives and other visitors to the home. All complaints are recorded and include actions taken and outcomes achieved. The management team evidently operates an open doorpolicy and is clearly considered to be very approachable and understanding. Close working relationships and effective communication and consultation between service users and staff also provides adequate opportunities for any concerns to be raised and discussed before they become complaints. Service users, relatives and members of staff confirmed that they would have no hesitation in speaking to the manager, or making a complaint if necessary, and each person was confident that they would be listened to. There has evidently been one anonymous complaint received by the home since the last inspection. It was noted that it had been investigated and recorded appropriately. Care Homes for Older People Page 20 of 30 Evidence: The home has produced detailed policies and procedures, relating to safeguarding adults, including a whistle blowing policy. These documents have evidently been drawn up in accordance with the multi agency guidelines. The AMM confirmed that all care staff have also received appropriate training regarding abuse awareness and procedures relating to Safeguarding Adults. She added that she recently attended a conference on safeguarding adults and the acting manager had undertaken relevant training, including the Mental Capacity Act and Deprivation of Liberty. This was supported through discussions with members of staff, during the inspection, and evidenced through individual training records. Service users are encouraged to handle their own financial affairs and a lockable facility is provided for each client. Provisions are made to hold money for service users if they feel unable to maintain their own financial affairs and records are maintained with receipts being kept for all income and expenditure. Care Homes for Older People Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for its stated purpose. Service users benefit from all necessary specialist equipment and adaptations in a pleasant environment that is comfortable, well maintained and decorated and furnished to a high standard. Evidence: Environmental standards at Wavertree House remain largely unchanged and the premises, including service user accommodation and spacious communal areas, continue to be safe, accessible and well maintained. Appropriate adaptations and specialist equipment are provided as necessary, to meet the individual and collective needs of the service users. Among the many such adaptations are large arabic and braille numbers on all flat doors, handrails throughout the home, appropriate lighting to meet individual needs and requirements, colour contrasting and textured flooring to indicate changes in direction in corridors and communal areas. There are safe, flat pathways free of obstructions around the garden and court yard to enable easy access and orientation, automatic door closures on each room, linked to the fire alarm system and grab rails in service users flats and toilets, as required. Care Homes for Older People Page 22 of 30 Evidence: Positive comments from service users, spoken with during the inspection, reflected a high level of satisfaction with the home and the services provided: This is my home now and Im very happy here. The manager confirmed that independence and individuality continue to be promoted within the home, as far as is practicable, and this is evident from the personalising of service users rooms, which clearly reflects individual tastes, preferences and interests. All rooms were found to be exceptionally well decorated and contain personal furniture and belongings. The home provides spacious communal facilities including several lounges, a library and a spacious dining room. There is a large well maintained garden, which has a courtyard area, several patios and seating areas, as well as lawned areas and flower beds. Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Care Homes for Older People Page 23 of 30 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. There are sufficient trained and competent staff on duty at all times to meet the assessed care and support needs of the service users and their best interests are safeguarded by thorough recruitment policies and procedures. Evidence: To help safeguiard service users, the home continues to operate thorough and robust recruitment procedures. Individual recruitment files, relating to recently appointed staff, were exaimined and found to contain all relevant details and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. From rotas viewed and through discussion with staff, service users and their relatives, it is evident that staffing levels within the home are adequate and continue to reflect service users assessed support needs. The manager clearly recognises the importance of a skilled and competent workforce. All new staff receive comprehensive induction and foundation training. In addition to these programmes, appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with members of staff and supported by Care Homes for Older People Page 24 of 30 Evidence: training records examined. However, through talking with care workers and the AAM, it is evident that the overall quality of training has slipped and too much emphasis is currently placed on one model of training provision: There is always plenty of training going on here. Ive had loads of training since I started but most of it has involved me watching a DVD, then filling in a questionnaire. So obviously I cant ask any questions. They just sit you down in front of a DVD. Then you have to answer questions on what youve seen. It would be better if there was more of you so you could discuss things. The AAM acknowledged this shortfall and is to addresss the issue, through consultation with the Care Home Coordinator. Currently 72 of the care staff are trained to NVQ level 2 or above. In accordance with company policy, the manager confirmed that formal supervision is provided for all support staff on a regular basis. Care Homes for Older People Page 25 of 30 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. Despite changes and associated concerns, service users benefit from effective management, appropriately supervised staff and satisfactory quality assurance systems. Their best interests are safeguarded by adequate health and safety policies and procedures, within the home. Evidence: Wavertree House is facing a potentially unsettled period and some concerns were raised, during the inspection, regarding the current managerial situation. The registered manager has been on long term sick leave since April 2009 and it is evidently uncertain when or if she will be returning. In her absence, an acting manager has been appointed who is a qualified nurse, RGN, holds the Registered Managers Award, RMA and has been at Wavertree House for many years. However, it is understood that she is due to retire shortly, in April 2010. A Care Home Coordinator, with responsibility for several services within RNIB, is clearly aware of the situation and has been providing supervision and support to both Care Homes for Older People Page 26 of 30 Evidence: of the acting managers. Unfortunately, for Wavertree House, she is due to take up another position within the organisation, in the near future. Although her post will be filled, there are clearly some uncertainties and concerns within the home regarding the continuity of management and an obvious need for reassurance for senior staff who are remaining. The AAM confirmed that the health, safety and welfare of service users and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Care Homes for Older People Page 27 of 30 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 28 of 30 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 1 It is recommended that information made available to prospective service users be reviewed and amended to accurately reflect the current situation. It is recommended that a total reviewe of staff training be undertaken and consideration given to other, more effective and innovative models of training provision. It is recommended that the necessary changes within the management structure be carried out swiftly and sensitively, to allay anxieties and ensure continuity. 2 30 3 31 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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