Care Home: Webber House Residential Home

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What the care home does well The service has robust recruitment procedures in place and staff only start work at the home once all recruitment checks have been undertaken and this provides protection for service users. We observed staff interacting with service users and we saw that people are treated with respect and their right to dignity maintained. Those service users we spoke to told us that staff listen and act on what they say. The daily routines in the home are flexible and service users are able to make informed choices, there was evidence in care plans to show that service users were able to make their own decisions wherever possible and this allows service users to be in control of their lives as much as possible. The visiting routines at the home are flexible and family and friends can visit at any time. The home supports staff to obtain recognised qualifications and staff are provided with training so they can meet residents needs. What has improved since the last inspection? Since the last visit to the home the following improvements have been made; Staff involved in the handling of medication have all received appropriate training and have been deemed competent to carry out the task. The home has continued with its programme of decoration and all of the vacant residents rooms have been decorated. Hand rails have been put in place around the home and a ramp has been fitted to the entrance to the home. What the care home could do better: This report will make 3 requirements to help improve the service for residents. The main body of the report also details other areas where the home could do better. General observations were; Although care plans gave staff some information about the support needs of the residents they did not provide information for staff on the type and level of support that was required. Care plans need to be updated and expanded to provide staff with clear information on what care and support is required for each service user to ensure that each resident`s care needs are met. Care plan reviews could also be improved to provide more information and evaluation on how the care plan has been working for the individual. More information would also provide evidence that the service user or their representative are involved in the review process. The storage arrangements for controlled drugs that are kept in the home do not meet the requirements that are required by law and the home must obtain a suitable cupboard for storing any controlled drugs. We noted that the fire risk assessment had identified a number of concerns and it was not clear if all of these points had been addressed. The registered person needs to ensure that all the points raised in the fire risk assessment are appropriately dealt with to ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. On the day of our visit the manager could not locate the current certificates for the servicing of the passenger lift, the gas appliances or the fire alarm system. We saw that contracts are in place for the servicing of this equipment and the registered person must contact the servicing engineers to obtain up to date copies of these certificates. The manager has agreed to provide us with copies of the certificates as soon as they are obtained. Also the certificate we saw for the homes fixed electrical wiring was out of date and the manager agreed to follow this up with the landlord of the premises. Key inspection report Care homes for older people Name: Address: Webber House Residential Home 3 Station Road Park Gate Southampton Hampshire SO31 7GJ     The quality rating for this care home is:   one star adequate 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: Mick Gough     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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 26 Information about the care home Name of care home: Address: Webber House Residential Home 3 Station Road Park Gate Southampton Hampshire SO31 7GJ 01489581249 01849581249 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Marie McCann care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 13 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: Old age, not falling within any other category (OP). Dementia (DE). Date of last inspection Brief description of the care home Webber House is a small home for older people and people who have dementia. The home has 13 rooms on the ground and first floor including one double room. People living in the home have a lounge with a conservatory to the rear of it leading to to an attractive moderately sized back garden equipped with tables and chairs. They have and additional lounge that is reached from the first lounge through a corridoor and two bedrooms are entered from this area. Care Homes for Older People Page 4 of 26 Over 65 0 13 13 0 2 5 0 2 2 0 0 9 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: one star adequate 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 report details the evaluation of the quality of the service provided at Webber House and takes into account the accumulated evidence of the activity at the home since the last key inspection, which was carried out in February 2009. We also took into account the homes Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Included in the inspection was an unannounced site visit to the home, which was conducted on the 19 January 2010. For this visit we involved 4 users of the service and 2 members of staff who we spoke with on the day of the visit and this provided us with additional information about the home. Other evidence for this report was obtained from reading and inspecting records; including pre admission assessments, plans of care, risk assessments, medication Care Homes for Older People Page 5 of 26 records training and recruitment records and records relating to health and safety and quality assurance. We also looked at how the home deals with any complaints and issues regarding the protection of vulnerable adults. We also looked at some of the homes policies and procedures and throughout our time in the home we observed the interaction between staff and users of the service. We were assisted throughout the visit by the homes registered manager. The home is registered to provide support for 13 residents and at the time of the visit there were 5 people living at the home. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: This report will make 3 requirements to help improve the service for residents. The main body of the report also details other areas where the home could do better. General observations were; Although care plans gave staff some information about the support needs of the residents they did not provide information for staff on the type and level of support that was required. Care plans need to be updated and expanded to provide staff with clear information on what care and support is required for each service user to ensure that each residents care needs are met. Care plan reviews could also be improved to provide more information and evaluation on how the care plan has been working for the individual. More information would also provide evidence that the service user or their representative are involved in the review process. The storage arrangements for controlled drugs that are kept in the home do not meet the requirements that are required by law and the home must obtain a suitable Care Homes for Older People Page 7 of 26 cupboard for storing any controlled drugs. We noted that the fire risk assessment had identified a number of concerns and it was not clear if all of these points had been addressed. The registered person needs to ensure that all the points raised in the fire risk assessment are appropriately dealt with to ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. On the day of our visit the manager could not locate the current certificates for the servicing of the passenger lift, the gas appliances or the fire alarm system. We saw that contracts are in place for the servicing of this equipment and the registered person must contact the servicing engineers to obtain up to date copies of these certificates. The manager has agreed to provide us with copies of the certificates as soon as they are obtained. Also the certificate we saw for the homes fixed electrical wiring was out of date and the manager agreed to follow this up with the landlord of the premises. 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 8 of 26 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 9 of 26 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. All people are assessed prior to moving into the home to determine if their individual needs can be fully met, however more information is required to ensure that all needs are identified. Service users or their representatives are able to visit the home prior to any admission to assess the quality, facilities and suitability of the home. Evidence: The home carries out an individual needs assessment prior to service users moving into the home. Assessments were on file at the home and were looked at for 2 service users. Assessments were made using a needs assessment form, which was kept on file and we were told that the manager would visits potential new residents before they moved into the home. Care management assessments were also on file. The home used its own assessment form and this contained information on; mobility, history of falls, eating and drinking, washing and dressing, hearing, sight, diet, social and recreational Care Homes for Older People Page 10 of 26 Evidence: needs, continence and communication. Although the form identified if there was a need in any of these areas they would benefit from further information about the type and level of support that may be required. The manager informed us that she would be amending the forms to ensure that more information was obtained during the admission process. Intermediate care is not provided at the home. Care Homes for Older People Page 11 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health, personal and social care needs are set out in an individual plan. However more information is required in care plans to provide staff with the information they need to provide the correct type and level of support. Also the reviews of care plans require more information to evidence how the care plan is meeting individual needs. The health care needs of service users are met and the home has a satisfactory system for administering medication. The storage arrangement for medication is generally satisfactory, however the home must obtain a suitable cabinet for the storage of controlled drugs that complies with the law. Service users at the home are treated with dignity and respect. Evidence: Care plans were inspected for 2 residents. Care plans had a personal profile and this contained information about the persons past history. Care plans gave staff some information about the support needs of the residents but they did not inform staff of Care Homes for Older People Page 12 of 26 Evidence: the type and level of support required. For example the care plan for one person stated needs help with washing and dressing but this did not tell staff what actual help was required. Another plan stated that the person needed minimal assistance with washing and dressing and went on to tell staff to give help as required. This was discussed with the home manager who told us that staff were aware of residents needs, however she understood the need to have more information in the care plans for all of the residents identified needs. Care plans need to be updated and expanded to provide staff with clear information on what care and support is required for each service user to ensure that all of the residents care needs are met. We saw that care plans were regularly reviewed however, review notes seen did not provide any information on how the care plans was working. The review notes had very little information and recording was basic information such as no change and a signature. This was discussed with the homes manager and she agreed that the care plan reviews needed to be improved to provide more information and evaluation on how the care plan has been working. More information would also provide evidence that the service user was involved in the review process. Care plan reviews should provide information on how the plan was working for the individual and should identify the persons changing needs. Daily recording in care plans was good and recording takes place at the end of each shift. Records showed how the resident had been supported and gave information on how they had been during the shift and provided good evidence of care delivery. We saw that there were risk assessments in place for residents and these have been updated and amended since the last inspection of the service. We noted that risk assessments and care plans were hand written and if changes were required, the whole of the care plan and risk assessment needed to be re written and this could be time consuming for staff. Residents at the home are registered with 2 different GP surgeries and they may keep their own GP if possible. Community Nurses are provided by a central service and the home is able to contact them directly. One service user who has a special diet has been seen by a nutritionist who has developed a menu for the person. The manager informed us that eye and hearing test are provided and dental checks are carried out at a local NHS practise. The home has a visiting chiropodist who calls when required and a continence adviser is available through the community nurse service. The manager told us that other health care professionals are arranged through GP referral. The home kept records of any health care visits and records of appointments were recorded and after each visit a note on the outcome of the visit was recorded. Care Homes for Older People Page 13 of 26 Evidence: Residents spoken to told us that their health care needs were met and that they could see a doctor whenever they needed to. We looked at medication procedures at the home and all staff who are authorised to administer medication have received appropriate training. The home has policies and procedures in place and the home uses a monitored dose system provided by a local pharmacist. We looked at medication administration recording and this was up to date with no omissions. The home holds some controlled drugs and these were kept in a lockable cupboard, within a lockable cupboard. However the storage arrangements do not meet the requirements that are required by law and the home must obtain a suitable cupboard for storing any controlled drugs. The requirements for CD storage are: Metal cupboard of specified gauge. Specified double locking mechanism. Fixed to a solid wall or a wall that has a steel plate mounted behind it. Fixed with either Rawl or Rag bolts The Misuse of Drugs (Safe Custody) Regulations 1973 gives full details and suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. We recommend that care homes request formal confirmation when purchasing a CD cabinet. Staff were observed interacting with service users appropriately and they were seen to treat service users with dignity and respect. We saw that staff sat down with residents when they were talking to them and it appeared that they get on well together. Staff were heard to use service users preferred form of address and staff were seen to knock on service users doors before entering. Service users told us that they were very happy with the staff at the home. Care Homes for Older People Page 14 of 26 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. The home provides a range of activities for service users and residents are able to maintain contact with family and friends and visitors are welcome at any time. Residents are supported to exercise choice and control over their lives as much as possible and are provided with a wholesome and balanced diet at a time convenient to them. Evidence: The home provides a range of activities for residents and these include bingo, card games, TV, radio and knitting. The manager told us that she intends to start armchair aerobics and reminiscence sessions and is looking to arrange card making, painting and crafts in the next few months. One service user chooses not to be involved in the homes activities as she prefers her own company and enjoys jigsaws and puzzles in her room. The home records any activities that take place but they do not record who was involved and this was discussed with the manager who told us that she will ensure that this is recorded in the future. On the day of our visit we observed residents playing bingo and the residents told us that they enjoyed this. Visitors are welcome at any time and the visitors book in the hallway of the home confirmed that there are regular visitors to the home. One resident told us that her Care Homes for Older People Page 15 of 26 Evidence: daughter visits on a regular basis and that she goes out with her daughter in the local community. There is a visiting church that calls once per month and administer communion to those residents who wish to participate. Staff told us that they would respect residents wishes on who they did or did not wish to see. Residents spoken to confirmed that they are able to make informed choices and were able to control their own lives as much as possible. One of the residents at the home is able to access the local community independently and on the day of the visit she was waiting for the local church group to pick her up and she told us that she can come and go as she pleases and there are no restrictions. We observed staff and residents interacting and it was clear that they get on well together and this was confirmed by both residents and staff. We observed residents being consulted throughout the day from the choice of what was on TV to what they wanted to do. Staff spoken to told us that they always ask residents what they want and would always respect their wishes and views. Staff were observed speaking to residents appropriately using their preferred form of address, also knocking on residents doors before entering. Residents are encouraged to bring some of their own possessions into the home and those rooms seen had been personalised. Due to the small number of residents the manager has gone round and spoken with everyone to get their preferences for meals. The manager told us that she knows what everyone likes and staff go round each morning to inform residents what is on for lunch that day and if this is not to the service users liking an alternative can be provided. Residents spoken with were generally happy with the food provided by the home. Breakfast is normally porridge and toast. Lunch is the main meal of the day and tea is normally served around 1700 and this is a snack type meal such as cheese on toast or scrambled eggs. Supper is served at 2000 and this is a sandwich or a piece of cake with a hot drink. The kitchen is open 24 hours a day and staff can make residents a sandwich or drink at any time of the day or night. One resident at the home has a special diet and the home cooks separate meals for this person. A dietitian has been involved in planning a special menu to meet her needs. We spoke to the person concerned who told us that staff do their best but as there is not a dedicated cook at times her meals can be a bit bland. The manager told us that as soon as service user numbers increase she is planning to employ a dedicated cook as at present staff carry out cooking duties at the home. Care Homes for Older People Page 16 of 26 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 a complaints procedure in place, which includes all of the required information. The homes policies and procedures help to protect residents from any form of abuse. Evidence: The home has a complaints procedure, which contains all of the required information and there is a log where any complaints made to the home can be recorded. Service users spoken with said they would speak to a member of staff if they had any concerns and they were confident that any issues would be dealt with. Staff members spoken to were aware of the complaints procedure and said that they would support any service user to make a complaint if they wished to do so. The manager informed us that there had been no complaints made to the home since the last visit to the service. Staff at the home have all received training with regard to adult protection and staff members spoken to said that they would report any concerns to the manger. The home has a whistle blowing policy and also a copy of the Hampshire Adult Protection procedure. We spoke with the manager who was aware of her responsibilities in this area. Care Homes for Older People Page 17 of 26 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 reasonably well-maintained environment and have access to comfortable indoor and outdoor facilities. Residents have the specialist equipment they require to maximise their independence and the home was generally clean, pleasant and hygienic. Evidence: During our visit to the home we took the opportunity to tour the premises. We found that the home was clean and tidy. The manager told us that currently the home does not employ and dedicated cleaning staff and that care staff carry out domestic duties, however the manager told us that when service user numbers increase that she will look to employ dedicated domestic staff. We looked at the laundry in the home and this is located adjacent to the kitchen but can be accessed without having to bring any dirty laundry through the kitchen area. The laundry contained a washing machine and tumble drier. Care staff carry out laundry duties and any soiled items are brought down to the laundry in sealed bags. There is a sink in the laundry area and the manager told us this is used for washing clothes. There is no dedicated hand washing facilities and the manager was advised to put up clear signs directing staff to the nearest hand washing facilities. All staff have received training on infection control issues and staff are provided with appropriate protective clothing. Care Homes for Older People Page 18 of 26 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 home has sufficient staff on duty to ensure service users receive the support they require. Staff were found to be well motivated and service users are protected by the homes recruitment procedures. Staff have been provided with training to meet peoples needs. Evidence: On the day of the visit we looked at the staffing levels for the day of the visit and this showed that between 0800 and 2200 there are 2 care staff on duty. Between 2200 & 0800 there is one staff member on duty, who is awake throughout the night. Staffing numbers were discussed with the manager and she stated that she felt that staffing levels were sufficient with the current number of residents but that staffing numbers would be kept under review. Service users spoken to said that they felt that staffing levels were adequate and comments received included - the staff are very good, there is always someone around and if i use my call bell someone comes quickly. Staff members spoken to told us that they felt that there were enough staff on duty to meet the needs of the service users at the home. The home employs a total of 7 care staff and 6 members of staff have a minimum of NVQ2 or equivalent with 1 staff member currently studying for NVQ2. The manager stated that the home would support staff to obtain National Vocational Qualifications. Care Homes for Older People Page 19 of 26 Evidence: Recruitment records were seen for 2 members of staff and the records we saw contained all of the required information including; application form, 2 references, photograph, birth certificate, Criminal Record Bureau and Protection of Vulnerable Adults checks. From the records seen we found that the recruitment practises were robust and this helps to protect service users. The home had an induction process that is based on skills for care and staff are expected to complete an induction booklet in their first few weeks of employment. Training records were kept in staff files and the manager showed us a training book, which gave details of the training that had been undertaken by all staff. We saw that staff had received training with regard to; manual handling, food hygiene, health and safety, adult protection, medication administration, infection control, dementia with dignity and first aid. Care Homes for Older People Page 20 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a manager in place who has the skills and abilities to manage the home effectively. However some areas are still in need of improvement before we can be confident that improvements to practise in the home that protect the safety and well being of the residents are sustained and embedded in practise. The health and safety of service users and staff are generally promoted and protected, however not all certificates for the safety of equipment were available on the day of our visit. Evidence: The home has a manager in place who is also the registered provider. She is a qualified nurse and has enrolled on a course in higher dementia studies. She informed us that she continues to update her skills and knowledge. Service users and staff who we spoke with had no concerns about the management of the home and told us that the manager was very approachable. However we found that she has not ensured that the care practises with regard to care plans and reviews fully supports the delivery of care to service users. Care Homes for Older People Page 21 of 26 Evidence: We looked at the homes quality assurance system and there were surveys that had been sent out to service users, relatives and staff, however these were all dated February 2009 and the manager told us that she intended to send out surveys in the next few weeks. The manager told us that she operates an open door policy and staff and visitors are free to talk with her at any time, she said that she speaks with residents on a daily basis and takes their views into consideration. The manager told us that she does not hold any monies on behalf of service users. Residents finances are managed by their family and each service user has a lockable facility in their rooms. The manager told us that if anyone needed the home to hold any personal spending money for them, then suitable arrangements could be made. One service user who we spoke with was concerned about the payment of her fees. The manager informed us that she had been in touch with social services regarding this matter but had not received a satisfactory response. The manager told us that she would again contact social services to try and resolve this matter as it was worrying for the service user concerned. Since the last inspection the manager has commissioned an independent person to carry out a fire risk assessment for the building and the home had a copy of the fire risk assessment. However there were a number of points raised in the risk assessment report and it was not clear if all of these points had been addressed. The registered person must ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. The manager told us that regular health and safety monitoring takes place. The fire logbook was inspected and testing and checks of fire equipment have been recorded. The home has contracts for the servicing of lifts, gas appliances and for fire alarms systems and equipment. However the manager could not locate the current safety certificates. We were informed that engineers had called at the home to service the equipment and she agreed to provide us with copies of the certificates as soon as they were located. Also the certificate we saw for the homes fixed electrical wiring was out of date and the manager agreed to follow this up with the landlord of the premises. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 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 7 15 The registered person must 01/03/2010 ensure that all service users have a clear plan of care that sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health and personal and social care needs of service users are met. This will ensure that staff have the information they need to provide the care and support that service users need and in the way they prefer. Good recording in monthly reviews will also ensure that there is good evidence that service users care needs are and continue to be met. 2 8 13 All Controlled Drugs, 31/03/2010 must be stored in a cabinet that meets the requirements of Care Homes for Older People Page 24 of 26 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 The Misuse of Drugs (Safe Custody) regulations 1973. In order to comply with the law. 3 38 13 The registered person must 01/03/2010 ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. This will help ensure that service users are kept safe. 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 25 of 26 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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