Care Home: Whitehall Lodge Residential Care Home

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well People told us they had good experiences living at this home. They told us that staff were always about and described them as wonderful, very caring, friendly and helpful. Visitors told us they were very satisfied with the care their relatives received and three people told us they had seen improvements in their relatives health since they had moved into the home. The records we saw showed that staff received good training and were competent and well supported. People live in a very comfortable and homely environment and they told us they were very pleased and satisfied with their personal space. They described how they could bring items of their own into the home to make their rooms feel more personal to them. The atmosphere in the home was very good, with plenty of laughter and smiles throughout the day. People told us there was plenty for them to do and they liked the range of activities available which they could join in with if they wanted to. They also told us they appreciated the events that were arranged for outside of the home and were particularly looking forward to a visit to the Great Yarmouth Circus followed by high tea on the week following inspection What has improved since the last inspection? We looked at the improvement plan that had been requested following the last inspection and assessed what improvements have taken place since March of this year. The work completed has been significant and the proprietors, manager and staff are commended for their hard work and commitment. The areas that have improved include a more accessible complaints procedure that is now provided to all residents and next of kin. People now know how to raise concerns and complaints and were aware of what actions they can expect the home to take. There have been very significant improvements in staff training and all mandatory training had been completed by the time of this inspection. Staff also receive regular supervision to ensure they were well supported in their role. Another area of significant improvement was around care planning. We could see that good practice was now in place although discussion about further improvement also took place during the inspection to make sure there was continuous improvement. The way the service now looks after residents personal allowances has been overhauled and embraces good practice. With the better practice and improved recording, plus regular audits carried out by the manager, the revised practice now helps to ensure residents are protected from financial abuse. There has been a continuous programme of redecoration and renewal since the last inspection and this was ongoing. All areas of the environment have benefited from this programme including bedrooms, bath and toileting facilities, communal areas and the garden. Facilities within bedrooms have also been improved and all residents are now provided with a bedside light and lockable cabinets if they wish.Recruitment and induction processes have improved and staff are subjected to appropriate checks such as Criminal Records Bureau and a minimum of two written references. These practices will help to protect people from abuse. The home had implemented its quality assurance system for the first time shortly before the inspection took place. Although it is at an early stage, the manager was able to describe how she was going to analyse the responses she received and how she would share those findings and an improvement plan with residents, visitors and others. Fire safety has improved at the home and staff were receiving regular fire drills and training at the time of inspection. The fire alarm testing is also taking place regularly and in line with best practice. All staff had received training about safeguarding vulnerable adults and had also received booklets telling them about abuse and how it should be identified and what they should do if they saw abusive practice.. What the care home could do better: As previously stated, significant improvements have taken place and are continuing to do so at this time. Inevitably, there remain areas where practice could be improved and these were discussed in detail with the manager at the time of inspection. We have made one requirement and six good practice recommendations as a result of this inspection. The requirement we have made concerns a balcony that is accessed from one of the bedrooms. The fencing around the balcony needs to be repaired or replaced so that, should the resident wish to access the balcony, it will be safe for them to do so. It is acknowledged that at the time of inspection, the resident in this bedroom had no desire to use the balcony and access had therefore been restricted. The manager needs to make sure that as much detail as possible is recorded at the time of the pre-admission assessment, so that she can better assess if the service can meet the individual`s needs. This will also help when staff develop initial care plans. Further developments based on good practice were discussed with regards to the care plans. These included a specific care plan detailing the social and emotional needs of people and also better recording arrangements, so that information could be found and retrieved easily. The manager was advised to use a checklist when recruiting staff to make sure that all information is requested and received in a timely way. It would also be helpful to reorganise the staff files, so that all of the information contained is kept in a uniform way and information can be found more easily. Key inspection report Care homes for older people Name: Address: Whitehall Lodge Residential Care Home 56/112 Whitehall Road Norwich Norfolk NR2 3EW     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: Geraldine Allen     Date: 2 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Whitehall Lodge Residential Care Home 56/112 Whitehall Road Norwich Norfolk NR2 3EW 01603618332 01603766506 whitehall.lodge@gmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Whitehall Care Ltd care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Whitehall Lodge is a registered care home for older people accommodating up to 29 service users. The home comprises three Victorian terraced houses linked together to a further Victorian detached house. The accommodation has three levels and provides 23 single and 3 double rooms, some of which have en suite facilities. There is a rear garden with a patio area and the home is situated in a residential area within walking distance of the local shops and other amenities. The city centre is also within walking distance. Charges for the service vary depending on need and people should contact the service to get up to date information . A copy of the most recent inspection report is available in the entranceway to the home or can be downloaded via the internet from: www.csci.org 2 4 0 3 2 0 0 9 0 Over 65 29 Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before this inspection we looked at all of the information we had received about the service during the last 12 months. This included the Annual Quality Assurance Assessment (AQAA). The AQAA is completed each year by the service and gives us information about how well the service meets the desired outcomes for the people living at the home. It also provides us with numerical information and details of the policies and procedures used at the home. We also received completed surveys from residents and staff. Our inspection took place unannounced on Tuesday, 25 August 2009. During the course of the day we obtained information from various sources, including looking at various files and records, touring the premises, speaking with residents and visitors, speaking with staff and the manager. We also had lunch with residents in the dining room so that we could observe arrangements with mealtimes and also discreetly observe staff practice and interaction with residents. Care Homes for Older People Page 5 of 28 As a result of this inspection, we have made one requirement and six good practice recommendations. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? We looked at the improvement plan that had been requested following the last inspection and assessed what improvements have taken place since March of this year. The work completed has been significant and the proprietors, manager and staff are commended for their hard work and commitment. The areas that have improved include a more accessible complaints procedure that is now provided to all residents and next of kin. People now know how to raise concerns and complaints and were aware of what actions they can expect the home to take. There have been very significant improvements in staff training and all mandatory training had been completed by the time of this inspection. Staff also receive regular supervision to ensure they were well supported in their role. Another area of significant improvement was around care planning. We could see that good practice was now in place although discussion about further improvement also took place during the inspection to make sure there was continuous improvement. The way the service now looks after residents personal allowances has been overhauled and embraces good practice. With the better practice and improved recording, plus regular audits carried out by the manager, the revised practice now helps to ensure residents are protected from financial abuse. There has been a continuous programme of redecoration and renewal since the last inspection and this was ongoing. All areas of the environment have benefited from this programme including bedrooms, bath and toileting facilities, communal areas and the garden. Facilities within bedrooms have also been improved and all residents are now provided with a bedside light and lockable cabinets if they wish. Care Homes for Older People Page 7 of 28 Recruitment and induction processes have improved and staff are subjected to appropriate checks such as Criminal Records Bureau and a minimum of two written references. These practices will help to protect people from abuse. The home had implemented its quality assurance system for the first time shortly before the inspection took place. Although it is at an early stage, the manager was able to describe how she was going to analyse the responses she received and how she would share those findings and an improvement plan with residents, visitors and others. Fire safety has improved at the home and staff were receiving regular fire drills and training at the time of inspection. The fire alarm testing is also taking place regularly and in line with best practice. All staff had received training about safeguarding vulnerable adults and had also received booklets telling them about abuse and how it should be identified and what they should do if they saw abusive practice.. 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 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions to the service are only made after a full needs assessment has been completed. People are only admitted to the home if the service is confident their individual needs can be met. People receive a statement of terms and conditions that sets out in detail what is included in the fee, the responsibilities of the provider and the rights and obligations of the resident. Evidence: The manager confirmed that all people living at the home receive a contract which outlines the terms and conditions of residence. A review was completed in July 2009 to confirm all people had received a copy. Before entering the home, all people have a full assessment of their needs completed by the manager. This looks at a wide range of issues and helps to establish whether or Care Homes for Older People Page 11 of 28 Evidence: not the service is able to meet the persons needs in full. Whilst a full needs assessments is carried out, there was some discussion about the need for more detailed information to be recorded at this stage. Not only will this help to ensure the service is able to meet the persons needs, it will also give much more detailed information to help staff formulate initial care plans for when the person moves into the home. The manager undertook to implement these recommendations immediately. This service does not provide intermediate care. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have an individual plan of care that sets out the support they need and how and when it should be provided. The care plan needs more information about how social and emotional needs can be met. People receive personal and health care support in an appropriate and timely way. Staff receive training in health care matters. Medication practices and procedures are safe and will be further improved when the appropriate controlled drug storage cabinet is installed. People are treated in a dignified way and their right for privacy is protected. Evidence: For this inspection, we looked in detail at three residents care plans. They showed us that there has been a significant improvement in the way the service assesses peoples needs on a regular basis and records what staff need to do in order to support them. The manager told us that she has consulted with a professional body to ensure best practice. However, there are still areas where improvements could be Care Homes for Older People Page 13 of 28 Evidence: made and these were discussed with the manager. For example, it was suggested that the care plans are laid out in such a way that it is possible to view any changes in a chronological order. It was also suggested that care plans reflecting the social and emotional needs and preferences of the person should be developed. Good records were seen in respect of visits by health professionals such as the GP, district nurses and chiropodists. However, these records were included within the daily record and were therefore difficult to locate and follow through. It was therefore recommended that a separate health care interventions sheet should be developed so that all information about health interventions can be retrieved more easily. A visiting health professional was spoken with during the course of the inspection. She told us she was impressed with the standard of care and support provided to people living at this home. She felt staff were competent and used initiative. She also told us she felt real improvements had been achieved since the manager has taken over. The arrangements for the storage, administration and recording of medicines kept at the home was looked at and the procedures discussed with the senior member of staff. Good practices were seen and all records were kept up-to-date and were legible. The arrangements for the storage and recording of controlled medicines was discussed with the manager. At the time of inspection, the service did not have a lockable facility that was compliant with current legislation and the manager undertook to resolve this without delay. The service has developed its own register of administration and some suggestions were made to make the record easier to follow. The manager undertook to deal with this also. People told us that staff always supported them and respected their privacy and dignity. During the course of the inspection, staff practice was discreetly observed and it was seen that all personal care was delivered in private. Staff spoke with residents appropriately and treated them in a dignified manner. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are enabled to develop and maintain personal and family relationships, with visitors being actively welcomed into the home. People are supported to access the local community. People are encouraged to make choices around their daily living and these choices are understood and respected by staff. People receive a varied and nutritious diet that is well balanced and meets the dietary needs of the individual. Evidence: Most residents were spoken with during the course of the day and five were spoken with at some length. People told us they could choose to spend their day how they wished and were supported by staff to do so. One person told us that he likes to get up very early in the morning and staff were always very happy to support him to do so. People also told us about the activities that take place both in and outside of the home. For example, the week before inspection a fete had been held at the home and this had been very well supported by relatives and friends. The week following inspection, residents were going on an outing to the Great Yarmouth Circus followed Care Homes for Older People Page 15 of 28 Evidence: by high tea at a Hotel. There was a great deal of talk about the planned outing and this was clearly being looked forward to. On the day of inspection, staff led a singalong followed by a quiz, both of which were well attended and enjoyed. A significant number of visitors called into the home during the day of inspection and some of these people were spoken with. Three different people told us that their relatives health had improved since moving into the home. Very positive comments were made about the staff and the care they provided. People living in the home gave us many examples of how they are encouraged and supported to make choices around their daily living and all were confident that staff would support the choices they made. A meal was eaten with residents, allowing plenty of discussion about food provided at the home. People told us they were offered plenty of choices and the cook always asked them what they would like. They said the quality of food was very good and there was always plenty of it. It was noted that there was very little waste food on the day of inspection. Food was presented ready plated and covered. The opportunity was taken to speak with the cook and she described the special diets provided by the home. The dry food store was clean and very well organised, ensuring good stock rotation. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure that is clearly written and well known to residents and people visiting the service. People are protected from abuse by staff who are well trained and who are subjected to rigourous checks before they are employed at the home. Evidence: The service has a complaints procedure that is displayed in the entrance hall. The manager told us that all residents and relatives have received a copy and copies were seen displayed on the back of bedroom doors. The procedure explains to people how to go about making a complaint and who to contact if they are dissatisfied with the outcome. The manager told us that one complaint has been received at the service since the last inspection and records about this were looked at. These showed that the manager had acted promptly and investigated appropriately. We spoke with people living at the home and also visitors to the service and they were all aware of what to do if they had any complaints or concerns about the care at the home. People said the manager was very approachable and they were confident she would deal with any concerns they had. We looked at the training records for staff and confirmed that all staff have received training about safeguarding vulnerable people. Staff spoken to were knowledgeable Care Homes for Older People Page 17 of 28 Evidence: about safeguarding matters. Staff practice was observed and it was appropriate. The service has robust staff recruitment procedures in place that include a Criminal Records Bureau check before staff commence working at the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well maintained, clean and safe. An extensive redecoration and refurbishment plan is in place to continuously improve the environment. Privacy screens were in place in shared bedrooms. Peoples personal space reflects their choices and preferences. All areas were clear of clutter and emergency exit routes were unimpeded. Lighting and ventilation were adequate and hot water temperatures were appropriately controlled. Evidence: An extensive redecoration and refurbishment programme has been taking place at the home since the last inspection. A tour of the premises was undertaken with the manager and this demonstrated the significant improvements that have been achieved in the environment in recent months. A programme of routine maintenance was in place and records showed that this was up-to-date. Some bedrooms were seen and these had varying amounts of personalisation, based on the choices expressed by the resident. A record has been kept where residents have declined such items as lockable cabinets and bedside lights. It was noted that a Care Homes for Older People Page 19 of 28 Evidence: shared bedroom suffered from a urine odour. This was early in the morning and it was noted the room was being aired. The problem was discussed with the manager, who said she was taking steps to resolve this issue effectively. The manager told us that one of the bathrooms that is currently not being used was to be decommissioned and used for much-needed storage space. At the time of inspection, a level access shower room was being installed. Whilst it was small, the laundry room was equipped with a washing machine that had sluicing and disinfection programs installed. The lounges and dining rooms were appropriately furnished, clean and tidy. The small lounge/dining room was in use during the morning for staff training but was available again during the afternoon. Residents were moving freely about the building and were choosing where to sit. Externally, improvements have been made to the garden and residents were seen making use of the space throughout the day. One of the first floor bedrooms has direct access to a balcony and concern was expressed at the time of inspection about the state of the fencing around the balcony. The manager confirmed that the resident does not access the balcony and steps will be taken to ensure no one makes use of the space until the fencing has been repaired. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service employs sufficient staff to ensure residents needs are met in a timely way. There is a good recruitment process that ensures people living at the home are protected. All staff receive training that is relevant to their roles, including fully recorded induction training. Evidence: The staff roster for the week of inspection was provided. This showed that sufficient staff were employed to meet the needs of the residents. People living at the home confirmed that there were always plenty of staff available to help them although they acknowledged that at busy times they may have to wait a few minutes. On the day of inspection, agency staff had been employed so that permanent staff could attend statutory training during the morning. Three staff files were looked at in detail. These showed that the home follows a robust recruitment process that includes a Criminal Records Bureau check, a minimum of two written references, a completed application form and attendance at a formal interview. This practice helps to ensure people living at the home are protected from abuse. It was suggested to the manager that a recruitment checklist would help her ensure that all the necessary information is received in a timely way. It was also suggested that Care Homes for Older People Page 21 of 28 Evidence: she would find it easier to retrieve information if she standardised the way the staff files were put together. Newly appointed staff are required to complete a fully recorded induction program. The induction programme was seen and was compliant with the common induction standards and the General Social Care Council code of conduct. The service has also developed a training plan that is appropriate to the needs of the residents and provides staff with the skills and knowledge to undertake their roles. On the day of inspection, staff were attending manual handling training. Other training that has been taking place since the last inspection includes infection control, fire safety, first aid and safeguarding vulnerable adults. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is experienced and competent to run the home. She ensures an open positive and inclusive atmosphere. People are consulted as part of an annual quality assurance process. The service has an improvement plan and this will be continually updated as a result of the views of people using the service. People are protected from financial abuse by good practices in respect of personal allowances looked after by the home. Staff are supported through a fully recorded and regular supervision programme. The health, safety and welfare of residents and people using the service are protected by good and safe working practices. Care Homes for Older People Page 23 of 28 Evidence: The manager, Mrs Albas, has been in her role since January 2009 although she has worked at this home for many years. Although not yet registered, Mrs Albas has applied to us to become the registered manager of this home. She is currently studying NVQ at level IV and will commence the registered managers award shortly. People told us that Mrs Albas is very approachable and will always listen to what they have to say and act on it if she possibly can. Staff said she was very supportive. The homes quality assurance processes were looked at. These have recently been developed and the first questionnaires were recently sent out to all interested parties to complete and return. We were told that, on receipt of completed questionnaires, an analysis of the responses will take place and from this an improvement plan will be developed. We were told this process will be repeated each year to give people an opportunity to express their views. Residents and staff also told us they were able to attend regular meetings with the manager. The arrangements for looking after residents personal allowances were looked at and it was found that significant improvements have been made. Good practice was seen and the manager confirmed that monies held were checked against records every two weeks. Money is kept locked in the office. During the course of this inspection, we checked the money held against records and this was correct. It was recommended that both people signing as witnesses to transactions should sign in full and not initial so that a clear audit trail can be maintained. Staff supervision records were looked at. This practice has started since the last inspection. Each supervision was fully recorded and signed by the manager and member of staff. Health and safety records were looked at including fire safety, accident records, hot water, and health and safety. All records were up-to-date and legible. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 Access to the balcony from 03/11/2009 bedroom 16 must be restricted until the fencing has been repaired and made safe. This will ensure the risk of accidents is reduced. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 It is recommended that the pre admission assessment is further developed to ensure that more detailed information is recorded. This will ensure the service can accurately judge if they can meet the individuals needs and will also aid staff to develop more detailed initial care plans. It is recommended that a separate record is kept of all health professional interventions. This will mean that information will be kept in a chronological order and will be more easily retrieved. It is recommended that a care plan reflecting the social and emotional needs of the individual is developed. This will ensure that staff will understand how they can support people effectively. Page 26 of 28 2 7 3 7 Care Homes for Older People 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 4 7 It is recommended that care plans are developed further so that individual care plans are recorded separately. This will mean that staff will be able to identify changes in the persons condition and will be able to see a chronological record. It is recommended that staff files are organised so that the format is standardised and information can be retrieved easily. It is recommended that a recruitment checklist is used so that any missing documents required for the recruitment process can be identified in a timely way. 5 29 6 29 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!