Care Home: Windmill Care Centre

Similar services:

• Flint House
• St Vincents
• The Cotswold Home
• Fairways
• Winton House
• Treloar College
• Rush Court

What the care home does well The residents are provided with a varied and interesting range of activities in which to participate. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. Relatives are always made welcome and are offered appropriate hospitality during their visits. Residents can rise and retire at a time of their choosing. They can choose whether to be alone or in company and may wander freely around there units. The garden is well used and is the focus for many activities and entertainments. The home is well maintained for the benefit of residents. All communal areas were clean, airy and well lit and were decorated and furnished to a comfortable standard. The home has a rolling programme of routine maintenance and renewal and a budget is available that reflects this. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. The home understands the importance of having sufficient accessible information to enable prospective residents to decide if the home is right for them. What has improved since the last inspection? Since the last inspection people have been weighed at regular intervals and referred to specialist dietitians if and when needed. What the care home could do better: There is a need to include more person centred information in the care plans to ensure they reflect the particular preferences of the residents. They should be signed and dated to evidence the input of the resident or other stakeholders. There is a need to ensure that staff are provided with the skills and knowledge they need to effectively meet the needs of the residents. This should include training in the Mental Capacity Act and Deprivation of Liberty legislation. There is a need for the Organisation to ensure consistency of management as lack of continuity has had a detrimental impact on the residents and staff. Staff should be effectively supervised and supported to enable them to effectively care for the residents. Key inspection report Care homes for older people Name: Address: Windmill Care Centre 104 Bath Road Slough Berkshire SL1 3SY     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: Julie Willis     Date: 2 7 0 5 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Windmill Care Centre 104 Bath Road Slough Berkshire SL1 3SY 01753213010 01753575450 windmill@schealthcare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gertrude Mashungupa Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 53. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Physical disability (PD). Date of last inspection Brief description of the care home This purpose-built Nursing Home for 53 residents caters for people with frailty associated with older age including mental frailty. It also caters for younger people with physical disabilities. The accommodation is arranged over three floors with separate facilities on each level including lounges, dining rooms and kitchenettes. Care Homes for Older People Page 4 of 29 0 0 0 Over 65 0 0 0 Brief description of the care home There are two lifts that service the floors and basement. The catering, laundry, hairdressing and sensory room facilities are located in the basement. All bedrooms are single rooms with en suite facilities. Cost of service GBP 619.87 - GBP 918.05 per week Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection of the service was an unannounced Key Inspection. The inspector arrived at the service at 09:45 am and was in the service for four hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the services manager, and any information that CQC has received about the service since the last inspection. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met most of the residents. The inspector also spent time talking informally to staff and observing how care was being delivered to the residents. Care Homes for Older People Page 6 of 29 From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspector gave feedback about her findings to the homes Acting Manager at the end of inspection. There were a number of legal requirements made as a result of this inspection. The Commission has received information concerning complaints and safeguarding matters since the last key inspection which took place on 25th July 2008, as a result there was a random focused inspection carried out on the 6th July 2009. There was one requirement arising from the inspection which has been met. Care Homes for Older People Page 7 of 29 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 29 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives have the information they need to choose a home that will be able to meet their need. People are fully assessed prior to admission to ensure the home will be able to effectively meet their need. Evidence: The home understands the importance of having sufficient information, set out in a clear, concise, user friendly format when people choose a care home. The home has developed a clear Statement of Purpose and Service User Guide which identifies the specialist services available at the home. It contains information about the terms and conditions of residency, a description of the accommodation, staffing and services as well as a copy of the complaint procedure. The home has a comprehensive admissions policy in place, which details the holistic Care Homes for Older People Page 11 of 29 Evidence: assessment that will take place prior to a residents admission. It identifies the need to fully involve the person to be admitted, their family, advocates and a multi-disciplinary team of professionals. From examination of care files it is evident that prospective residents are assessed prior to admission. The assessment usually takes place at home or in hospital and is carried out by the homes Registered Manager or one of the senior qualified nurses. The documentation for five residents was examined during inspection and these residents were case tracked from preadmission to date. From discussion with staff and management it is evident that planning is undertaken pre admission to ensure that the residents transition to the home goes smoothly, this includes ensuring that the home has in place any specialist equipment needed by the individual during their stay and ensuring that staff are conversant with the pre admission documentation. Examination of the records evidenced that information about the residents health and personal care needs were sought prior to admission. Clinical tools were used to assess the residents nutritional needs, communication needs and level of mobility. Manual handling risk assessments and safe systems of work have been developed to reduce the likelihood of injury to residents and to staff. Clinical tools were being used routinely to assess the residents risk of falls, continence needs and mental state. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with care in a manner, which maintains their right to dignity, privacy, independence and choice. The system for the administration of medication is good with clear and comprehensive arrangements in place to ensure the safety of residents Evidence: The care plans for five people were examined. They were in the main detailed and holistic. They considered many aspects of a persons lifestyle including their health and social care needs however, there was little evidence that users had been involved in planning their care. In the case of one user there was no photograph on file and two records did not give a clear indication of the residents input and were not signed or dated. It was clear that the care plans are regularly reviewed and updated. All risks to residents were assessed using a range of clinical tools and effective guidelines and equipment had been put in place to reduce the likelihood of occurrence. Care Homes for Older People Page 13 of 29 Evidence: All care given was documented in the daily records and examination of the content fully validated the care plans. Observation of practise demonstrated that care was provided in a manner, which maintained the residents right to dignity, privacy, independence and choice. Residents confirmed that they are provided with access to health and social care professionals for advice and support as necessary. They regularly see the GP who visits weekly and are referred to hospital when necessary for further advice, support and treatment. Routine screening and preventative treatments are provided to all residents of the home. The home has a comprehensive medication policy, procedure and practise guidance in place. The nurses are aware of their responsibilities in relation to the safe administration of medication and follow clinical guidance. The system used for the safe administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. Medication is stored securely and disposal systems are safe. The Doom box system has been adopted by the home for the disposal of waste medication and the home has an appropriate contract with a registered disposal company. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its residents. Evidence: From discussion with staff and management and examination of records it is evident that there is a wide range of activities taking place at the home. The Activity Organiser has developed an activities plan for the home which includes bowling, hand massage and relaxation, car racing games, cookery, dominoes, basket ball, story telling, cinema afternoons and pampering sessions. At the time of inspection musical entertainments were taking place on the dementia floor and a number of users were outside enjoying the sunshine. There are regular parties organised to celebrate special occasions and to mark festivals and special birthdays. There have been a number of recent trips out by bus which include outings to Ascot Races and theatre trips to see an Elvis tribute act. Care Homes for Older People Page 15 of 29 Evidence: Entertainments are also sourced from outside including an Elvis impersonator which is a residents particular favourite and regular sessions with singers and other musicians. One user said I like music, the Elvis is good, he makes me laugh. The gardens are well kept and they are well used by the residents who participate in horticultural pursuits. A large gazebo is used in the summertime and is a popular venue for undertaking a variety of activities. It was clear that the residents capacity to join in with activities varies according to their particular needs, however support and one to one assistance is offered on a routine basis. Residents that are bedfast are offered one to one manicures, hand massage and can be chatted or read to. Efforts are made to engage with all of the residents on a daily basis. Residents may have visitors at any time and relatives confirm that they are always made welcome and are offered appropriate hospitality during their visits. The routines at the home are flexible and are designed to offer residents choice and autonomy. Residents can rise and retire at a time of their choosing. They can choose whether to be alone or in company and may wander freely around the home and gardens. Policies, procedures and practise guidance at the home focus on residents being empowered to take control over their own lives. The menu at the home is varied and choices are offered. On the day of inspection there was a choice of beef stew with fresh honey roast potatoes, cut leeks and mashed potatoes or vegetable pasta. Asian food is also available. On the day of inspection vegetable curry and chappati was on offer. A range of other options is available daily including omelettes, baked potatoes with fillings or salad. Dessert was bread and butter pudding with custard. There is a need to ensure that the menus on each unit are an accurate reflection of what is on offer. On the day of inspection the menus stated that the lunch was Irish stew or vegetable lasagna with rice pudding and jam for dessert. This was found to be incorrect when the chef was spoke with. The home operates a revolving menu and uses the Nutmeg system for meal provision. This is the Organisations system for ensuring all meals are nutritionally balanced. The chef confirmed that he is able to cater for a range of special diets and cultural menus including diabetic diets, vegetarian diets, Halal meats and Kosher food if required. Care Homes for Older People Page 16 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 satisfactory complaints system. Residents feel their views are listened to and acted upon. Not all staff have received training in safeguarding which puts residents at risk. Evidence: The complaint policy in the home meets the requirement of Standard and Regulation. Residents and relatives are provided with information on how to make a complaint to the home and the formal stages in procedures. Examination of the complaint records indicated that there have been five complaints made to the home since the last inspection. The details of the complaints were well documented and indicated that an investigation had taken place and an outcome had been provided to the complainant. Information about one complaint had been reported to the Commission since the last inspection. This matter has been dealt with by safeguarding procedures and has been fully resolved to the satisfaction of the complainant. There was evidence in staff files and from discussion with staff, that they receive basic training in safeguarding adults as part of their formal induction to the home. The training is later consolidated when staff undertake NVQ training in which it forms a core module. The training matrix for the home indicates that 67 of staff have been trained in safeguarding adults and a number of staff are due to undertake training on Care Homes for Older People Page 17 of 29 Evidence: 17th June 2010. There is a need to ensure that everyone is aware of what constitutes abuse as one member of staff when questioned was not able to say what the training had been about although they had received training in October 2009. Observation of care practise concluded that staff were patient and understanding when dealing with residents and appeared mindful of the need to respect their privacy at all times. The majority of staff spoken with were aware of the homes whistle blowing policy and understood the importance of protecting residents from abuse and exploitation at all times. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standards of decor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. Evidence: From a tour of the building it is clear that the home is well maintained. Areas of the home have been redecorated since the last inspection for the benefit of residents. All communal areas were clean, airy and well lit and were decorated and furnished to a comfortable standard. New furniture has been provided to the Sunflower lounge to improve the comfort and environment for the residents of the unit. The home has a rolling programme of routine maintenance and renewal and a budget is available that reflects this. The handy person checks the maintenance book each morning to ensure that minor deficiencies can be put right in timely fashion. The bedrooms were all highly personalised and were warm spacious and comfortable. The home has a range of aids and equipment available to maintain residents independence and to promote safe care. Profiling beds are available for residents that need them and specialist mattresses are used routinely to promote tissue viability. There is a choice of bathing and showering facilities both assisted and unassisted and there are sufficient toilets placed strategically around the home to meet the needs of Care Homes for Older People Page 19 of 29 Evidence: residents. All bathrooms, toilets and sluices have a supply of liquid soap and hand towels to maintain satisfactory infection control standards. The AQAA states that all staff receive training in hand washing and reminders are at each sink. There is a need however, to ensure that all staff have infection control training as the training matrix for the home indicates that only 49 of the staff have received the appropriate level of training at the time of inspection. The home was clean and hygienic throughout there were no residual odours noted. Residents confirmed that the home is always clean and well maintained and staff work hard to provide a pleasant environment for the residents. The laundry was sited in the basement so that soiled articles, clothing and infected linens are not carried thorough areas where food is stored, prepared, cooked or handled. There is a separate service lift for staff. The red sack system is in operation at the home to assist in the safe handling of soiled linens. Care Homes for Older People Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. Recruitment policies and procedures at the home are robust and transparent and ensure the safety of residents. There were gaps in staff training records that puts residents at risk. Evidence: Examination of five staff records and discussion with staff and management indicated that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. Recruitment records were well kept and met the required standard. It is clear that the homes policy on recruitment is robust, transparent and meets the requirements of current good practise guidance and legislation. Examination of the training records evidenced that 25 of the current staff have either gained or are in the process of attaining NVQ qualifications at levels II & III. The management and senior staff provide the necessary support and guidance to candidates. There are currently 15 staff already qualified to NVQ level 2 and five people are undertaking the training currently. Care Homes for Older People Page 21 of 29 Evidence: There were a number of training sessions booked for June 2010 which included Health & safety, COSHH, safeguarding, nutrition and dealing with challenging behaviour. The homes training statistics evidenced gaps in training for a large number of staff. Training statistics dated 25/05/10 indicated that 84 of the staff had up to date fire safety training, 82 fire evacuation training, 92 had been involved with fire drills, 84 had food hygiene training, 69 had manual handling training, 53 had COSHH training, 57 had health & safety training, 67 had up to date safeguarding training, 79 had nutrition training, 40 had received medication training, 64 had pressure area care training, 71 had been provided with customer care training, 70 care plan training, 43 had challenging behaviour training, 43 dementia awareness training. Only 2 of the staff had received training in YTT (Yesterday, today, tomorrow) dementia training and 62 had received training in safer use of bed rails. There was no evidence that staff had been provided with Mental Capacity Act or DOLS training. There is an urgent need to ensure that everyone has the training they need to carry out the tasks of their job. The home should develop some way of checking that people understand what they have learnt and can effectively put theory into practise. One member of staff was unable to answer basic questions about what they had learnt on the courses they had attended. Their record said that they had received safeguarding training in October 2009, COSHH awareness in November 2009 and customer care training in June & September 2009. There was no evidence that they had been provided with any training in manual handling, fire safety, infection control, health & safety or first aid since they had been recruited. There was evidence that all staff are inducted and complete a period of shadowing senior staff to ensure that they are confident and competent to carry out the tasks of the job. Staff confirmed that they had undertaken an in house induction and foundation training to Skills for Care specification. The staff records were well kept and contained copies of induction training, job descriptions, application forms, two written references, training certificates, supervision and appraisal records. These were examined to evidence compliance with good practise. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent frequent changes in management have had a detrimental effect on the running of the home. Supervision of staff has been infrequent which does not provide staff with sufficient support and guidance to provide effective care to residents. Quality assurance processes are not sufficiently robust to effectively seek the views of residents and other stakeholders about the quality of the service. Evidence: At the time of inspection the Registered Manager had not been on duty for over nine months and the home has been managed in the interim by a number of acting managers. The change of management and the consequent inconsistency of management style has had a detrimental impact on residents and staff at the home resulting in a number of complaints and safeguarding matters being raised. Care Homes for Older People Page 23 of 29 Evidence: The home is currently being managed by an acting manager. The acting manager is a qualified nurse with an NVQ level 4 in management. He has been working to try to improve the quality of service to residents and to support and develop the staff team. Staff spoken with during inspection confirmed that the acting manager was helpful and supportive. There is a need to provide more support to staff as there was evidence of a deficit in the frequency of one to one supervision sessions which help to support staff in their work role. Records indicated that group supervision had been undertaken for nursing staff on at least one occasion. Records of supervision were duplicated across several nursing staff. There were large gaps in the frequency of supervision for care staff. Records were repetitive in their content and information recorded was scant and lacked sufficient detail. The Regulation 26 (Proprietors Representative) reports for December 2009, January, February & March 2010 were not available for inspection. The acting manager was unable to confirm if the visits had taken place. There is a need to ensure that the Proprietors Representative carries out monthly unannounced visits to the home to tour the premises, interview residents and staff and check written records to monitor quality assurance and meet requirements of regulation. Examination of a sample of health & safety records indicated that they were up to date and in good order. Routine servicing and maintenance of equipment is undertaken at appropriate intervals to maintain the home as a safe and risk free environment for residents. There is a need however, to ensure all staff have regular refresher training in health & safety, manual handling and infection control as records indicated a deficit. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Ensure care plans are person centred and residents input into their care plans is clearly documented. To ensure that residents have a say in how their care will be delivered 25/07/2010 2 26 13 Ensure that all staff receive training in infection control on a regular and on going basis. To reduce the risk of cross infection 22/08/2010 3 30 18 Staff should be provided with the training they need to carry out the tasks of their job. This includes access to National Vocational Qualifications. To ensure service users are provided with appropriate care from fully trained staff. 23/08/2010 Care Homes for Older People Page 26 of 29 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 4 33 26 The Proprietors 25/07/2010 Representative should carry out an unannounced monthly visit to the home. They should tour the home, talk to staff and residents and check written records. A report must be written about the conduct of the home which must be available to the inspector. To ensure that the quality of service provided to residents is effectively monitored 5 36 18 A programme of supervision 25/07/2010 should be developed which ensures that all care staff are provided with regular supervision at least six times a year. Records should be kept of each supervision which ensures that supervision covers all aspects of practise, the ethos of the home and identifies career development needs for the individual. To ensure that service users are cared for by appropriately supervised, trained and supported staff. Care Homes for Older People Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 18 The home should ensure that staff fully understand what they have been taught in training sessions. All staff should understand what constitutes abuse and should be aware of the whistle blowing policy. Staff should be provided with Mental Capacity Act and Deprivation of Liberty training in order to heighten their awareness of these issues. 2 30 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 29 of 29 - 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!