Care Home: Woodford Care Home

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What the care home does well People have their care and health care needs well assessed before they move into the home. People have good diverse and individual care and health care plans in place, they are well protected by the home`s systems for handling medication and they experience good maintenance of their privacy and dignity. People enjoy a satisfactory level of entertainment, activity and contact with family and the community, making their own informed choices where possible and they enjoy good nourishing food provision. People are listened to and have their complaints effectively resolved by the home`s systems for handling complaints. People are well protected from abuse by the systems for monitoring, recording and referring issues on protection. People have a safe, clean and pleasant home to live in that only requires some minor upgrades or repairs. People are cared for and supported by well qualified and trained staff in good numbers, so their needs are well met. People enjoy a well managed home that is run in their best interests, by two efficient deputies, using an adequate quality assurance system, offering financial protection and ensuring people and staff health, safety and welfare are well maintained. What has improved since the last inspection? People now have improved protection from the risk of harm from taking the wrong medication because two staff now sign the medication administration record (MAR) sheets when a change in or a new medicine has been prescribed and it needs adding to the MAR sheet. People now have improved protection from the risk of employing unsafe staff because any previous identified or declared convictions highlighted on a person`s criminal records bureau check are now discussed with them before a decision is made to employ them. What the care home could do better: People could have their care needs better known and met if the service made sure recent copies of the placing local authority `community care` assessment documents were held in people`s files with the home`s assessments. People could have their care needs better known and met if the service made sure the most recent placing local authority `community care` care plan was held in people`s file, so they know their care and health care needs are known and are being met. People could enjoy their living environment more if the service carried out a full audit of the environment and redecorated rooms and communal areas where identified as needed, so people have a well maintained home to live in. People could enjoy their living environment more if the service made sure an audit of repairs and refurbishment was done to identify any specific needs for upgrading of the home and also carried out the following:- replace damaged or old commodes and wardrobes, fit all beds with headboards and repair the broken conduit around the front door alarm wires, so people are confident they live in a safe, pleasant and well maintained home. Some people could experience improved privacy if the service made sure staff did not use the connecting door between two rooms on the upper floor to access different parts of the house except in extreme emergencies or in the case of fire, so people know their privacy will not be intruded upon. People could be more protected if the service made sure staff only started work after their CRB had been received. People could be more protected if the service made sure staff supplied two written references, one from the most recent employer and one from a previous employer, not from a family member. References should also be obtained before a staff starts work. People could be more protected if the service made sure all receipts kept of expenditure by people were numbered and the corresponding number was written in people`s individual recording books, so easier auditing can be done. Key inspection report Care homes for older people Name: Address: Woodford Care Home 592-596 Holderness Road Hull N Humberside HU9 3EU     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: Janet Lamb     Date: 0 5 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 27 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 27 Information about the care home Name of care home: Address: Woodford Care Home 592-596 Holderness Road Hull N Humberside HU9 3EU Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Bostan Care Homes Ltd TA Woodford Care Home Type of registration: Number of places registered: care home 23 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 who may be accommodated is: 23 The Registered person may provide the following category of service only: care Home only- Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia-Code DE; Old Age , not falling within any other category-Code OP Date of last inspection Brief description of the care home Woodford Care Home is situated on Holderness Road in the east of the City of Hull, opposite a leisure centre and within walking distance of local shops and services. A main bus route in and out of the city runs passed the front door. Care Homes for Older People Page 4 of 27 Over 65 23 23 0 0 Brief description of the care home The home is two joined properties and has single and double bedrooms on both the ground and first floor, which is accessed by a stair lift. There is one lounge dining room that runs into another lounge at one side and into an overflow dining room at the other side, a kitchen, a laundry and bathrooms facilities. There is no garden to the property, but two small patio areas are available, though neither have a view of any sort. Car parking is on the main road outside the house. The current weekly fees range from £365.00 to £410.00 per person and there are no extra charges, except for hairdressing and newspapers at cost. Information about the home can be obtained in the form of a statement of purpose and a service user guide on request. Care Homes for Older People Page 5 of 27 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: The Key Inspection of Woodford has taken place over a period of time and involved sending a request to complete an annual quality assurance assessment (AQAA) in March 2010, containing information about people who use the service and staff and details of the homes policies, procedures and practices. The Commission received the requested information in April 2010 and survey questionnaires were sent to people living in the home, to health care professionals and to staff working there. Of these surveys 13 were returned from the people in the home, 3 from relatives, 4 from staff and 2 from health care professionals. All of the information obtained in surveys, from notifications received and information already known from having had contact with the home since the last key inspection was used to suggest what it must be like living there. Then on 5th May 2010 Janet Lamb made a site visit to the home to test these Care Homes for Older People Page 6 of 27 suggestions and to interview people, staff, visitors and the home manager. Some documents were viewed with permission from those people they concerned and some records were also looked at. The communal areas of the home were viewed along with eight bedrooms. There were three people who use the service, two deputy managers and two staff interviewed and other people were spoken with during the site visit to seek information. Two relatives were very briefly spoken to. What was said was checked against the information obtained through questionnaires and details already known because of previous information gathering and contact with the home. Judgements were made using the information and some of the evidence used at the last inspection to say what it is like living in the home. This report shows those findings and judgements. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: People could have their care needs better known and met if the service made sure recent copies of the placing local authority community care assessment documents were held in peoples files with the homes assessments. People could have their care needs better known and met if the service made sure the most recent placing local authority community care care plan was held in peoples file, so they know their care and health care needs are known and are being met. People could enjoy their living environment more if the service carried out a full audit of the environment and redecorated rooms and communal areas where identified as needed, so people have a well maintained home to live in. Care Homes for Older People Page 8 of 27 People could enjoy their living environment more if the service made sure an audit of repairs and refurbishment was done to identify any specific needs for upgrading of the home and also carried out the following:- replace damaged or old commodes and wardrobes, fit all beds with headboards and repair the broken conduit around the front door alarm wires, so people are confident they live in a safe, pleasant and well maintained home. Some people could experience improved privacy if the service made sure staff did not use the connecting door between two rooms on the upper floor to access different parts of the house except in extreme emergencies or in the case of fire, so people know their privacy will not be intruded upon. People could be more protected if the service made sure staff only started work after their CRB had been received. People could be more protected if the service made sure staff supplied two written references, one from the most recent employer and one from a previous employer, not from a family member. References should also be obtained before a staff starts work. People could be more protected if the service made sure all receipts kept of expenditure by people were numbered and the corresponding number was written in peoples individual recording books, so easier auditing can be done. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 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 27 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 have their care and health care needs well assessed before they move into the home. Evidence: Discussion with the deputy managers, with people in the home and viewing of case files with permission, shows people are always assessed before entering the home for care. People are given every opportunity to visit the home, stay over and to spend a trial period there before they commit to residing permanently. A statement of purpose and a service user guide are provided as information on the home and people receive a contract of residence once they do move in. The assessment of peoples needs is carried out in their own home or in hospital and involves the completing of a Standex assessment form. It is completed with the cooperation of people or their relative and is agreed and signed where possible and it contains comprehensive information on peoples individual and diverse needs. The Care Homes for Older People Page 11 of 27 Evidence: copies of the most recent placing local authority community care assessment documents should be kept in peoples files with the copies of the homes Standex assessment forms. A recommendation on this is being made in this report. Care Homes for Older People Page 12 of 27 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 good diverse and individual care and health care plans in place, they are well protected by the homes systems for handling medication and they experience good maintenance of their privacy and dignity. Evidence: Discussion with the deputy managers and people in the home and viewing of case files and records shows care and health care plans are in place, medication is handled safely to protect people and privacy and dignity are upheld well. Everyone has a care and health care plan in the format of a Standex care plan. These are compiled with cooperation from people or their families, are signed and dated and only cover identified and relevant areas of need. One care plan seen looked particularly at mobility, safety, eating and drinking, nutrition, physical care and social activities. Accompanying the care plan was relevant risk assessment documents for nutrition, helping the person to move and mobilise and for falling. People also have a patient passport in place should they need to be admitted to hospital. Care Homes for Older People Page 13 of 27 Evidence: Each case file also shows evidence of assistance with personal care, any key worker input or time spent with them, GP or district nurse visits and any accidents that have occurred. Care plans are reviewed as changes in need arise or otherwise each year in consultation with the placing local authority and family members. A recommendation is being made to ensure the original or most recent placing local authority community care care plan is also held on file. There is a medication administration policy and procedure for staff to follow. Only those trained in medication administration through Lloyds Chemist actually administer drugs from a monitored dosage system. Evidence of training was seen in staff files. The medication administration round was observed at lunch time and practice is satisfactory. A recommendation made at the last key inspection to ensure two staff sign a change of dosage directions or make an addition of a medicine on the medication administration record (MAR) sheet, is now being met. MAR sheets seen were appropriately completed. Any controlled drugs or those required to be stored as controlled drugs are kept in a double locked facility and recorded with two signatures on administration in a controlled drug register. People spoken to say they are satisfied with the medication arrangements as not having the responsibility suits them. One did say she used to administer her own insulin injections and would still like to even though the District Nurse calls daily to do so. This was discussed with the deputy managers. The maintaining of privacy and dignity for people is well managed. People only receive personal care in their room or a bathroom, doors are knocked on before entering a room and people are given their mail unopened. The staff were observed talking respectfully to people and treating them as adults able to make their own decisions wherever possible. Care Homes for Older People Page 14 of 27 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 enjoy a satisfactory level of entertainment, activity and contact with family and the community, making their own informed choices where possible and they enjoy good nourishing food provision. Evidence: Discussion with the deputy managers and people in the home, viewing of some records and documents and observation of the midday meal shows there are satisfactory activities and pastimes to occupy people and that though they would like to go out more they do receive plenty of visitors and they do enjoy home cooked food. People say they see relatives, do not do a lot or go out as much as they would like to, but do enjoy any activity that is arranged for them. Three people were observed with visitors. People say they take part in resident meetings once in a while and that they discuss foods, activities, the seasons festivities and so on. There is one care staff allocated a small number of hours per week to undertake activities with people, usually crafts, knitting etc. and the home has tapped into Hull City Arts Project who visit regularly and supply ideas for activities and entertainment. Where possible people are fully encouraged to make their own decisions about life and Care Homes for Older People Page 15 of 27 Evidence: daily living and to handle their own finances. This is usually a limited amount of money they keep on their person or in their room, but mostly people have money held in safe keeping or family members take control of it. The home has a simple system for keeping money safe, recording expenditure or credit in and for auditing peoples money through individual recording books and the keeping of receipts. Two checks on money held in safe keeping were carried out and showed finances are accurately and well maintained. One recommendation is being made in the section on management and administration in this report to ensure receipts kept against any expenditure are numbered and this number is also recorded at the appropriate place in the recording book for easier identification and auditing. See standard 35. People spoken to say they are very satisfied with the food provision, three meals a day plus a snack at supper. They say food is good, that it is a set menu but if they dont like or want whats on offer they can request an alternative, and that they sometimes make choices for the menu in resident meetings. The meal at midday and seen on the day of the site visit was home made sausage pie, mashed potatoes and peas with gravy and fruit sponge and custard for pudding. There were no adverse comments about food, either verbal or on surveys returned to us, except for one person stating they didnt always like the meals. Generally everyone else was quite satisfied though. Care Homes for Older People Page 16 of 27 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. People are listened to and have their complaints effectively resolved by the homes systems for handling complaints. People are well protected from abuse by the systems for monitoring, recording and referring issues on protection. Evidence: Discussion with the deputy managers and people in the home and viewing of records and documents shows the systems for making and dealing with complaints and handling issues of a safeguarding nature are good and effectively used. There is a complaint policy and procedure for staff to follow, a complaint form to complete and a record of all complaints made, though there has been no serious complaint since the last key inspection. People spoken to say they make their views known as they need to or complain as issues arise. They know who to complain to and when. There is a safeguarding procedure in place in line with the Hull & East Riding Safeguarding Adults protocol. The deputy managers and all but two staff have completed safeguarding adults training with Hull & East Riding on 23/02/10 and evidence is available in staff files. There has been one serious safeguarding referral that the home appropriately referred to social services, which was dealt with by the safeguarding team and the Police. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a safe, clean and pleasant home to live in that only requires some minor upgrades or repairs. Evidence: Discussion with the deputy managers and people in the home and viewing of some parts of the home show the environment is generally adequate and in need of some upgrading. Some of the communal areas seen are clean, pleasant and comfortable. Some private areas viewed have need of some upgrading and general refurbishment to ensure peoples rooms are well decorated. Some commodes and some wardrobes need replacing and at least one bed requires a headboard fitting to it. Also there is a loose wire, said to be from the security alarm on the front door, which needs making safe, as the conduit around it has broken. There are two bedrooms on the upper floor that have a connecting door between them to enable access from one property to the other, because there is no connecting corridor on this floor. This connecting door must never be used by staff during the day or night to access one side of the house from the other, as it is an invasion of peoples privacy to do so. Access must only be used in an emergency and in the event of a fire. Hygiene and infection control measures and the facilities for doing laundry appear to Care Homes for Older People Page 18 of 27 Evidence: be good. Staff complete infection control training and keep details in their files. The laundry was briefly viewed and appears to meet requirements of the Water Supply (Water Fittings) Regulations 1999. Practice of staff when dealing with body spills was observed and considered to be good. They use personal protective equipment and a disinfectant and they clean spills up quickly. Staff also deal with people sensitively. Care Homes for Older People Page 19 of 27 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. People are cared for and supported by well qualified and trained staff in good numbers, so their needs are well met. People are not as well protected as they could be by the homes recruitment systems and practices. Evidence: Discussion with the deputies and with staff and viewing of staff files, records and documents shows there are sufficient numbers of staff on duty to care for the 19 people in the home at the moment, that training and development opportunities are good but that recruitment needs to be tighter and must follow procedure. There are sufficient staff on duty according to those seen on the day of the site visit and to rosters. Three carers, one cook and one cleaner are usually on duty in the day time with one deputy manager. There are two night staff. The home currently has 19 people living there and so needs are being well met at the moment. Staff were observed meeting peoples needs in a steady and unhurried manner. Staff had time to talk to people as well as to meet their physical and health care needs. Staffing qualifications were checked and two staff files contained evidence of NVQ level 2. All staff are keen to complete qualifications. The deputies are doing NVQ level 4 in Management. Care Homes for Older People Page 20 of 27 Evidence: Recruitment systems and practices have lapsed over the last year or so to the extent that staff files were not up to date nor did they contain the right documents. The deputies are ensuring all procedures are now being followed and are trying to tidy up files where documents are missing. Two staff files were checked and we found that although applications were made before people actually started the job, the staff did start jobs on basic initial security checks (POVA first) and before receipt of a full criminal records bureau (CRB) check. This should not happen as a matter of course, but only in exceptional circumstances and then staff must be fully supervised and have their supervised shifts recorded. We discussed this practice with the deputy and explained the home must get a full CRB for a person before they start to work in the home. A requirement is being made to make sure the practice of starting staff with only an initial security check does not continue. Another area we found to have lapsed was the taking up of references. We found that references were not always appropriate, one staff had obtained a reference from a family member and had also started her job before the references had been received. A recommendation is being made to ensure the last employer and a previous employer are the only people references are obtained from. Evidence shows that staff training opportunities are good, that staff complete an induction, are supervised and do mandatory courses in fire safety, medication administration, dementia awareness, challenging and aggressive behaviour and safeguarding adults. Staff have also done such as Mental Capacity Act and Deprivation of Liberty training. Records are kept in staff files of all courses completed. Care Homes for Older People Page 21 of 27 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. People enjoy a well managed home that is run in their best interests, by two efficient deputies, using an adequate quality assurance system, offering financial protection and ensuring people and staff health, safety and welfare are well maintained. Evidence: Discussion with the deputies about roles, quality assurance and handling finances and viewing of some of the homes maintenance check records and certificates shows this section is being satisfactorily monitored and maintained. The registered manager is currently on maternity leave and not due to return until September. There are two deputy managers covering at the moment doing a job share. The provider is also supporting them on a daily basis if needed. The standard is currently being met. There is a tentative quality assurance system in place that surveys people in the home and their relatives, that carries out audits on a weekly or monthly basis and that Care Homes for Older People Page 22 of 27 Evidence: involves the use of resident and staff meetings. The home needs to develop the system to include an annual report on the successes and failings of the service. People say they handle their own finances wherever possible, though mostly it is family members that actually control finances for them. The home holds a small amount of cash for each person in safe keeping and maintains individual recording books and keeps receipts against any expenditures. Checks were carried out on two peoples finances and records and they were both found to be accurately maintained. A recommendation is being made however to ensure all receipts kept against expenditure are numbered and the corresponding number is written in the finance accounting recording book for each person to enable easier auditing of the system. There are health and safety policies and procedures in place in ring binders for staff to consult, there is a general health and safety policy statement, and there are safe working guidelines in use. There is a staff handbook in use that was last updated in March 2010 and there are copies of the General Social Care Council code of conduct available. Some safety checks were sampled, including hot water temperature safety checks on outlets and on storage of hot water, fire safety, hoists and lifting equipment, gas and electricity. These proved to be satisfactory and supporting evidence was seen. Care Homes for Older People Page 23 of 27 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 24 of 27 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 29 19 The registered provider should make sure staff only start work after their CRB has been received. So people know they are protected from the risk of harm. 07/07/2010 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 The registered provider should make sure recent copies of the placing local authority community care assessment documents are held in peoples files with the homes assessments, so people know their needs are well known and are being met. The registered provider should make sure the most recent placing local authority community care care plan is held in peoples file, so they know their care and health care needs are known and are being met. The registered provider should make sure staff do not use the connecting door between two rooms on the upper floor to access different parts of the house except in extreme emergencies or in the case of fire, so people know their Page 25 of 27 2 7 3 19 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 privacy will not be intruded upon. 4 19 The registered provider should make sure an audit of repairs and refurbishment is done to identify any specific needs for upgrading of the home and should also carry out the following:- replace damaged or old commodes and wardrobes, fit all beds with headboards and repair the broken conduit around the front door alarm wires, to make sure people are confident they live in a safe, pleasant and well maintained home. The registered provider should carry out a full audit of the environment and redecorate rooms and communal areas where identified as needed, so people have a well maintained home to live in. The registered provider should make sure staff supply two written references, one from the most recent employer and one from a previous employer, not from a family member. References must also be obtained before a staff starts work, so people know they are protected from the risk of harm. The registered provider should make sure all receipts kept of expenditure by people are numbered and the corresponding number is written in peoples individual recording books, so easier auditing can be done and so people know their finances are being well protected. 5 19 6 29 7 35 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!