Care Home: Zapuzino

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well When people were interested in moving into the home the manager gave them a folder of information including the statement of purpose and complaints procedure. This meant that people received enough information to decide whether the home was the right place for them. Once a person had moved into the home their needs were assessed so that their needs would be met. Following an assessment a care plan was developed to make sure that the person`s personal and healthcare needs would be met. Medication was stored properly and records were kept when people were given medication. This meant that people were generally protected by the medication practices. People were supported to take part in their choice of activities, both in the home and in the community. People liked to read the paper and books and to do crossword puzzles. They could also go out into the community for example to the shops and garden centre. People were able to maintain contact with friends and family and visitors were always welcome in the home. A variety of meals were served and people were asked what they would like to eat. People were offered a wholesome, appealing and balanced diet and enjoyed their food. There was a complaints procedure and any complaints were looked into thoroughly by the manager. This showed that people`s complaints were listened to, taken seriously and acted upon. There was a procedure about prevention of abuse and staff knew what to do if an allegation was made so that people were safeguarded from abuse. The accommodation was very homely and comfortable. There was a lounge-dining room and a separate conservatory. The home was well maintained, clean and hygienic. All the bedrooms were single and people could bring their own things into their bedrooms. These rooms were decorated and equipped to meet people`s needs. People were supported by sufficient staff who were appropriately trained. There were usually two members of staff on duty and staff received a range of training. People were protected from staff who may be unsuitable by the recruitment practices. The home was managed by a person who was qualified and experienced so that people benefited from living in a well run home. Questionnaires were given to people to collect people`s views about the service in the home and people were also asked their views informally when staff were chatting to them. Staff made changes based on these views for example to the meals and activities. People`s health, safety and welfare were protected by the systems in place. What has improved since the last inspection? The manager and staff were having more meetings and chats with people who lived in the home to obtain their views. Staff had involved people more in developing their care plans. More care staff had been employed so that people could have more outings and a member of staff was working in the office so that the paperwork was in better order. New staff were providing a statement that they were physically and mentally fit so that people were being cared for by staff who had been approved as fit. More work had taken place to collect the views of people and develop a quality assurance system so that service developments were based more on people`s views. What the care home could do better: The format for care planning should include information about needs relating to disability, gender, age, race, ethnicity, faith and sexual orientation to ensure that these needs will be met. The AQAA should also contain information about how the home promotes equality and diversity to show how these needs are being met. Improvements need to be made to the recording of medication when it is given so that people receive the correct medication and are kept safe. A controlled drugs cabinet should be obtained so that any controlled drugs prescribed can be stored properly straight away. The induction for new staff should be based on the Skills for Care common induction standards to make sure that they have the basic knowledge to care for people. The systems for collecting people`s views about the service in the home and producing an annual development plan could be developed further so that all service improvements are based on people`s views. Key inspection report Care homes for older people Name: Address: Zapuzino 205 Alexander Drive Cirencester Glos GL7 1UH     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: Elaine Barber     Date: 2 5 0 6 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 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) 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 27 Information about the care home Name of care home: Address: Zapuzino 205 Alexander Drive Cirencester Glos GL7 1UH 01285651057 01285651057 david@kilby9.orangehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Rosemary Teresa Kilby care home 6 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 Zapuzino is a small Care Home within a quiet cul-de-sac, on a large housing estate on the outskirts of Cirencester town. The Home offers accommodation to older people who require assistance and supervision in some of their daily activities. There is a loungedining room on the ground floor and also a conservatory which provides the Home with separate dining facilities. Other accommodation consists of one bedroom on the ground floor; this has communal bathing and toilet facilities next door. There are five other bedrooms on the first floor which are accessed by a stair lift. One of the bedrooms has en-suite facilities while the other four have hand washbasins. There are usually two staff on duty during the day. The home does not have waking night staff and the Registered Provider/Manager provides emergency night cover. Information about the service is made available by the provider to prospective service users through the homes Statement of Purpose and Service Users Guide. CSCI and CQC inspection reports are also available from the home and from the Commissions website cqc.org.uk. Information about the fees is available from the home. Hairdressing, Care Homes for Older People Page 4 of 27 Over 65 6 0 Brief description of the care home toiletries, and newspapers are charged for in addition to the fees. 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: We asked the home to complete an Annual Quality Assurance Assessment, known as the AQAA. This was their own assessment of how they were performing. It also gave us information about what has happened during the last year and about their plans for the future. We sent out surveys so that these could be completed by the people who lived in the home. We had surveys back from three people and comments from a relative. We looked at all the information that we had received about the home since the last inspection. This helped us to decide what we should focus on during our inspection. We visited the home on the 25th June 2009. We talked to the registered manager and three staff. We looked at some of the agencys records. We met with three people who lived in the home and asked them about their experience of living in the home. The judgments contained in this report have been made from all the evidence gathered Care Homes for Older People Page 6 of 27 during the inspection, including the visits. The last inspection of the home was on 26th June 2007. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The manager and staff were having more meetings and chats with people who lived in the home to obtain their views. Staff had involved people more in developing their care plans. More care staff had been employed so that people could have more outings and a member of staff was working in the office so that the paperwork was in better order. New staff were providing a statement that they were physically and mentally fit so that people were being cared for by staff who had been approved as fit. Care Homes for Older People Page 8 of 27 More work had taken place to collect the views of people and develop a quality assurance system so that service developments were based more on peoples views. 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. 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 received enough information to decide whether the home was the right place for them. Peoples needs were assessed so that their needs would be met. Evidence: We saw that there was a statement of purpose which gave people the required information about the service provided. This was put into a folder together with a copy of the complaints procedure and the policy about rights. A member of staff told us that any one who was interested in moving into the home was given a copy. She also told us that everyone who lived in the home had a copy which they kept in their room. Three people who completed surveys said that they received enough information to help them decide whether the home was the right place for them, before they moved in. We looked at the files of three people who lived in the home. We saw that two people, who had lived in the home for some time, had assessments of their needs conducted Care Homes for Older People Page 11 of 27 Evidence: by the home. These assessments contained information about their nationality and their religion. One of these people also had had an assessment by a social worker before they moved into the home. The third person had moved in recently. A staff member told us that they had not yet received an assessment and care plan from social services and they were waiting for this before they completed their own assessment of the persons needs. When we read this persons daily records we saw that these contained very detailed information about this persons needs. At the last inspection The Commission for Social Care Inspection, (CSCI) received a complaint about the care of one person. Following investigation (see complaints section) CSCI concluded that there had been a breach of Regulation 13(4)(c) which says The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. CSCI noted that this would be looked into at the next inspection. When we looked at the files we saw that each person had an assessment of the risks involved in delivering their care and these included action to reduce risk and keep them safe. 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. Peoples personal and healthcare needs were being met. People were generally protected by the medication practices but improvements need to be made to the recording so that people are kept safe. Evidence: When we looked at the care records we saw that two people had care plans and the dates were recorded when these were reviewed. Each person also had a daily routine which provided details about the care and support that they needed throughout the day and their preferred routine. They also had risk assessments and dependency assessments and these were reviewed. The care plans did not make specific reference to peoples diverse needs such as whether they had a disability or their racial origin. However, information about their religion and gender was recorded. The third person did not have a care plan. A staff member told us that they would complete a care plan for this person once they had received the care plan from social services. This person had very detailed information in their daily records about how their care needs were being met. Three people said in their surveys that they always received the care and support that they needed. One relative said about their mothers care, The care she Care Homes for Older People Page 13 of 27 Evidence: has at Zapuzino is excellent in all respects and we are perfectly happy with the service. If there are any issues over day to day care we are fully consulted and deal directly with the owner who provides 4/5 star service. We saw that there was a policy about rights and the statement of purpose contained information about peoples rights to dignity and respect. We observed staff speak to people respectfully and we saw them knock on peoples doors and wait for a reply before entering. Each person had their own single room with their name on their door. People were individually dressed and their clothes were well kept. Entries in the daily records showed that care was being given promptly when needed. Details about peoples healthcare needs and current medication were recorded in their care notes. A member of staff told us that a brief record was kept of each persons healthcare needs and medication so that the sheet could be handed to a paramedic or hospital staff if anyone needed to go into hospital. We saw that records were kept when people saw the GP, district nurse, chiropodist, dentist, and optician. A member of staff told us that the district nurse visited people at home but staff took people to see the dentist, optician and chiropodist. Three people told us in their surveys that the home always made sure that they got the medical care that they needed. Following the last inspection the Commission for Social Care Inspection (CSCI) received a complaint about the care of one person. Following investigation (see complaints section) CSCI concluded that there had been a breach of Regulation 13(1)(b) that states that people who live in the home are to receive where necessary treatment, advice and other services from any health care professional. CSCI stated that this would be looked into at the next inspection. When we looked at the files we saw that appointments and visits from health care professionals were recorded. Two people that we talked to said that their health care needs were being met. We saw that information about the medication each person took was recorded in their personal file. Medication was stored in a locked cupboard. There was no separate cupboard for the storage of controlled drugs. There was a controlled drugs register but the manager told us that no-one was taking controlled drugs. A monitored dosage system was used and there were printed medication administration record (MAR) sheets. Medication received into the home and administered was recorded on these sheets. Any hand written additions had two staff signatures and the date so that they could be easily cross-referenced with directions from the prescribing GP. During the morning of our visit we saw a member of staff sign all the MAR sheets together. We did not see them give the morning medication and thought that this must have been given before we arrived. 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 were supported to take part in their choice of activities, both in the home and in the community. They were able to maintain contact with friends and family. People were offered a wholesome, appealing and balanced diet and enjoyed their food. Evidence: When we read the daily records we saw that people had visits from their family and friends. We saw people sitting in the lounge in the morning reading books and newspapers. One person told us that they liked reading the newspaper and doing the cross words everyday. After lunch people went to spend a couple of hours in their rooms. Then they all came back down to the lounge to watch Count Down on the television. A member of staff told us that people sometimes played bingo or played board games but they did not always want to do this. We asked people in their surveys whether the home arranged activities that they could take part in if they wanted. One person said that the home always arranged activities and two people said that they sometimes did. The owner had two dogs and two cats and we saw that people enjoyed stroking them and seeing them around the home. We saw that there was a high level of interaction between the people who lived in the home, between the people and the staff and between the people and the pets. People were engaged in whatever they were doing at the time and appeared content. Care Homes for Older People Page 15 of 27 Evidence: We saw in the care records that people went out occasionally to the chiropodist and optician. A member of staff told us that one person went to the optician recently and after this they took the person out for a cup of coffee. The member of staff said that they also took people out to the shops and to the garden centre. Another member of staff said that the vicar visited once a month to give communion. There was information about this in the statement of purpose and a statement that other religious needs would be met if required. The manager told us that people did not always want to go out. However, she said that staff would take people out on an individual basis. The manager told us in the AQAA that one of the things that the home did well was letting people choose for themselves. When we talked to people they said that they chose how and where to spend their time. We saw that some people preferred to spend time in the lounge while others preferred to be in their rooms. Some people went to their rooms after lunch. A member of staff told us that they had frequent chats with people in the lounge about what meals they wanted and what activities they wanted to do. We saw that there was a varied menu. The manager said that she asked people when they moved into the home whether there was anything they did not like. She said that she knew what people liked and would offer an alternative if someone did not like what was on the menu for the day. Throughout the day we saw that people were frequently offered drinks. People told us that they enjoyed the food. 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. Peoples complaints were listened to, taken seriously and acted upon. People were safeguarded from abuse. Evidence: When we looked at the statement of purpose we saw that this included a complaints procedure. This had been updated to include the address and contact details for the Care Quality Commission. Mrs Kilbey told us that a copy was given to each person who lived in the home. The Commission for Social Care Inspection (CSCI) received two complaints since the last inspection. The first was about the care of one person and was investigated by Mrs Kilbey. She identified several areas for service improvement including some reviews of procedures. Following the investigation CSCI identified that there had been two beaches of regulations. These were Regulation 13(1)(b) that states that people at the home are to receive where necessary treatment, advice and other services from any health care professional; and also Regulation 13(4)(c) The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. CSCI concluded that these specific Regulations will be monitored closely at the next inspection. We have looked into these regulations during this inspection and commented on them earlier in this report. We have found no further breaches of these regulations. The second complaint was also about the care of a person who lived at the home. This Care Homes for Older People Page 17 of 27 Evidence: was also investigated by Mrs Kilbey. Following her investigation CSCI concluded that they did not think that the home had breached any regulations and therefore they would not be taking any further action. The coroner was conducting their own investigation as is usual in these circumstances and during the inspection Mrs Kilbey told us she had not heard the outcome. We saw that here was a policy about prevention of abuse and how to make a referral if an allegation was made. When we looked at the training records we saw that all staff had received training about prevention of abuse. A member of staff told us that they had information about how to make a referral if an allegation was made. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained, clean and hygienic. Bedrooms were decorated and equipped to meet peoples needs. Evidence: Zapuzino is an ordinary semi-detached house in a quiet residential area of Cirencester. The manager, Mrs Kilbey, lives next door. The accommodation was very homely. There was a cosy lounge and a separate dining room and a garden where people could sit out if they chose. There was a bathroom and toilet and a shower room with toilet. We looked at all the bedrooms and saw that these were individually decorated and furnished. People had brought personal items into their rooms. A member of staff told us that each person had arranged their room how they wanted it. People told us that they liked their rooms. The accommodation was clean and odour free. There were cleaning schedules and information for staff about infection control. Three people told us in their surveys that the home was always fresh and clean. There was a domestic type washing machine and tumble drier suited to the size of the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported by sufficient staff who were appropriately trained. People were protected from staff who may be unsuitable by the recruitment practices. Evidence: The manager and a member of staff told us that the home employs six staff, including two of the providers daughters, one whom is deputy manager and the other is responsible for all the administration in the home and some care. The care staff in the home provide all care, cooking and cleaning. There are no waking night staff but the manager, who lives in the adjoining house is on-call. All rooms have emergency alarm bells which sound in the adjoining house and there is a door through to the house next door on the first floor. When we visited we found that there were two staff on duty. We looked at the rota which showed that there were usually two staff on duty in the morning and afternoon during the week. The manager and her husband covered the weekends and sleep-ins. Three people said in their surveys that they always received the care and support that they needed. Two said that the staff were usually available when they needed them and one said that staff were always available. The manager told us in the AQAA that there were seven permanent staff (including the manager) and three had a National Vocational Qualification (NVQ) at level 2 or above. We looked at the training certificates and saw that one member of staff had NVQ 2, one had NVQ 3 and the manager had NVQ level 4. The manager told us that Care Homes for Older People Page 20 of 27 Evidence: the information in the AQAA included her qualification. One member of staff told us that they were working towards NVQ 2. When they have completed this 50 of the staff will have an NVQ. We looked at the recruitment records for two new staff. Each staff member had completed an application form which included a declaration that they had no convictions and that they were physically and medically fit. We made a requirement at the last inspection that all staff before appointment to a position must sign a statement to confirm their mental and physical fitness. The manager had introduced a medical questionnaire which both members of staff had signed to confirm their physical and mental fitness. Both members of staff had two written references, a Protection of Vulnerable Adults (POVA) first check, and a Criminal Records Bureau (CRB) check before they started work. When we looked at the training records we saw that the two new members of staff had had an induction. However, we noted that this did not include the Skills for Care Common Induction Standards. We discussed this with the manager who said that she would introduce these induction standards. The staff training records showed that staff received training in basic emergency first aid, moving and handling, infection control, safe handling of medicines, dementia care, catheter care, loss and bereavement, cancer, communication skills, care practice, protection of vulnerable adults, malnutrition and dehydration. We saw training certificates that confirmed this. A member of staff told us that there was a mixture of internal and external training. The manager and the staff member said that they had introduced a new form of distance learning training. Staff completed a workbook at their own pace and it was sent to the training company to be marked. When they passed they received a certificate. 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. The home was managed by a person who was qualified and experienced so that people benefited from living in a well run home. There were systems for collecting peoples views about the service in the home but these could be developed further so that all service improvements are based on peoples views. Peoples health, safety and welfare were protected by the systems in place. Evidence: The owner-manager has many years experience in caring for older people both in a hospital and private care setting. She has completed NVQ 4 Registered Managers Award, and also undertaken any relevant training to make sure she is kept up to date. This training has included adult protection, food hygiene and fire training. As the home is small with few staff they meet every day to discuss anything relevant to the home and the people who live there. We looked at records of staff supervision and saw that supervision took place once a month. Care Homes for Older People Page 22 of 27 Evidence: We made a requirement at the last inspection that a system must be maintained to review and improve the quality of care provided in the home. This had been an outstanding requirement from the previous inspection with the timescale of 28/02/07 not met. This was being addressed. The manager had said that she sent questionnaires to people once a year to measure satisfaction with the quality of care. The last questionnaire was sent in 2008. A staff member told us that they talked to people on a day to day basis about how things could be improved, for example activities and meals. We saw that a brief development plan had been produced. The manager had also completed the AQAA and sent it to CQC. This gave quite brief information about what the service did well, what had improved since the last inspection and plans for improvement over the next twelve months. It did not provide any information about how trhe home promotes equality and diversity. We discussed the possibility of using the AQAA more as a development plan as well as the questionnaires. Together they could be used as a system for reviewing and improving the quality of care provided in the home so that any service improvements are based upon the views of people who live in the home. Peoples finances were generally looked after by their families and the home did not act as appointee to anyone. The manager told us that she kept small amounts of money for three people for hairdressing. We saw that appropriate records were kept with two staff signatures for each transaction. We saw records to confirm that regular maintenance and servicing of equipment is carried out, to include electrical wiring and portable appliance testing, gas and central heating, lift and hoist servicing. There was information about control of substances hazardous to health (COSHH). We saw that there were individual risk assessments Which included the action needed to keep people safe. Fire equipment was also serviced regularly and the fire alarms and emergency lighting were tested regularly. The records showed that staff also received fire training. 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 9 13 When staff give people their medication they must make sure that the person has taken the medication then make a record immediately afterwards to confirm this. This is to ensure that each person is given the right medicines at the right times. 13/07/2009 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 7 The format for care planning should include information about needs relating to disability, gender, age, race, ethnicity, faith and sexual orientation to ensure that these needs will be met. A controlled drugs cabinet that meets the current storage regulations (The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007) should be obtained so that any controlled drugs prescribed can be stored properly immediately. The induction for new staff should be based on the Skills for Care common induction standards to make sure that Page 25 of 27 2 9 3 30 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 they have the basic knowledge to care for people. 4 33 More detail should be provided in the AQAA about service improvements based on listening to the views of people who live in the home and plans for development over the next twelve months. This will provide a way of reviewing the quality of care and producing an annual development plan for the home based on peoples views. The AQAA should contain information about how the home promotes equality and diversity with particular reference to disability, gender, age, race, ethnicity, faith and sexual orientation to show how these needs are being met. 5 33 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. 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 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!