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Transcription:

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rose Farm Care Home Main Street Styrrup Doncaster South Yorkshire DN11 8NB The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a key inspection. Lead inspector: Date: Angela Starr 0 3 1 1 2 0 0 9

This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29

Reader Information Document Purpose Author Audience Further copies from Copyright Internet address Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Care Homes for Older People Page 3 of 29

Information about the care home Name of care home: Address: Rose Farm Care Home Main Street Styrrup Doncaster South Yorkshire DN11 8NB Telephone number: 01302744664 Fax number: 01302746900 Email address: admin@rosefarmhome.co.uk Provider web address: Name of registered provider(s): Type of registration: R S Care Homes Ltd care home Number of places registered: 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 dementia 2 35 old age, not falling within any other category 0 19 Additional conditions: The total number of beds shall be 54. Within the total number of beds a maximum of 19 may be used for the category OP. Within the total number of beds a maximum of 2 may be used for the category DE. Within the total number of beds a maximum of 35 may be used for the category DE(E). Date of last inspection Brief description of the care home The home is situated in the quiet village of Styrrup. There is good access to nearby towns of Retford, Doncaster, Rotherham and Worksop. The home comprises of three units. The Cottage which caters for 8 people with low dependency needs, The Barns, for 22 people with varying dependency needs and the Garden Wing caters for 24 people and offers a safe and a secure environment for other people with dementia. The Cottage is an adapted building more suited to service users with low dependency needs due to its sizes and layout. The Barns and The Garden Wing are purpose built. The gardens are pleasant and safe and include a large patio area and a 'sensory Care Homes for Older People Page 4 of 29

Brief description of the care home garden' is currently under construction. There is ample car parking space at the front of the building. The home appears to be sufficiently adapted to cater for the needs of people with a disability. There is a passenger lift. A call bell system is in place throughout the building. The fee range in the service user guide is stated as between 379.00 and 480.00 depending on needs. Copies of previous inspection reports and the Service User Guide are on display in the home. 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: two star good service Our judgement for each outcome: Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star good. This means that the people who use this service experience good quality outcomes. The focus of Inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the provider's capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us about how well their service provides for the needs of the people who use it and how they intend to improve their service. We received this back Care Homes for Older People Page 6 of 29

from the manager within the required timescale and the form was completed in a satisfactory manner, providing us with information to assist in planning our visit and deciding what areas to look at. We also reviewed all the information we have received about the service since we last visited and we considered this in planning the visit and deciding what areas to look at. The main method of Inspection we use is called 'case tracking' which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading their records and asking staff about their needs. We also sent 'Have Your Say' questionnaires to a random selection of people who use the service and some staff members. The information provided in the replies we received, was also a contributory factor in the focus of our inspection visit. A representative from Age Concern, 'Expert by Experience' accompanied us on this inspection visit. This person spent time with the people who live at the service, talking to them and observing the interaction between staff and the people they are supporting. Their findings are included in this report. We spoke with three members of staff, three people who use the service and two relatives to form an opinion about the quality of the service being provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who use the service.

What the care home does well: People are given good information about the service and can be assured that staff will be able to meet their assessed needs. Peoples health, personal and social care needs are set out in an individual plan of care and their health needs are fully met. People are treated with respect and digmity and their privacy is upheld. Positive interactions between staff and people living at the service were observed and staff demonstrated kindness and proffessionalism at all times. People live in a comfortable, homely, clean environment with a choice of communal areas and personalised bedrooms. There is a clear and accountable management structure that is appropriate for the size of the service. The manager was observed to be a good and very knowledgable leader who has the respect and support of her staff team. What has improved since the last inspection? A key worker system has been introduced which enables the senior care workers to take more responsibility for reviewing and up dating care plans. Staff numbers have increased at peak times of day to enable people to receive more person centred support. What they could do better: Staff files would benefit from being audited and maintained in a methodical manner. Although staff do deliver person centred care, this is not evidenced in peoples care plans. Care plans would benefit from being revised. Fresh vegetables could be provided several times a week. As there is only one heated trolley for food, some people wait too long in the dining room for their midday meal to be served and this could improve by the purchasing of another heated trolley. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Older People Page 8 of 29

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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who want to live at the service have their needs assessed and can be assured these will be met. They receive good quality information about the service to enable them to make an informed choice about living there. The service does not provide intermediate care and therefore this standard was not assessed. Evidence: Care files we looked at told us that people considering living at the service are seen by the manager or senior carer and a pre admission assessment is completed to ensure that each persons needs can be met. Where it is appropriate, a persons relatives are involved in this process and as much information as possible is gathered to enable staff to ensure that Rose Farm can provide the required support. We saw a copy of the statement of purpose and service user guide and both were Care Homes for Older People Page 11 of 29

Evidence: comprehensive and included a lot of useful and relevant information. We were told that the service has access to interpreters and sign language specialists if required. Upon enquiry, people are given copies of these. The complaints procedure, terms and conditions of residence and other information is also provided at this time. This provides people with information to assist their decision making. People we spoke with told us that they were seen by a member of staff prior to moving to the service and that they felt they had been given all the information they needed. We received six completed surveys from people living at Rose Farm and where we asked "Did you receive enough information to help you decide if this home was the right place for you?" All six people replied "Yes" Some people we spoke with said they did feel they had been provided with information but some people told us their family had chosen the home for them. As part of our case tracking process, we looked at files for four people living at the service. All four files contained pre-admission assessments. There were also copies of contracts and terms and conditions of residency in the files. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare needs are assessed and provided for in a way which shows respect for the privacy and dignity of people who live at the service whilst meeting their identified needs. Evidence: As part of our case tracking process we looked at files for four people and all contained up to date care plans that had been regularly reviewed. The care plans viewed on the day we visited, all included an initial assessment that identified areas of support needed including mobility, personal care, health care support etc. Although the care plans contained a lot of necessary information, and some evidence that people had been involved in the reviews, they lacked evidence that the person had been involved in the creation of the plan and were task oriented as opposed to being person centred. Care Homes for Older People Page 13 of 29

Evidence: Risk assessments were in place and addressed a wide area of identified risks, including nutrition, self administration of medication and moving and handling. However, these could be more comprehensive therefore giving staff more detailed information. Files we looked at also contained evidence of visits from Doctors, District Nurses, Opticians, Dentist, Chiropodist etc. and the relating records were clear and comprehensive. People we spoke with told us that they see a Doctor whenever necessary and only have to ask staff for this to be arranged. They said it was the same for other appointments out of the home. Staff accompany people for hospital visits etc where necessary but relatives we spoke with said they prefer to do this whenever possible. The files contained daily report sheets outlining each persons daily activities and well being and information about the persons medication. We looked at the Medication Administration Records for the people we case tracked and found these to be completed correctly. We looked at the storage of medication and found it to be suitable, with the trolleys kept in a locked treatment room. We saw that the storage of controlled drugs was also suitable and the records correct. Records are kept of the room and fridge temperatures and were seen to be within the correct range. We observed staff doing part of the medication round and saw that it is conducted in a safe and organised manner. Staff we spoke with told us that they have recieved training for handling medication and this is regularly refreshed. We looked at staff training records and saw that the relevant staff have had training in administration of medication and that this was up to date. The care plans we saw all made reference to peoples privacy and dignity and we observed staff treating people with respect throughout our visit. People told us that the staff always knock on doors before entering a persons room and said they believe the staff to be respectful at all times. Care Homes for Older People Page 14 of 29

Evidence: Relatives we spoke with echoed this and said "I have never seen people being treated with anything other than kindness and respect." People we spoke with told us "They are lovely. They always treat me properly." We were accompanied on this inspection visit by a represenative from Age Concern (Expert by Experience) and her report included comments such as "Having spent three hours going round the care home, at no time did I feel as if the dignity or respect of any of the people was jeopardized." "The staff were very aware of the needs of the residents. And they did have a good rapport with them. All the residents were well dressed and clean in their appearance." Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a range of activities and a flexible menu that meets their needs and wishes. Evidence: We saw records that told us a variety of activities take place each week. An activities co-ordinator is employed and works for eighteen hours a week, over three days. She facilitates a variety of one to one activity, such as therapeutic hand massage as well as organising group activities. The range of activities include a monthly theme day, sing a long, quiz and armchair exercise. The service has also purchased a 'sensory machine' which is used to aid relaxation and is particularly useful for people who may have difficulty in taking part in more structured activity. There is also a monthly church service for people to attend if they wish. Following her attendance at a recent training event, the activities co-ordinator is currently working with people to develop 'memory boxes'. These were in place in some peoples bedrooms and contained a variety of relevant things to aid memory and stimulate conversation. Care Homes for Older People Page 16 of 29

Evidence: During this inspection visit we observed people enjoying the hand massage and a quiz took place in the afternoon. People we spoke with told us that they decide what activities they would like to join in with and this is respected. People also said that they like to join in with some things but not others. Visitors are always welcome and relatives we spoke with confirmed this and told us that they are offered refreshments and would be able to have a meal if they wished. "I visit frequently and always feel welcome." We observed people having lunch and saw that they were relaxed and enjoying the pleasant surroundings. Extra staff were available to assist at meal times enabling people who required assistance to be supported in a dignified and un-hurried manner. Relatives we spoke with said they thought the food was very good. People we spoke with on the day of the inspection visit all said that there is plenty for them to do and that the standard and choice of food is good. A four weekly menu is in place and it shows that a variety of food is provided giving people choice as well as necessary nutritional benefits. All three areas of the service receive meals from the main kitchen via a heated trolley. There was just one trolley to go round all the areas with the chef serving the meals. This meant people having their meals at different times but no-one expressed any concern about this. The 'Expert by Experience' spoke with the chef who told her that that all the vegetables used are frozen. Fresh fruit is provided each afternoon and is quite popular with the residents. The meal served on the day of the inspection was mince and onion pie, peas and carrots or sweet and sour pork with rice. The pudding was pineapple pudding and custard. Each person was observed to be offered a choice of main course. It was also observed that people were offered the choice of wearing a plastic apron or not. People we spoke with said they have no complaints about the food. They said the quality is good and there is plenty to eat. Care Homes for Older People Page 17 of 29

Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident that any concerns would be acted upon and responded to. The people living at the service are safeguarded from harm and abuse by staff who adhere to robust policies and procedures. Evidence: The information provided to us by the manager tells us "The service has a clear and accessible concerns/complaints procedure. Each person is informed of this and the service keep records of all concerns and complaints." It also states that all staff are trained in the protection of vulnerable adults. On arrival at the service we saw the complaints procedure clearly displayed in the entrance. The care files we saw all contained copies of the complaints procedure and some people we spoke with could recall seeing it. We spoke with some people who live at the service and one told us that they did know how to complain and who to complain to but one said they did not know. We discussed this with the manager who confirmed that some people are unable to remember details such as this. Staff we spoke with told us that they would always encourage and Care Homes for Older People Page 19 of 29

Evidence: assist people to make a complaint where necessary and would seek the support of family, friends or advocate where appropriate. We looked at the records of complaints and saw that six had been recorded since the last key inspection. The evidence we saw told us that these had been investigated within the policy and procedures of the service, the outcomes recorded and shared with the complainant. The questionnaires that were returned to us told us that people do know who to speak to if they are unhappy about anything. Relatives we spoke with confirmed that they would feel confident to complain and some added "I have never had anything to complain about" We looked at training records with regard to staff attending Safeguarding Adults training and saw that all staff receive this training during their induction period. Staff we spoke with demonstrated a good level of knowledge and understanding and said they would not hesitate to report anything of concern. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk. There have been no Safeguarding Referrals made, since the last inspection. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe and comfortable home which is well maintained and equipped to meet their needs. Evidence: Rose Farm consists of three areas called 'The Barns', 'The Gardens' and 'The Cottage'. Each of these areas caters for people with varying needs. We undertook a partial tour of the service where we looked at some bedrooms, bathrooms, communal areas such as lounges and dining rooms, the kitchen and laundry. All these area were clean and tidy and the home appeared to be well maintained, warm and comfortable. A maintenance man is employed who undertakes all regular repairs and on-going tasks, calling on tradesmen for any specialist work/repairs. There is also a gardener who takes care of the extensive outside areas. A sensory garden is currently being built and should be in use next year. Peoples bedrooms that we saw had a variety of personal possessions and some had their own furniture. We noticed that there was a lockable drawer in the bedside Care Homes for Older People Page 21 of 29

Evidence: cabinets for people to keep things of personal value. Each room also has a nurse call system installed and we saw that these were accessible to people and were working. They are tested on a weekly basis. Most of the bedrooms had en-suite facilities and those that did not, were near to a bathroom and toilet. People we spoke with told us "I have a very nice bedroom with my things around me." and "I like spending some time in my room but I also enjoy being in the lounge with other people." The bedrooms that are in 'The Gardens' area of the service are kept locked during the day because some of the people living there wander about. However, this does not prevent people from accessing their rooms if they wish, as staff will unlock doors for people to gain access. Necessary equipment is provided to assist people and enable access to all areas of the service. This includes hoists, stand aids, and rotunda's, all of which have been regularly serviced and maintained in good order. The laundry area was very well organsied and measures were in place to manage infection control. Some people told us that items of clothing do sometimes go missing but staff are usually able to find them. Care Homes for Older People Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected from harm by trained staff in sufficient numbers to meet their needs. Evidence: We looked at files for four members of staff, including the last person to be recruited. All the files contained the necessary paperwork and information to tell us that the recruitment policies and procedures are safe and are being strictly adhered to. We saw that staff had provided a minimum of two written references and the required Criminal Record Bureau and Protection of Vulnerable Adults checks had been completed. We also saw evidence that staff receive an induction when they commence employment and staff we spoke with confirmed this. We looked at training records and saw that all staff have had mandatory training such as Moving and Handling. This training was up to date with refresher training planned as necessary. We saw evidence that a considerable amount of additional training has been provided. We spoke with three members of staff, one of whom told us "I've worked here for seven years. I left once but came back because I didn't like the other place. I love it here, it's a nice place and the staff are nice." Care Homes for Older People Page 23 of 29

Evidence: The information we received from the manager prior to this visit, told us that well over 50% of care staff have NVQ level 2. Several staff have gone on to take NVQ Level 3. People we spoke with told us "The staff are very good." A relative said "The staff are caring, loving, hard workers." Training records showed us that all staff receive necessary training and all have been trained in 'Safeguarding Adults' and 'Whistle Blowing' Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk. Whistle Blowing is a means for staff to feel supported to report anything of concern that they may witness. Staff we spoke with demonstrated a good level of knowledge and understanding of these areas and told us "I would always report anything of concern, instantly. Without any doubt." "The residents come first." "I know the people who live here are safe." The Expert by Experience spent three hours going round the care home, and expressed that at no time did she feel that the dignity or respect of any of the people she observed was jeopardized. She reported that the staff were very aware of the needs of people and they had a good rapport with them. Care Homes for Older People Page 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is being run in the best interests of the people who live there. Evidence: The manager returned the Annual Quality Assurance Assessment within the required timescale and it was completed in a manner which provided us with a lot of useful information. The manager has the relevant qualifications and many years experience of managing a care home. She was able to demonstrate her awareness of her responsibilities and the importance of maintaining her level of knowledge. This means that people who live at the service benefit from a knowledgable manager who understands the needs of older people. Care Homes for Older People Page 25 of 29

Evidence: People who live at the service, relatives and staff we spoke with all told us that the manager is very approachable and that she actively seeks their views about the service provided. One staff member said "The manager has an open door policy and is always available to offer support and guidance." Staff we spoke with told us that they receive regular supervision and find it to be a useful process. They are given opportunities to discuss things such as any worries or concerns they may have, any training needs or personal development issues etc. Staff spoke highly of the manager and said "She is very supportive and I can always go to her about anything." The service has an internal Quality Assurance system in place whereby people are asked to complete questionnaires to provide feedback about their experience of living at Rose Farm. This ensures that the manager and provider are able to respond to peoples needs and provide a good level of service. We saw that the evidence gathered through the questionnaires is used to improve the service provided. People we spoke with said they felt their opinions were listened to and taken into account. The service manages some peoples finances finances and the records we looked at showed us that this is done efficiently, as all were correct. Health and safety measures are in place to ensure the Health and Safety of staff and people living at Rose Farm. This is evidenced by the implementation of a Health & Safety Policy, which clearly identifies the responsibilities of management and staff. We looked at the records of accidents and incidents that had been recorded since the last Key Inspection. The recording provided accurate descriptions of the events and all were dated and signed. As part of our inspection process we looked at the relevant safety certificates for servicing and maintenance of equipment and services. All were in place and up to date. The fire safety equipment and testing was also seen to be up to date. Staff we spoke with told us that any maintenance tasks are reported and recorded for the benefit of the handyman, who completes the task and then signs to say this has been done. Care Homes for Older People Page 26 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 27 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 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 Care plans would benefit from further development of 'person centred' planning, evidencing that people had been activley involved in outlining their care needs and the ways in which they would prefer these to be met. Care Homes for Older People Page 28 of 29

Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29