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Inspection on 10/12/08 for Ashbury Lodge Residential Home

Also see our care home review for Ashbury Lodge Residential Home for more information

This is the latest available inspection report for this service, carried out on 10th December 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashbury Lodge Residential Home 261 Marlborough Road Swindon Wiltshire SN3 1NW     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: Alyson Fairweather     Date: 1 1 1 2 2 0 0 8 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright 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 Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ashbury Lodge Residential Home 261 Marlborough Road Swindon Wiltshire SN3 1NW 01793496827 01793525953 coatewatercare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Coate Water Care Company Limited Name of registered manager (if applicable) Mrs Geraldine Frances Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The only service user in the age range 18 - 64 years with a physical disability who may be accommodated in the home is the named, male client referred to in the application dated 26 March 2004 The only service user in the age range 18-64 years with dementia who may be accommodated in the home is the named, male client referred to in the application dated 7th February 2006. Date of last inspection 1 0 0 1 Over 65 0 25 19 0 care home 44 Care Homes for Older People Page 4 of 28 Brief description of the care home Ashbury Lodge is a private care home situated on the outskirts of Swindon. The owners also own another care home in the area. They operate the home as a family business. The home fulfils three distinct but complementary services. On the ground floor care and accommodation is provided to older people who need less supervision and have more awareness of their environment. On the first floor care and accommodation is provide to older people who need extra supervision. For reasons of safety the exit from this floor is electronically locked, and a lift has been installed. Each floor to all intents and purposes operates as a separate unit. The home provides for older people who either have dementia type conditions or experience (or have experienced) mental illness and older people who need care only because of infirmity or reasons associated with getting old. All but four rooms provide single accommodation, some with en-suite facilities. A copy of the service users guide is given to all new residents. Fees vary from 430.93 pounds to 625 pounds per week. Additional charges are made for chiropody, hairdressing, newspapers and toiletries. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We recently asked the home to complete an Annual Quality Assurance Assessment (known as the AQAA). This was their own assessment of how well they were performing and it gave us information about their future plans. We also sent out surveys to the service users, to staff and to health care professionals, so that we could get their views about the home. Eight service users replied, some with help from their families. Three staff members, a community nurse, and a GP also wrote to us. We reviewed the information that we had received about the home since the last inspection in 2006. We made an unannounced visit in December 2008 and met with Care Homes for Older People Page 6 of 28 most of the residents and staff as well as the manager and team leaders, the activities coordinator, and administrative and laundry staff. We looked around the home and saw a number of records, including care plans, risk assessments, health and safety procedures, staff files and medication records. A previous inspection was made in March 2007 to follow up after an accident had occurred in the home. We found that most of the windows had restrictors in place, although there were some windows in communal areas which did not. There were no formal risk assessments regarding those which did not, and we asked the providers to make sure that they were done. They did so immediately, and have since had all windows fitted with restrictors. People using the service prefer to be called residents and this is the terminology we use in the report to describe people who live at Ashbury Lodge. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? What they could do better: We found evidence that staff had been offered a great deal of training. However, there were some areas where not all staff had been trained, notably in fire safety, safeguarding adults and infection control This was highlighted by a community nurse who wrote to us saying that more infection control training was needed. The provider has been asked to make sure that all staff have this training. The premises are extremely well maintained, but during our visit we noted areas where hygiene and infection control were at risk. These included toiletries and a hairbrush in communal bathroom areas and a stained shower cubicle. The provider has been asked to make sure that these areas are improved on and the shower cubicle cleaned. Care Homes for Older People Page 8 of 28 Staff supervision sessions had been neglected, and some staff had no recorded meetings with their manager for some time. This means that they do not have the opportunity to discuss their working practices or how they might improve. The provider has been asked to make sure that regular supervision sessions take place, and that these are recorded and kept alongside the individuals staff files. 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 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are informed about the services offered by the home, in order to help them and their families decide if they want to move in. All residents admitted for long-term care had a contract in place. Everyone had an assessment of their needs prior to admission and the home was able to demonstrate that it could meet the needs of its residents. Evidence: Ashbury Lodge has a statement of purpose and service users guide, which describe the services offered. This is given to either the resident or their family member when a referral is made to the home. Of the eight residents who wrote to us, all of them felt that they had had enough information on the home prior to admission and seven said that they had a written contract, although one person couldnt remember if they did or not. Care Homes for Older People Page 11 of 28 Evidence: The records of three residents who had been recently admitted to the home were examined. A detailed range of information is obtained, including information on mobility, communication, specific health needs and family circumstances. Details of any medication support needed is written down and agreed with the service user or a relative. A member of the senior management team meets with any prospective service user and family as part of the assessment process. Following admission, the home then develops an initial care plan based on the assessment, in order to ensure the needs of service users are being safely met. Staff are issued with a procedure to help new residents settle in, and this includes giving them a cup of tea, helping them unpack, showing them round and sitting with them and talking over the first few days to help them get used to their new environment. We spoke to several relatives during our visit, and all of them said they were happy with the service offered to them and their family members. There were no intermediate care beds in Ashbury Lodge. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have all their health, personal and social care needs set out in care plans. Their health needs are fully met. Residents are protected by the homes medication procedures, and they feel they are treated with dignity and respect. Evidence: Care plans were in place for all residents and showed evidence of regular review. Care staff were seen to use the care plans as working documents, seeking information from them and adding entries as necessary. Whilst talking to staff, it was clear that they were aware of individuals needs, and daily records reflected this. Information on care plans related to sleep routines, eating, communication, mobility, personal care, emotional well being, a medical report, and socialisation likes and dislikes. We saw that people were having Mental Capacity Act assessments done monthly and that these looked at all of their daily living skills. We also saw that one person had a palliative care plan in place, and that this looked at matters such as pressure care and the risks of bruising. One person said to us: We are treated like royalty in here. One Care Homes for Older People Page 13 of 28 Evidence: staff member said: I update my residents care plans daily, weekly and monthly to ensure the best care is rendered and staff are well informed with all recent developments. All residents are registered with a General Practitioner (GP) and there is input from other health professionals, such as psychiatrists, dentists and opticians as required, with appointments being recorded in the care plan. Care plans also contain a section where GPs and district nurses can record their notes when visiting a resident. Weight checks are done for residents where there is any concern. The home notifies the Commission for Social Care Inspection (CSCI) of any incident where a resident is ill and needs to go to hospital, and these records show that emergency services are sent for quickly. One community nurse who visits the home said that if she gave any specialist advice, it was incorporated in the care plan, and that she was satisfied with the overall care provided to residents in the home. Medication is stored securely in the home, and staff do not administer medicines until they have received appropriate training. Information about various medicines is available in the home and all the medication administration records checked were clear, although one had not been signed by staff when medication had been given. Staff assured us that there is a robust system of checking to make sure that this is done, but that this had slipped through. The manager must make sure that the records are signed every time medication is administered. All residents spoken with confirmed satisfaction with staff members and expressed that his or her privacy and dignity were respected at all times. Staff were observed knocking on doors and residents were spoken to with their preferred form of address. Residents confirmed that all personal care was given appropriately and staff respected their wishes when they wanted to spend time in their room. Staff induction training makes it clear that the homes expectation is that residents will be treated with dignity, and that their independence and self esteem must be encouraged. All relatives we spoke to said that they could visit their relative in private. The community nurse who wrote to us said: Staff are always doing their best to maintain dignity and individualisation of people all the time. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has developed regular activities provision that links with residents individual interests and capabilities. Residents are encouraged to follow their preferred routines and make their own choices. People can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. Residents receive a wholesome, appealing, balanced diet. Evidence: All residents spoken to reported that they are able to follow their preferred routines and choose how they spend their day. Residents are therefore able to get up and go to bed at preferred times and spend time in their room as required. Some residents enjoy solitary interests such as reading, crosswords and television. When we met with the homes activities coordinator, she described some of the various activities the residents participated in, including going to a football club for lunch, a local Arts Centre, music nights, manicure and beauty treatments (ladies in the lounge all had beautifully polished nails courtesy of staff), a visit to a butterfly farm, knitting and sewing. A visit to a pantomime was planned, and the enthusiasm of staff to encourage residents in keeping active was very apparent. A register is kept of all the daily activities, and the names of all residents who choose to participate are recorded. Care Homes for Older People Page 15 of 28 Evidence: Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Some family members keep in touch with regular phone calls and others visit whenever they can. Residents can bring some of their own possessions to the home when they move in, and many of the rooms contained personal items. It is the policy of the home not to become involved in residents finances. These are normally managed themselves or by their representative. Advocacy information is available at the home for those people who might need some independent support or advice. Improvements have been made to the preparation and quality of meals served. There are two cooked choices at the main meal and fresh fruit available at all times. There is a choice of meal at tea times including hot snacks. The cook ensures that all soft diets or pureed food is liquidised separately to ensure they are more presentable and palatable for service users. While one resident said: The food is good and plentiful, one relative commented that their family member Gets fed up with so often having sandwiches. One resident reported that the plates were sometimes cold, and had not been heated prior to putting the food on them. Lunch on the day we visited was turkey with stuffing, vegetables and potatoes. Some people need their drinks thickened and this was seen to be recorded in the care plan with instructions given as to the consistency needed. We saw some people being assisted with their meal and staff were patient and took time with them. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. The policies and procedures which the home has in place ensure that residents are protected from abuse, although some staff need training in safeguarding adults. Evidence: The home has a complaints procedure in place, and this is given to residents and their families. There is a compliments and complaints file, and several compliments have been received from the families of people who have had care provided in Ashbury Lodge. Staff spoken to were clear that they wished the service to be run in the interests of the service users. The few complaints made by residents had been seen to be dealt with and residents and their families were satisfied with the outcome. All eight residents who wrote to us said they knew who to speak to if they were not happy and knew how to make a complaint. The home has copies of the No Secrets document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members are encouraged to report any incidences of poor practice, and a Whistle Blowing procedure is also available. There are guidelines in place for the management of challenging behaviour. All long term staff have had training in Safeguarding Adults, although some of the Care Homes for Older People Page 17 of 28 Evidence: newer staff had not done so. The provider has been asked to make sure that all staff have this training. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well maintained and comfortable environment, although some work must be done to ensure it is kept clean and hygienic. They have the specialist equipment they need to maximise their independence. Evidence: Ashbury Lodge is an attractive home, with large airy rooms and comfortable furnishings. A great deal of refurbishment has taken place, and the providers are to be congratulated on this upgrading. Walls have been opened and corridors have been widened, as well as ceilings being replaced. Furnishing and fittings were of a good standard, and many areas have been repainted and carpeted. The home employs a full time maintenance person, which ensures minor repairs are dealt with quickly. A lift has been installed for the benefit of those people who live on the upper floor of the home. Bedrooms were homely and each contained individual personal items. A cleaner is employed for each floor of the house, and a separate laundry worker is employed. Both the kitchen and laundry have their own cleaning routines. However, there were some areas of the home which needed attention. The shower stall in the downstairs shower room was very stained and must be thoroughly cleaned. The stained ceiling tiles in hallway where there had been a leak must be replaced. Care Homes for Older People Page 19 of 28 Evidence: There were various toiletries, creams and a hairbrush in the bathrooms/showers, and the providers have been asked to make sure that these items are always removed from communal areas and kept in peoples own rooms. These measures will help prevent the spread of any cross infection. Several residents commented on the clean, fresh rooms. Five residents who responded to our questionnaire said the house was always fresh and clean and three said it usually was. One person said the home was: Cleaned daily and extra if there is a mess. A wide variety of specialist equipment was available for residents. Some were using rollators to help them move more easily around the home, and some were using walking frames. Wheelchairs were available for those who could no longer walk. The home uses sliding sheets to help people move in bed, hoists to help them move, and has handrails and built up toilet seats for those who need them. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the number and skill mix of staff to meet residents care needs. A safe system for recruitment and selection of staff is in place, although some photographic ID is needed. Residents are supported by staff who are mainly trained in their roles. Evidence: The home has employed three unit leaders to ensure there is a senior member of staff on duty at all times. The rota showed there are a minimum of two care staff on each unit and four waking night staff. In addition the home employs an activities coordinator, laundry person, maintenance person and two domestics, which would indicate care staff are not taken away from the task of caring for service users. Five residents told us that staff were always available when you need them and three said: Usually. One said: There’s a buzzer for help by the bed. Staff members told us that there were usually enough staff to meet the individual needs of all the people who use the service. One person said: We may have the odd call from staff who are sick, but we are generally able to call someone who is able to cover the shift. At one stage during the visit we tested the call bell and a staff member responded within a minute. The GP who wrote to us said that staff demonstrate a clear understanding of the care Care Homes for Older People Page 21 of 28 Evidence: needs of residents, and the community nurse said: I enjoy coming to the home when I visit. I am approached positively and I encourage staff to discuss care and health issues. They are an enthusiastic team. Ashbury Lodges employment checks include Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, two written references and a medical declaration. All potential staff complete an application form, and this is kept by the home. Any staff who had been subject to disciplinary measures had this clearly recorded in their file. However, there were several files which had no photographic ID, and the providers have been asked to ensure that this information is kept for all staff. All new staff receive induction training, and a training plan is in place for the others. Some staff have a nursing qualification, although they are not currently employed as nurses. Several staff have done their NVQ Level 2 and NVQ Level 3, and others have started to work towards it. Staff training has included first aid, food hygiene, dementia, eating and drinking, continence and catheter care. However, it was noted that some staff were not up to date with infection control training. When we asked the community nurse how the service could improve, she said that infection control knowledge could be improved on. They need disposable wash wipes and individual hand gels for staff. More training in infection control and diabetes monitoring would be helpful. The providers have been asked to make sure that all staff have infection control training, and it is recommended that staff also have training in diabetes care. There is a training plan in place, but it was fairly confused, and did not always show which staff needed to update their training. It is recommended that the providers introduce a clearer method of highlighting training needs. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which is run and managed by a person who is fit to be in charge, and which is run in their best interests. Their financial interests are safeguarded and their health, safety and welfare is mainly promoted and protected. Evidence: The manager, Ms Geraldine Smith, has been in partnership running care homes for older people for many years. The deputy manager, Ms Polly Williams is now preparing to take over the management of Ashbury Lodge. She has achieved her NVQ Level 3 and her Registered Managers Award (RMA). She is expected to make an application to register with CSCI within the next few months. A quality assurance survey undertaken with residents and their families had resulted in mostly favourable responses. Where there was a concern raised, this was dealt with promptly, and people were informed of any change made as a result of their comments. The deputy manager visits all areas of the home and speaks to residents Care Homes for Older People Page 23 of 28 Evidence: every day, which helps to foster good relationships. The company has achieved the Investors in People Award. Although no bank accounts are held for residents, the home manages the personal allowances for most of them. This means that the home starts with a balance sheet of money from the family and deducts any personal expenditure. The homes administrator usually takes responsibility for all financial transactions, and clear records and receipts are kept. All money in and out of the balance sheets was able to be accounted for when we checked it. When we looked through staff files we saw that several staff members had not had regular supervision sessions with their senior manager. These sessions are important for staff so that they can discuss their working practice and how their performance might be improved. However, staff told us that they feel supported by their manager, and can give their input and receive an honest evaluation based on our abilities at work. The provider has been asked to make sure that all staff receive regular one to one supervision sessions, and that these are recorded. There were good health and safety records in place. Records show that staff have been trained in areas relating to health and safety, such as manual handling. However, it was noted that not all staff had done fire training, and the providers have been asked to make sure this is done. The homes fire extinguishers and other equipment are serviced on a contractual basis, and fire drills take place quarterly. We also saw that the fire risk assessment which had been done by an external company, had been reviewed, although previous recommendations had not been recorded as dealt with. The acting manager was able to show what had been done, but it is recommended that with any fire risk assessment changes are recorded. Over the last two years the providers have had guards or low surface temperatures added to radiators throughout the house. When we visited, one of the rooms still had a very hot radiator, although there was a piece of wooden furniture in front of it. It is recommended that this radiator is also covered or has a cool-wall surface. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 All medication must be signed for when it is administered. So that people know when they have had their medication. 24/04/2009 2 18 3 All staff must have training in safeguarding adults. So that people can be safely protected. 24/04/2009 3 26 23 The ceiling tiles marked by water leaks must be replaced. To make the environment more homely for residents 24/04/2009 4 26 13 The downstairs shower staff must be thoroughly cleaned to remove staining. To reduce the likelihood of cross infection. 24/04/2009 5 26 13 All toiletries, hairbrushes etc. must be removed from communal areas in bathrooms and shower 24/04/2009 Care Homes for Older People Page 26 of 28 rooms, and must be kept in peoples own rooms. To reduce the likelihood of cross infection. 6 29 19 All staff files must contain photographic ID To protect residents from unsuitable staff. 7 30 18 All staff must have infection control training. So that residents can be safe. 8 36 18 All staff must have regular supervision sessions with a senior line manager. So that staff can discuss work improvements. 9 38 23 All staff must have training in the homes fire procedures. So that residents will be safe in the event of fire. 24/04/2009 24/04/2009 24/04/2009 24/04/2009 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 2 3 4 30 30 38 38 It is recommended that a clear method of highlighting staff training needs is introduced. It is recommended that staff have training in diabetes monitoring. Any recommendations made in the homes fire risk assessment should be recorded when completed. The radiator in Room 12 should have a guard fixed or have a cool-wall system installed. Page 27 of 28 Care Homes for Older People 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. 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