Inspection on 12/04/10 for Glottenham Manor Care Home

This is the latest available inspection report for this service, carried out on 12th April 2010.

CQC 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.

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Key inspection report Care homes for older people Name: Address: Glottenham Manor Care Home Bishops Lane Robertsbridge E Sussex TN32 5EB     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: Deborah Calveley     Date: 1 2 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Glottenham Manor Care Home Bishops Lane Robertsbridge E Sussex TN32 5EB 01580880212 01580881113 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care @ Robertsbridge Limited Name of registered manager (if applicable) Miss Nicola Ann Wickstead Type of registration: Number of places registered: care home 52 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 52 The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender : Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Physical Disability (PD) Date of last inspection Brief description of the care home Glottenham Manor is a converted and extended Victorian Manor House, providing nursing care for up to fifty-two older people or those with a physical disability. The home is set in three acres of private grounds reached by a long access road, just outside the village of Robertsbridge. It provides a pleasant setting for the people who use the service and visit with views over the surrounding countryside. There is a car Care Homes for Older People Page 4 of 28 Over 65 52 0 0 52 Brief description of the care home parking area at the front of the home. The home provides accommodation over two floors and has forty-two single rooms and five rooms that can be used as a shared facility. The majority of the rooms have ensuite facilities. There is a large dining area and sitting room plus a quiet lounge areas in which residents can receive visitors in private. At present the home is being updated and there are building works in progress. These are being managed effectively and safely and do not impact negatively on the people who use the service. The home has a contract with the local authority to provide respite care beds. The current fees are available on request from the home manager. 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. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service userto describe those living in care home settings. For the purpose of this report those living at Glottenham Manor will be referred to as residents. This was the first key inspection since the home was registered 02 November 2010. It included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 5.5 hours on the 12 April 2010. There were thirty-eight residents living in the home on the day, of which five were case Care Homes for Older People Page 6 of 28 tracked and spoken with. During the tour of the premises seven other residents both male and female were also spoken with. The purpose of the inspection was to inspect all the National Minimum key standards. During the site visit a range of documentation was viewed which included, the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Six members of care staff , the registered provider Mr Sean Costelloe and the registered manager Miss Nicola Wicksted were spoken. Telephone contact was made with visiting professionals following the visit and two relatives were spoken with on receipt of the surveys received prior to the inspection visit. The information received verbally has been incorporated into this report. An Annual Quality Assurance Assessment was received from the Miss Wicksted completed in full prior to this key inspection. It was informative and transparent. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: As discussed during the site visit, there are areas that do need further development and these were fully discussed with Miss Wicksted. The care plans at present are mostly health orientated and need to contain the important social and welfare needs to ensure a holistic approach is maintained. The staff training records need to be more robust so as to ensure all the staff are competent and safe in their practice whilst caring for the people who use the service. Care Homes for Older People Page 8 of 28 A more stimulating activity programme would be beneficial for the younger residents who use the service. 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 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. The home provides prospective residents and relatives with a good level of information about the home, its facilities services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission however little information is documented thus not evidencing their needs can be met. Evidence: There is a Statement of Purpose and Service Users Guide which together contain clear information about the home the facilities and the services it provides. The Statement of Purpose as a stand alone document needs to be further developed as discussed. These documents are given to all prospective residents and /or their representatives on their initial enquiry and are also available in the reception area. These documents give prospective residents and their families the information they need to make an informed choice about where to live. Care Homes for Older People Page 11 of 28 Evidence: It was confirmed whilst talking to residents that the contract arrangements were clear and understood. A review of the care documentation confirmed that pre-admission assessments are completed by Miss Wicksted or her deputy. The format of the pre-admission document was seen to be relevant, however more information should be recorded which will inform the inspection process and ensure that the home can meet the specific identified needs. The prospective residents are seen either in their home or hospital before admission and it was confirmed that wherever possible the family or representatives are involved. One visitor spoken with confirmed that they were involved in the whole admission process. A recommendation of good practice is that the venue and all the people involved in the assessment are documented. The manager was able to verbally demonstrate her knowledge and awareness of the different specialties required in the home and ensures that the staff employed have attended relevant courses to deal with the needs of the elderly, for those who have a physical disability and also specialised courses for certain diseases. Trial visits to the home can be arranged. Miss Wicksted confirmed that residents are invited to a trial period to ensure suitability of the home. This is clearly stated in the Statement of Purpose and in the statement of terms and conditions. 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. Care plans provide a good framework for the delivery of care which give clear guidance to care staff on all the care needs of all the residents. The home was found to be meeting residents health and general needs with accessed additional specialist support when needed. Medication practices in the home promote and protect the health needs of residents and on the whole the privacy and dignity of residents are promoted. Evidence: The care documentation pertaining to five residents were reviewed as part of the inspection process, these residents were also visited and spoken with. The care plans have recently been rewritten with a new format over the past three months and clearly identified the individual residents health needs with the expected outcome and steps for care staff to follow to ensure these needs are met in a consistent manner. There is however little written about the individual residents social Care Homes for Older People Page 13 of 28 Evidence: and welfare needs and this is an area that does need to be developed. This was fully discussed. On the whole the care documentation demonstrated that the health needs of individual residents were reviewed and evaluated regularly. The care plans do not evidence any involvement of resident and whilst the care plans evidenced regular review there was no evidence of involvement with the resident or their representative. Risk assessments for health needs are included in the care planning format used by the home, and all risk assessments were found to be completed and followed through with an appropriate plan of action when identified as required. Recommendations of good practice included documenting the correct setting for pressure mattresses, the hoist to be used and the sling size. Staff spoken with confirmed that they received a full report on each resident daily and read the care documentation that is kept in the staff office. They felt that their views were taken into account when planning residents care. The care staff write in the care plans daily, this is then countersigned by the registered nurse. Relatives and residents spoken with were satisfied with the care provided at the home one saying that the home should be congratulated for its care, Staff are efficient, courteous and very kind. Further comments included They look after me very well, I am have my own room and the staff are kind, Its my home. The home have the services of the local Doctors surgery and they visit the home every Monday and as required. Ms Wicksted confirmed that specialist external advice is sought as necessary and included the dietitian, chiropodist, palliative care and tissue viability nurses. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. These are currently being updated and therefore not available for review. The systems for recording and checking controlled drugs were found to be thorough. Medication Administration Charts (MAR) have recently been audited by the deputy manager. Shortfalls have been identified and these will be followed up in supervision sessions on an individual basis. Some areas of good practice were discussed during the site visit in respect of dating the identification photographs and ensuring that the as required (PRN) medication has clear guidance included in the specific residents care plan. Staff were seen to be respectful and considerate to all residents and visitors whilst Care Homes for Older People Page 14 of 28 Evidence: attending to their needs. Each of the residents were addressed by their preferred term and dressed appropriately in well-laundered clothing. Residents confirmed that their personal preferences and wishes are followed and that the staff treat them with courtesy and respect. Care Homes for Older People Page 15 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. Residents are enabled to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: The lifestyle within the home is flexible and residents choose when they get up, have breakfast and how they spend their day. The care plans at this time do not evidence residents past histories and social preferences and how the home aim to meet their social needs. As discussed this needs to be developed and an introduction of regular review with each resident will identify if they are meeting their needs. This has been acknowledged and will be addressed. Activities are provided six days a week and there is a team of three activity co ordinators as well as an independent home visitor that visits individual residents and will read letters to them or just chat on a one to one basis. The activity programme is displayed in the entrance area of the home and in the lounge areas within the home. The activities are on a four weekly rolling programme and evidence that there is a varied range of activities offered morning and afternoon. The residents are consulted regularly on the activities provided and these are acted on accordingly. The home do have some younger people in the home and a recommendation is that activities reflect Care Homes for Older People Page 16 of 28 Evidence: their preferences as well. There are shopping visits available for those that wish them but more outings for the younger people should be considered especially in to the local community. Feedback from surveys received felt that activities could be more stimulating. Residents are facilitated and encouraged to maintain their independence for as long as they are able within a risk assessment framework. There are no restrictions on visiting times as long as consideration is shown to all the residents. Many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely. The home has an advocacy policy in place and the information regarding this is available to all residents. The main dining area is pleasant and well furnished with natural light residents can choose where they take their meals from a choice of communal areas or their bedroom. The kitchen has recently been inspected by the Environmental Health Agency and the areas identified for action have been undertaken. Catering records as required by the Environmental Health Agency are in place and all catering staff have attended the food hygiene course. The menu is regularly reviewed in line with residents feedback taking in to consideration their preferences The meals provided for residents were seen to be nutritious and attractively presented including the pureed meal fresh fruit and vegetables are readily available. The residents comments included The food is good, We get a good variety, its okay. Each resident is visited by a member of the catering team with the days menu and establishes residents choices for the following day, at least two choices are available at each meal time. Residents who require assistance with their meal were assisted in a discreet manner and their dignity maintained. Records are kept in respect of the food and fluids taken by residents and whether they have had an alternative. As discussed these need to be consistently recorded to provide an accurate reflection of the food provided in the home. Care Homes for Older People Page 17 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. Practice in the home ensures that complaints are responded to with residents and their representatives being confident that they are listened to and demonstrated that robust procedures are followed. Practice in the home ensures that adult protection issues are responded to when identified. Evidence: The complaint policy and procedure for Glottenham Manor is clear and uncomplicated and a copy of this is readily available in the home and in the Service Users Guide. The system of recording complaints evidenced that complaints are taken seriously and that an investigation is undertaken within the timescales set and the outcome and action taken are clearly recorded. The home operate an open door policy and have regular meetings with residents, relatives and staff that encourage people to voice their concerns these meetings are documented and the concerns then answered. Minutes of staff, resident and relatives are kept as part of the quality assurance system. Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively Care Homes for Older People Page 18 of 28 Evidence: The home has relevant guidelines on the safeguarding of vulnerable adults and staff are receiving appropriate training on a rolling programme. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There have been no safeguarding referrals since the home was registered in November 2009. Care Homes for Older People Page 19 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. The home provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: The location and layout of the home is suitable for its stated purpose and meets the homes aims and objectives. The home is at the present time being extensively redecorated and the property upgraded. To protect the residents whilst this work is on going environmental risk assessments have been updated to reflect the presence of builders areas that are unsuitable for staff and residents and the fire hazards from paint pots and stored equipment. The home is generally well maintained and rooms are attractive with some being very personalised. There are suitably sized and comfortable communal areas, which allow for different uses ensuring residents have choice and how they spend their time. There are also safe outside areas which are easily assessable to all residents whatever their disability. There are adequate communal bathrooms and shower rooms in the home with Care Homes for Older People Page 20 of 28 Evidence: specialist equipment to ensure all residents can have a bath or shower. The registered provider has plans to provide ensuite wet rooms throughout the home in the future. The home has specialised equipment available throughout the home to promote independence and maintain the residents health and safety. During the inspection it was noted that staff were using lifting and supporting equipment appropriately. Call bells are provided in all bedroom areas and staff were seen to be attentive and ensured residents had access to these. However it was observed that the residents in the communal areas did not all have access to a call bell and therefore would not be able to summon assistance when required. Call bells need to be assessable at all times to the residents or a monitoring system put in to place within a risk assessment framework to ensure that residents safety is promoted at all times. The call bell system only has one level and therefore does not distinguish how long a bell has been ringing or if it is a different call. This has been identified by Miss wicksted and there are plans for introducing a call bell that rings with a different sound for the different floors enabling a better response time for staff. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. On the day of the visit the home was in the main clean and tidy and free from any offensive odours, the domestic team are working hard to ensure the impact of the redecoration does not impact on the residents and visitors during the planned works. In relation to fire safety, all records are current and in place to protect the safety of those living and visiting the home. All of the staff team attend regular fire safety training. It was confirmed that all staff receive training in infection control and that the policies and procedures are updated regularly. They are easily accessible to staff thus protecting those living and visiting the home from risk of cross infection. Good practice in respect of infection control by staff was observed during the inspection visit and there were gloves and aprons freely available in the home. Sluice areas were found to be clean and safe, with appropriate systems in place for soiled linen and waste. Care Homes for Older People Page 21 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. There are sufficient suitably qualified staff on duty to ensure that residents receive the level of care they need. Staff training will ensure they are aware of their roles and are able to provide the support and care the residents need. Evidence: At the time of the inspection visit thirty eight residents were living at Glottenham Manor The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. Miss Wicksted confirmed that the staffing arrangements are flexible and respond to residents dependency. Staff spoken to said that there was enough staff to look after the residents to a good standard. None of the residents spoken with raised any concerns regarding the staffing levels and there was no adverse comments from the surveys received from family and friends. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process is in place to protect residents and contained all the relevant information required. All the paperwork is kept within a locked room. The induction programme is now in place and has been introduced for all staff. Files seen confirmed this. Care Homes for Older People Page 22 of 28 Evidence: A training manager was employed in January 2010 and has commenced training passports It was difficult to ascertain whether all staff have had the training required to perform their job in a safe and competent manner. However the training programme will rectify any shortfalls and it is acknowledged that this is a work in progress. Records evidenced that all new staff undertake an induction in line skills for care induction guidelines. There was evidence that core areas of training are addressed regularly with a rolling programme, 8 of the 28 permanent staff have completed or are completing an NVQ in care. Care Homes for Older People Page 23 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. The overall management of this home is good with effective systems in place to protect residents. Evidence: Miss Wicksted is the registered manager of Glottenham Manor and is a level 1 registered nurse, she has been in post as manager for six months. The registered provider, Mr Costelloe has many years of experience is the care industry and owns another care home in Surrey. Miss Wicksted has the necessary qualifications and experience to run the home effectively and in the best interests of the residents. She has commenced her management qualification course. The feedback from staff, residents and visitors was that Miss Wicksted is approachable and knowledgeable and maintains a visible presence in the home. There is a strong management structure in place, which will benefit the people who use the service and the people working in the home. The quality assurance systems in the home include questionnaires sent out to Care Homes for Older People Page 24 of 28 Evidence: residents and relatives following admission to the home. The introduction of this formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results have been audited and action taken to address any suggestions of improvement. The regulation 26 visits are undertaken by Mr Costelloe and form part of the home quality assurance systems. Residents are enabled to manage their financial affairs for as long as they wish or are deemed safe. Solicitors and family support the majority while the home does not handle the financial affairs of residents. Staff supervision was discussed and staff supervision has been commenced and is up to date. Staff spoken with confirmed that they do receive supervision and found it helpful. All staff receive the necessary mandatory training to promote the safety and well being of the residents, and include moving and handling health and safety and fire safety. Miss Wicksted confirmed that all staff are appropriately supervised until they have received the necessary training and completed the induction programme The accident book is completed competently and appropriate action taken where necessary. It is recommended that an audit is performed regularly as to hour of accident incident location and number. This will monitor and help prevent a re occurrence. In the main good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. As previously identified in the environmental section call bells need to be assessable to all residents in communal areas. Care Homes for Older People Page 25 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 26 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 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 Care Homes for Older People Page 27 of 28 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). 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