Key inspection report
Care homes for older people
Name: Address: Hulcott Nursing Home The Old Rectory Hulcott Aylesbury Buckinghamshire HP22 5AX 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: Chris Sidwell
Date: 1 8 0 1 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home
Name of care home: Address: Hulcott Nursing Home The Old Rectory Hulcott Aylesbury Buckinghamshire HP22 5AX 01296488229 01296330834 hulcott@caringhomes.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hulcott Limited Name of registered manager (if applicable) Ms Marilyn Kimayong Type of registration: Number of places registered: care home 49 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 49 The registered person may provide the following category of service: 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 category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Hulcott nursing home is located a few miles outside of the centre of Aylesbury in a quiet hamlet location overlooking a green. The home is registered to provide accommodation for up to forty-nine service users requiring nursing input. The building has been attractively arranged to provide a pleasant environment for the people living there, with good quality furnishing and fittings. The majority of bedrooms Care Homes for Older People
Page 4 of 29 Over 65 49 0 0 6 0 5 2 0 0 9 Brief description of the care home have en suite facilities and all but two rooms are fully wheelchair accessible. There are three lounge areas, a large conservatory and a quiet area by the main entrance. The grounds are well maintained with a patio area and backs onto farmland. There are no public transport links and shops are some distance away. 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: 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: This inspection was conducted over three days and included a review of the information we hold about the service an unannounced visit of eight hours to the home and the time taken to prepare the report. The key standards for older peoples services were assessed. Information received about the home since the last inspection was taken into account in the planning of the visit. The manager completed an annual quality assurance assessment which was completed in full and returned on time. Surveys were sent to the home for distribution to residents, families and staff. Five residents, thirteen family members, three members of staff and one health care professional returned the surveys. Residents and visiting families were spoken to on the day of the unannounced visit. Discussions took place with the regional director, manager, nursing, care and ancillary staff. Care practice was observed and the care of a number of residents was followed through in detail. A tour of the building and examination of records was also Care Homes for Older People
Page 6 of 29 undertaken. The homes approach to equality and diversity was considered throughout. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Peoples healthcare needs are better met. The home has a developed a better working relationship with a local general practitioner practice. Peoples risk of developing pressure damage is accurately assessed and effective steps are taken to protect those at risk with appropriate mattresses and chair cushions and helping people to move more frequently to relieve pressure. Medication management has improved and accurate records of medication received, given and disposed of are kept. Menus have been reviewed with residents and the meals on the day of the unannounced visit were those stated on the menus. The manager has set up a system whereby the chef notifies her if for any reason the menu planned cannot be offered and Care Homes for Older People
Page 8 of 29 an accurate record of the food offered to residents is kept. Peoples concerns are listened to and the records showed that they received a timely response and that action was taken to address their concerns. People told us that communication in the home had improved since the appointment of the new manager and that they knew who to speak to if they had concerns and how to make a formal complaint. The home has cooperated with the local authority to investigate any safeguarding issues and contributed to a serious case review since the last inspection. The report of this review is not yet available. There has been an ongoing programme of refurbishment. New carpets, curtains and chairs have been bought for the communal areas and the manager said that peoples rooms could be redecorated as they wished or when the room was empty. The double rooms have now been changed to single rooms to give people privacy and dignity. Maintenance records are up to date and the lift has been repaired. The hot water boilers have been replaced and there have been no heating failures since the last inspection. There has been a focused approach to ensuring that all staff have completed basic mandatory training in safe working practices including moving and handling and the protection of vulnerable people. The management arrangements have been stabilised with the appointment of a new manager who has registered with us. People told us that there had been an improvement in the care and one said the whole place is being run to a higher standard. What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People
Page 9 of 29 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 10 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 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available and the opportunity to visit the home to help people decide whether they wish to move to the home. Peoples health and social care needs are assessed before they move to the home, to ensure they can be met. The home can meet a diverse range of faith and cultural needs. Evidence: There is information available to prospective residents in the form of a statement of purpose, which describes the services provided by the home and a home brochure. Prospective residents and their families are welcome to visit the home at any time before deciding whether the home is for them. The care files of four residents who have moved to the home since the last inspection were checked. The manager had met with them to assess their needs and wishes for care. The home had information from hospital discharge summaries and care managers where appropriate. A thorough care assessment had been undertaken. A recommendation was made at the last inspection that the home ensure that they have the specialist skills to meet peoples
Care Homes for Older People Page 12 of 29 Evidence: needs and steps have been taken to implement this. The manager has training to meet peoples end of life care and they are working with the local hospice to ensure that they can meet peoples palliative care needs at the end of their life. The manager said that she was careful to ensure that she could meet peoples needs before they moved to the home and would if necessary advise people that the home was not suitable if she felt they would be unable to meet their needs. The assessment documentation prompted staff to take note of peoples faith and cultural wishes as well as their health and social care needs. Care Homes for Older People Page 13 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. Peoples health, personal care and medication needs are generally met, with evidence that they see the general practitioner and other members of the healthcare team on a regular basis to promote their wellbeing. There is a need to ensure that people who require special diets, whether they be individualised, fortified high calorie diets or soft and pureed diets receive them in a consistent manner to ensure that they are well nourished, not losing weight or at risk of choking. Evidence: The care of four people living at the home was followed through. All had care plans which had been updated regularly. In some cases it was clear that the resident and their family had been involved in developing the initial care plan and in the ongoing monitoring. Residents diverse healthcare needs were recognised and recorded. Peoples risk of falling had been assessed and care plans to reduce the risk were in place and evaluated. Records were kept of falls. Peoples risk of developing pressure damage had been assessed and appropriate measures to prevent pressure damage had been taken. Four people had pressure damage. Of these, three had longstanding
Care Homes for Older People Page 14 of 29 Evidence: issues and the damage was now healing. One had developed damage during a hospital admission and records showed that it had improved considerably on moving to the home. Residents identified as at risk had the appropriate pressure relieving mattresses which were set up correctly. Peoples risk of losing weight due to ill health or inadequate diet had been assessed. Of the four people whose care was followed through, three had been assessed as at risk of losing weight and two had lost weight since moving to the home. The chef said that she fortified meals with additional calories in the form of cheese, full fat milk and yoghurts and cream. A high calorie smoothie is offered in the morning. She was not aware however of those who were losing weight. The menu plans identify special diets such as diabetic or soft diets but do not classify a calorie fortified diet for individuals as a special diet. This should be considered. Records were kept of food and fluid intake although for one resident the record showed that she was not eating. She had memory loss and was confused. The manager said that she had become unwell and had been referred to the general practitioner. Although not registered for the care of people with dementia, the home does have some people with memory loss whose physical care needs outweigh their dementia care needs. Staff have not had training in dementia care nor in the special nutritional needs of people with dementia. This should be undertaken. Although soft and pureed meals are offered at lunch time, they are not offered at supper time and the carers mash food to the desired consistency. The manager said that no one was on a soft or pureed diet because they had a swallowing problem and that whether they needed a soft diet depended on the texture of the food. This must be monitored carefully to ensure that people are not at risk of choking. The care files showed that residents see a general practitioner and other members of the local primary healthcare team regularly and are supported to visit hospital outpatient departments when necessary. Residents are supported to maintain their personal hygiene and to wear clothing of their choice. The atmosphere was noted to be relaxed and staff were speaking to residents politely and gently. They were not seen to hurry and residents were given time to express themselves. Residents said that all care is given in their rooms. Residents and their families were mixed in their views about the care and support that they received. Most said that they always or usually received the care and support they need although three had specific concerns that they felt had not been addressed. Positive comments included the staff give my mother pride in her appearance, care and attention from all staff is excellent and the staff are very good and friendly and Care Homes for Older People Page 15 of 29 Evidence: always have time to talk to you. Concerns were expressed about communication between staff and one family member said she hardly saw her family members key worker and leaving messages at the nurses station was a bit haphazard. This should be addressed. There are medication policies and procedures in place and the staff spoken to were aware of these. The storage facilities were satisfactory. Controlled medication was stored and recorded correctly. Records are kept of medication delivered and disposed of by the home. Residents individual medication administration records were completed in full and appropriate steps were taken to ensure that supplies were received regularly. None of the residents managed their own medication at the moment although there are policies and procedures in place to support this if residents wish. The staff spoken to said that medication was never given covertly. If a resident did not want to take their medication, this would be recorded. If the medication was essential and the resident lacked capacity, the doctor and family would be told and a way forward agreed. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can choose how they spend their day and are supported to take part in activities if they wish. Menus are varied and nutritionally sound and people have a choice at each meal to meet their likes and dislikes. Evidence: The activities coordinator organises a range of activities, including musical entertainments, quizzes and crosswords. A garden party was held in the summer for families and residents. People told us that they had a choice as to how they spent their day, whether they went to the lounge or whether they stayed in their rooms. They also said they had a choice as to when they got up or went to bed. The home is in a quiet hamlet and people are reliant on their families for trips out. The home has recently started taking people out for a short break. Two people visited the local garden centre and golf club for a cup of coffee recently. The menus have recently been reviewed with residents. There is a four week menu plan which was being followed on the day of the unannounced visit. There is a choice at all meals and a cooked breakfast is available for those who would like one. One lady said she enjoyed her breakfast and recalled her mothers advice to always have a good breakfast. Residents views about the standard of meals were mixed. Some saying that they usually enjoyed their food and some saying sometimes. The manager said that they
Care Homes for Older People Page 17 of 29 Evidence: had changed meat supplier in response to concerns. The menus showed that an alternative meal would be prepared if people did not like what was on offer and that snacks were available at all times. The conservatory has been refurbished to become a dining room although most residents prefer to eat in their rooms or in the lounge at small tables. 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. The home has systems in place which should protect residents from harm and their concerns are listened to and acted upon. Evidence: The organisation has complaints and safeguarding policies in place. These are well advertised in the home, as are details of local advocacy services. Complaints are monitored as part of the organisations quality assurance programme. The atmosphere in the home was relaxed and happy and those service users and their families who returned the surveys said that they knew who to speak to if they were not happy and how to make a formal complaint. The manager said in the Annual Quality Assurance Assessment (AQAA) that she had received nine complaints all of which were responded to within the timescales described in their policy. The complaints records were seen and showed that action had been taken to respond to peoples concerns. Families who returned the questionnaires said that communication had improved in the home since the appointment of the new manager, saying the service does very well in keeping me informed, they communicate well and my mother is confused and the staff spend time trying to understand any problem she has and are quick to contact me to discuss her needs There are safeguarding policies and procedures in place. The home has a copy of the local multi agency procedures. All staff have had training in safeguarding vulnerable people. There have been three safeguarding referrals since the last inspection, which were dealt with appropriately. The home has cooperated with the local authority in a serious case review since the last inspection.
Care Homes for Older People Page 19 of 29 Evidence: The final report of this review is not yet available. The requirements made at the last inspection that complaints should investigated and responded to in a timely way and that all staff should have training in safeguarding older people have been met. 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 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 clean, safe and homely environment for residents. Evidence: The home is an attractive older building set in landscaped gardens. There are attractive courtyard gardens. Some rooms on the ground floor open onto the gardens. There is a programme of ongoing refurbishment. New carpets have been laid and the lift has been repaired. Residents are supported to personalise their rooms with small items of furniture and personal mementos which many had chosen to do. There are a number of different places for people to sit so they can choose whether they would like company or would prefer some quiet time. The conservatory has been refurbished to provide a dining room although many people who have been used to eating at small tables in their rooms or in the lounge still choose to do so. The home was last inspected by the Fire safety Authority in August 2009 when all matters were satisfactory. The home has been awarded five stars by the Environmental health Agency for good practice in food hygiene. The home was clean and tidy on the day of the unannounced visit and there were no offensive odours. There are infection control policies and procedures in place. The laundry is well organised and the washing machines have programmes to deal with
Care Homes for Older People Page 21 of 29 Evidence: soiled linen and clothing. Residents do not share hoist slings or sliding sheets. There is liquid soap and paper towels in residents ensuites for the use of staff and visiting professionals. The home had a copy of the latest guidance from the Department of Health (DH) on infection control and had audited their infection control procedures using a template provided by the local Health Protection Agency (HPA). The manager confirmed that they had addressed the matters raised by the HPA in their last audit. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff to meet peoples needs although staffing levels should be monitored closely as more people move to the home. The recruitment procedure is thorough and should protect people from unsuitable carers. The training programme should be developed to ensure staff have the specialist knowledge and skills they need to support people with complex needs. Evidence: The staff rota shows that the home aims to have two registered nurses and six carers on duty throughout the day and one registered nurse and three carers at night. This is a reduction in the staffing levels at the last inspection and is due to a reduction in the number of residents. The Manager and Regional Director said that staffing levels are monitored using a dependency system and are adjusted according to the number of residents and their needs. People told us in the surveys that there had been a turnover of staff but that since the personnel had stabilised, staff were happier and had got to know the residents. Families made positive comments saying on the whole the staff are very good, care and attention for all staff is very good and the staff are very good, friendly and always have time to chat to you. Some concerns were expressed about staffing levels with comments such as there does seem to be a shortage of staff at times but they are usually helpful and willing, the staff work hard and if there were more staff people could go out more. Residents were mixed in their
Care Homes for Older People Page 23 of 29 Evidence: views as to the availability of staff. Of the six residents who returned the questionnaires two said staff were always available when they were needed, two said usually and two said sometimes. The home should continue to monitor staffing levels to ensure peoples needs are met in a timely way. There is a training programme in place. Training is offered to staff through a variety of means using in house training leads, e-learning and the companys training team. The Manager said in the AQAA that she was planning to seek some specialist external training locally. The training plan is broken into three pathways. Pathway 1 covers basic mandatory training in safe working practices such as moving and handling and protection of vulnerable people, Pathway 2 covers specific issues such as dementia care, end of life care, communication, understanding the Mental Capacity Act and clinical issues such as catheterisation, nutrition, glucose monitoring, syringe drivers. Pathway 3 describes staff progress through National Vocational Qualifications. Training records show most staff have completed Pathway 1 but none have started pathway 2, although individual records do show some specialist training has taken place. Although the company has a systematic approach to training this is not yet fully implemented in the home. The recruitment files of three members of staff who had started at the home since the last inspection were checked. The required checks had been undertaken to protect residents from potentially unsuitable staff. There was evidence that the staff members identity had been checked. Criminal Records Bureau disclosures and two references had been sought before the staff member started work. The application form showed the staff members work history and interview records were kept. 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 homes management arrangements have been stabilised with the appointment of a permanent manager who has registered with us and the quality of care and support for residents has improved since the last inspection. Evidence: An experienced manager was appointed in June 2009. She is a registered nurse and has experience managing care homes. She has registered with us. Residents were positive about the improvements in the home since her appointment and one commented there has been a vast improvement since the new managers appointment, the whole place is being run to a higher standard. The lines of accountability in the organisation are clear. The manager is accountable to the Operations Manager and through her to the Regional Director. The Regional Director visits the home regularly. The lines of accountability in the home should the manager be absent are less clear. The Manager and Regional Director said that they are currently recruiting a Head of Care. It was unclear whether that role would include deputising for the manager in her absence. The Regional Director said a temporary
Care Homes for Older People Page 25 of 29 Evidence: manager would always be put into the home when the manager was on holiday. The organisation must ensure that it is clear who is responsible for running the home on a day to day basis when the manager is absent to ensure continuity of care for residents. The organisation has a quality assurance system in place. Residents and families views are sought about the care and services offered. Regular residents and family meetings are held and the minutes of these are shared with all. A senior member of the management team visits the home regularly and records are kept of those visits. The organisations quality monitoring team has visited the home on three occasions since the last inspection to undertake a full audit of the care received by residents. An action plan has been developed after each visit and a clear improvement has been shown. The home does not manage residents finances. Residents may keep personal cash or valuables in their own rooms in locked storage at their own risk or any expenditure is invoiced to families. There are health and safety policies and procedures in place. The Annual Quality Assurance Assessment (AQAA) completed by the manager showed that maintenance records are up to date and essential equipment such as hoists have been checked. A requirement was made at the last inspection that the defects in the electrical system must be addressed. The manager stated that this had been addressed and stated in the AQAA that an electrical safety certificate was issued in June 2009. On the day of the unannounced visit a fuse had tripped in one part of the building which was being dealt with. The organisation should continue to monitor the number of faults on the system. At the last inspection there were three outstanding requirements which had not been met following the previous inspection and a further eleven requirements for improvement were made. The organisation and the newly appointed manager have worked hard to meet all of these. One requirement has been made at this inspection and recommendations for further improvements are made in the summary of the report. 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 1 8 12 The home must ensure that a soft or pureed diet is available at all meals for those who cannot for any reason eat or swallow food of a normal consistency. To minimise the risk that residents may choke on unsuitable food. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
