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Inspection on 27/04/10 for Ladycross House Care Home

Also see our care home review for Ladycross House Care Home for more information

This is the latest available inspection report for this service, carried out on 27th April 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

People told us they were encouraged to visit the service in order to familiarise themselves with the building, and to enable them to make a informed choice about their future. People told us they thought the service was "homely with a relaxed atmosphere". People said the routines were flexible and they could choose how they wished to spend their day. People told us they are "well looked after". They told us the staff team were: "caring" and "responsive" and provided "good care and support". People told us they were satisfied with the food provided, and they "had activities available each day to keep their minds and bodies active". People are supported by a stable and trained staff team who are dedicated to ensuring peoples needs are met to a good standard. The staff spoken with demonstrated a good understanding of the needs of the people they supported. People have opportunities to provide feedback about the service, through the quality assurance systems in place.

What has improved since the last inspection?

All of the requirements made at the last inspection have been met. Staff now have access to updated care plans and risk assessments to enable them to provide person centred care. Medication risk assessments are now undertaken on any person who wishes to self medicate, to ensure they are safe and are supported in these tasks. A record of complaints is now in place to demonstrate the procedures followed, and the outcome for the people involved. All staff have access to formal supervision.

What the care home could do better:

A system must be in place to ensure cover is arranged for when staff have planned annual leave. This is to ensure people are supported by sufficient staff team at all times. A full employment history must be obtained when recruiting new staff members. This is to ensure they are vetted in accordance with the regulations, and to safeguard people from potential risk.

Key inspection report Care homes for older people Name: Address: Ladycross House Care Home Travers Road Sandiacre Nottingham NG10 5GF     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: Claire Williams     Date: 2 7 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 30 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 30 Information about the care home Name of care home: Address: Ladycross House Care Home Travers Road Sandiacre Nottingham NG10 5GF 01629531818 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sara.Topham@Derbyshire.gov.uk www.derbyshire.gov.uk Derbyshire County Council Name of registered manager (if applicable) Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ladycross House provides personal care and accommodation for 35 Older People. The service is owned by Derbyshire County Council. It located in the town of Sandiacre on the outskirts of Nottingham. It is within easy reach of the M1 motorway and the A52 to Derby and Nottingham. The service provides ground floor accommodation in four wings, each with its own lounge and dining area. There is a separate communal room situated near to the main entrance. All bedrooms are single occupancy. There is separate bath, shower and toilet provision. The service also has a separate smoking area. Information about the service is provided to people and these include a Statement of Purpose and Service User Guide. Care Homes for Older People Page 4 of 30 0 Over 65 35 Brief description of the care home At the time of our the fees for the service were £108.90 to £406 per week, depending upon funding arrangements. Items not covered by the fees are recorded in the Service user guide. People are informed that they can access a copy of the inspection report. Care Homes for Older People Page 5 of 30 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 inspection was unannounced and involved a visit to the site which lasted for a period of a day. Key inspections take into account a wide range of information and commence before the site visit by assessing any information received such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken by the Care Quality Commission is upon outcomes for the people using the service and their views on the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers, which is a legal requirement. This assessment gives the provider an opportunity to let us know about their service and how well they Care Homes for Older People Page 6 of 30 think they are performing. The information provided in the AQAA is reflected within this report. At this inspection visit two people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Three members of staff were spoken with at some length. Their views and opinions of the care provided, the support and training given to them is included within this report. We also had the opportunity to speak with relatives who were visiting throughout the day. Their comments are included within this report. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 30 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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the home can support them, as accurate assessments are undertaken before admission is agreed. Evidence: In the self assessment the provider told us, they offer prospective people an opportunity to have day visits with them, which will allow them to make an informed choice about the service. They said they give people and their representatives relevant up to date information about the service. Managers carry out a full assessment of need ensuring that they can meet peoples needs fully. They told us they undertake an 72 hour review following admission to enable the person to mention any concerns, and to review the care plan and service plans. We looked at the records for two people who had recently moved into the service. The records in place confirmed assessments had been undertaken and a judgement had been made to confirm that the service is able to meet peoples assessed needs. This Care Homes for Older People Page 11 of 30 Evidence: ensures people move into a service that is right for them. People who we spoke with, told us they were encouraged to visit the service in order to familarise themselves with the routines and to meet the staff and people that live here. Some people told us Id heard about the home from some friends who visited someone here previously, they said it was nice, so my family came and had a look. I then moved in, I like it here. Care Homes for Older People Page 12 of 30 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The providers self assessment stated that care plans and risk assessments were in place. We looked at two peoples files, and both contained an updated plan of care covering all aspects of their needs. Most areas were completed from a person centred perspective, which ensures individualised care is provided. Each care plan that we sampled contained the required risk assessments that should be undertaken to monitor peoples mobility, pressure areas, nutrition and falls. These were reviewed as required. The care records that we sampled and discussions with people confirmed that contact with external health care services is routinely made. There was evidence in the files to support that the plan of care is reviewed on a monthly basis or in response to a change in a persons needs. People told us they are consulted about their plan of care and the records seen demonstrated this, as people Care Homes for Older People Page 13 of 30 Evidence: had signed a declaration about their plan in agreement. All of the people we spoke to and the feedback in the surveys, confirmed that people receive support which is provided in a safe, respectful and dignified manner, and our observations, supported this. People we spoke to made the following comments about the care they receive: The staff are good, they are very caring and meet my needs. Everything here is alright we are well looked after. The staff are very friendly, helpful and kind. I am well cared for. The staff are always ready to listen to you. They never ignore me. The home is good. We spoke with some relatives and they made the following comments: The staff seem to know what they are doing, and I think my relative receives a good standard of care. The staff are always respectful when supporting my relative and I am satisfied with the way they look after them. The staff are fantastic and very caring. My relative receives good care and the staff know how to support them. They are very helpful, and were great in supporting our relative to attend a family celebration. That was really appreciated and of great help to us. We are very happy, with the home, and its good see to people laughing and joking with the staff. The staff always keep me informed of my relatives well being, and they always seem to be well cared for when I visit. I think the staff do a good job, and my relatives needs are met to a good standard. Discussions with the staff members demonstrated that staff were able to think in a person centred way, and they had a good knowledge of how to meet peoples needs. Comments in the staff surveys, confirmed they are provided with up to date information to enable them to meet peoples needs. The medication practices were looked at for the two people case tracked. The administration records had been signed in accordance with their prescribed instructions. We saw that storage arrangements for controlled drugs met legal Care Homes for Older People Page 14 of 30 Evidence: requirements. We did identify that where a medication had a variable dose the number administered was not recorded. Action was taken to address this during our visit. Information provided in the self assessment told us that staff had received medication training, and the records we looked at confirmed this. An assessment of competence has not yet been undertaken to ensure staff are following the procedures in place. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their life style. Social educational, cultural and recreational activities meet peoples expectations Evidence: The providers self assessment told us they aim to provide a relaxed and comfortable environment, welcome families, friends and carers of the people and offer people choice of activities, entertainment and varied menus. People we spoke to told us they were happy with the provision of activities provided, and confirmed they are consulted about what is available by the two designated activities staff. One comment made was There is so much to do, we do not have time to get bored. People are aware of what activities are planned as information is displayed on a notice board, just outside the lounge area. This schedule demonstrated that people can access activities everyday of the week. This ensures peoples social needs and preferences are met, and means people have meaningful things to do on a daily basis. People told us they also have regular trips out, once a month and they have external entertainment that is arranged to come into the service which they really enjoy. Care Homes for Older People Page 16 of 30 Evidence: People told us they go out for meals, and really enjoy trips out. People are looking forward to the Trent cruise that has been arranged. People told us about the variety of activities they can participate in, and some of these included baking, knitting, arts and crafts, and reminiscence activities. People were observed gardening during our visit and some people were playing dominoes in the games room. People told us they have access to church services and communion in the home. This ensures peoples religious and spiritual needs are met. People told us they were able to choose how they wished to spend their day, and if this resulted in them remaining in their room, this decision was respected. The activities staff told us We ensure we spend some time with everyone, and we provide one to one to the people who do not wish to participant in the group activities. People told us their relatives are encouraged to visit and visitors we spoke to, made the following comments: I am always welcomed here, and I am kept informed of my relatives well being. It is like a family here, and I feel part of it, they are all very friendly. We joined people for their lunch-time meal. The tables were set with tablecloths and condiments so people could help themselves. People told us they have choices at each meal time and observations supported this. People told us they are asked their choice everyday. People said I like the food it is lovely and there is always plenty of choice. We visited the kitchen and spoke with the catering staff who were able to show us records of peoples dietary requirements. We looked at training records which demonstrated the cook was qualified to work in the kitchen, and she demonstrated a good knowledge of peoples food preferences. Care Homes for Older People Page 17 of 30 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. Systems in place ensure people have confidence to raise their concerns, and are safeguarded from harm. Evidence: As stated in the providers self assessment a complaints and safeguarding policy and procedure were in place. They also told us people are regularly consulted in the regular meetings they arrange. They said they offer an independent advocacy service and access to a befriending service such as age concern. During our discussions with people, and their visitors they told us they knew how to complain and said they would not hesitate to raise any issues with the staff team or manager. They appeared confident that any concerns they had would be taken seriously and addressed promptly. The feedback provided in the surveys also confirmed that people was aware of how to raise any concerns. People told us: If I was not happy I would go straight to the manager and tell her. We are regularly consulted about things, so we can raise any issues at any time, but I dont have any issues and am quite happy. People told us they have access to the complaints procedure in the information they have been provided with. The procedure is also displayed in the service. People have Care Homes for Older People Page 18 of 30 Evidence: recently attended a residents forum where a discussion was held by the activities staff on safeguarding, and the new legislation in relation to deprivation of liberty and mental capacity act. This ensures people are aware of there rights and the procedures in place to safeguard them from harm. The service has received seven complaints since our last visit. Some of these were in relation to a soiled toilet, lost clothing, and lack of communication. All issues were recorded, and investigated as appropriate, and action taken to improve the standards in these areas. The staff we spoke to demonstrated their awareness of both the complaints procedure and their role and responsibilities concerned with dealing with any potential abusive incidents. The staff and the records we looked at confirmed they had received training in these areas. The service have not had any safeguarding incidents since our last visit. The records seen also demonstrated that some staff have recently attended training in relation to the Mental Capacity Act. This ensures staff are aware and promote peoples rights to make decisions and ensures they are clear about how to safeguard people. Care Homes for Older People Page 19 of 30 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. People live in a homely environment which is comfortable and meets their needs. Evidence: The providers self assessment told us they provide a comfortable environment, to people. They said people have single rooms which are personalised and decorated to their choice. They provide good quality furniture and fittings, and the garden offers a good amount of seating which is easily accessible. People have access to a sensory garden and walkway. They said they have a good maintenance programme and repairs are carried out promptly. Our observations during our visit confirmed this information. During our brief tour of the building we found all areas to be clean, homely, warm and well lit. The physical environment was appropriate to the specific needs of the people who currently live there. It was well maintained and had the required aids and equipment in place in order to meet peoples specific needs. All of the people we spoke to told us they are encouraged to personalise their bedrooms and those visited reflected peoples preferences. People told us the building suited their needs and they confirmed they had access to equipment which encouraged and promoted their independence. Feedback in the surveys also confirmed this. Care Homes for Older People Page 20 of 30 Evidence: People told us they enjoyed accessing the garden and helping out with planting flowers. People were observed using this garden during our visit and we was told about the garden competition the service would be entering in the near future. People told us they were satisfied with the environment they lived in, and with the laundry service provided. Care Homes for Older People Page 21 of 30 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. People are supported by a skilled staff team who have been recruited appropriately. However staff shortages could compromise the delivery of care. Evidence: The providers self assessment told us they provide staffing to meet minimum standards. They said Staff are CRB checked, inducted, trained and supervised. They told us they provide training to meet the needs of the staff and the changing needs of the people who live in this service. They operate an open door policy for staff and people, and aim to be flexible where possible in order to embrace work life balance issues. People we spoke to told us the staffing levels were Enough to meet our needs. People said they Never have to wait too long for assistance. People spoke positively about the staff team and some of the comments made include the following: The staff look after me very well I am very happy here. The staff are good, they are very caring and meet my needs. Everything here is alright we are well looked after. The staff are very friendly, helpful and kind. I am well cared for. Care Homes for Older People Page 22 of 30 Evidence: The staff are always ready to listen to you. They never ignore me. The home is good. We spoke with some relatives and they made the following comments: The staff seem to know what they are doing, and I think my relative receives a good standard of care. The staff are always respectful when supporting my relative and I am satisfied with the way they look after them. The staff are fantastic and very caring. My relative receives good care and the staff know how to support them. They are very helpful, and were great in supporting our relative to attend a family celebration. That was really appreciated and of great help to us. We are very happy, with the home, and its good see to people laughing and joking with the staff. The staff always keep me informed of my relatives well being, and they always seem to be well cared for when I visit. I think the staff do a good job, and my relatives needs are met to a good standard. Discussions with the staff team confirmed that the staffing levels were usually sufficient to enable them to deliver person centred care. The staff demonstrated their enthusiasm, commitment and motivation to ensuring they support people to a good standard. We looked at the staff rotas and these demonstrated that sufficient staff was on duty, for most of the week. However we found that some shifts were vacant due to staffs planned annual leave, which had not been covered. This resulted in the service being short staffed on the afternoon of our visit. This has the potential to compromise the delivery of care as only one care staff and a relief manager was on duty supporting 27 people. Arrangements were finally made for additional staff to be on duty. We looked at the training records for three staff members. These confirmed that the staff had completed all of the required mandatory training. Discussions with staff members and the feedback from the surveys demonstrated that staff had regular training opportunities. The staff told us they have been encouraged to undertake National Vocational Training at level 2 and nearly all of the staff have completed this, and have moved on to level 3. This ensures people are supported by a competent and skilled workforce. Care Homes for Older People Page 23 of 30 Evidence: We looked at two newly employed staff members files. We found that majority of the required checks had been undertaken to ensure both staff members were suitable to work with vulnerable people. However for one staff member we found gaps in their employment history, and there was no written explanation recorded for these. There was evidence to support that both staff members had completed a service specific induction, and the Common induction standards. This will ensure they have the skills and knowledge for their role. Care Homes for Older People Page 24 of 30 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. Opinions are sought and acted upon to ensure the service is managed in the best interests of the people that live at the service. Evidence: The provider told us in their self assessment they have experienced and qualified acting manager and deputy managers. The service has a new manager who will be commencing employment a week following our visit. She is a qualified social worker and has many years experience working with this client group. People told us they are consulted about the service delivery, both informally and formally at the meetings they have. People said they can raise any comments at any time concerning any improvements they think could be made. The staff members we spoke to, told us they felt supported in their role. The staff files seen demonstrated that they have access to supervision, and team meetings. Comments from staff included: Care Homes for Older People Page 25 of 30 Evidence: I am very happy working here, things have improved and people are well cared for. I feel very supported. The managers are very supportive and operate a open door policy, so we only have to ask if we need any advice or support. We looked at the quality assurance survey report for 2009 and this demonstrated that people were satisfied with the service they received. The service have received many compliment cards and some of these comments include: Thank you for all that you have done and the way you have looked after our relative. Thank you staff for all of the hard work and commitment to providing a high level of care to our relative. Thank you so much for all your care you have given, you have been very kind and caring. The information provided in the self assessment told us that all aspects of health and safety were monitored, reviewed and up to date. Care Homes for Older People Page 26 of 30 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 30 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 27 18 A system must be in place, 31/07/2010 to ensure that all vacant shifts are covered and sufficient staff are on duty at all times. This is to ensure peoples needs are met at all times. 2 29 19 A full employment history 31/07/2010 must be obtained for all staff before they are employed This is to ensure people are safeguarded from risks. 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 9 All staff that administer medication should be assessed to ensure they are competent in these tasks and follow the procedures in place. Records of the medication audits should be in place to support these have been undertaken. When a medication instruction includes a Variable dose the Page 28 of 30 2 3 9 9 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations number of tablets adminstered should be recorded on the medication record. This is to ensure the records are accurate and reflect practices in place. Care Homes for Older People Page 29 of 30 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. 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