Inspection on 05/01/10 for Livesey Lodge

This is the latest available inspection report for this service, carried out on 5th January 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report Care homes for older people Name: Address: Livesey Lodge Livesey Drive Sapcote Leicestershire LE9 4LP     The quality rating for this care home is:   one star adequate 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: Keith Charlton     Date: 0 5 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: Livesey Lodge Livesey Drive Sapcote Leicestershire LE9 4LP 01455273536 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Greenleaf Healthcare Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following categories of service only: Care home only - Code PC 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 - Code OP Demetia - DE Date of last inspection Brief description of the care home The last key inspection of this service took place on 13/7/2009. Livesey Lodge provides care for up to 24 older persons. The home is purpose built, and situated in a residential area on the edge of the village of Sapcote. It is a single storey building, which is accessible throughout to residents with limited mobility. Communal areas consist of a large lounge, a dining roomconservatory, and a reception lounge. There are 20 single bedrooms, ten with en suite facilities, and two double bedrooms, both with en suite facilities. The home is set in mature gardens and there is car Care Homes for Older People Page 4 of 29 24 0 Over 65 0 24 Brief description of the care home parking at the front for visitors. The current fees per week range from GBP385 to GBP400. Further information about the home is available from the Owner or the Manager. 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: one star adequate 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 One Star. This means the people who use this service experience adequate quality outcomes. We, as it appears throughout the Inspection Report, refers to The Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is self-assessment tool completed by a representative of the service. We have sent surveys to people who use the service along with staff and relevant professionals such as GPs. We have included the results of them in this Report. The unannounced site visit commenced on the 5th January 2010 and was carried out by Keith Charlton. Care Homes for Older People Page 6 of 29 The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Livesey Lodge. Three people were selected. Discussions were held with seven people who live in the home, three relatives, the Manager, and two members of staff. We received surveys from two people living in the home, who were generally satisfied with the service though thought that some issues needed to be improved - staff availability and staff always listening to what people told them, meals need to be improved and more activities are needed. A relative said in a survey: The staff are all very caring, though went on to say that there was a need to have two staff on from 2.00 to 8.00pm because a lot of residents need two helpers to go to the toilet then no one is left for the other residents. Five surveys were returned from social and health professionals, which were a mix of positive and negative comments: Caring environment. Clean pleasant surroundings...Staff contact us quickly if they need D/N assessment...Friendly pleasant staff...residents seem happy with their surroundings. Staff endeavor to maintain residents independence and dignity. Clients have been happy with the care provision at this home. Communication between staff members needs to be improved. This issue was mentioned by three professionals. The staff have little time to interact with the residents...The home would benefit from a Manager to collate information and ensure continuity of care. More staff are needed, especially in the afternoon, working on minimal staff. Three staff surveys were returned, again a mixture of positive and negative comments: Livesey Lodge looks after residents very well...there is a homely atmosphere. It would be nice to spend more time with each resident than we do at the moment....as they like to hear about what is happening outside the home. The owners, talk in a derogatory manner to staff. Care Homes for Older People Page 7 of 29 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. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Livesey Lodge have not had their needs fully assessed before moving into the home, but this should change for new people moving in in the future, which should result in their needs then being fully met. Evidence: We case tracked a person living in the home who had moved into Livesey Lodge in the past. We also checked that this person had his needs properly assessed prior to moving in, to ensure that the staff at the home could meet the needs identified and we found that the assessment system did not have full information regarding peoples needs e.g. medical condition, medication, continence, mobility, past health checks, information regarding hobbies etc, to ensure that these needs are met from day one of their stay, though a new form had been devised to include this needed level of detail for people in the future. Care Homes for Older People Page 11 of 29 Evidence: We saw evidence that contracts have now been supplied to people so they can understand their rights. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Livesey Lodge receive adequate health and social care practice. Evidence: People and their relatives spoken with could recall having a care plan. I was told I could see the care plan if I wanted, one relative said. We checked the care plans of three people living at the home who were case tracked. Plans are beginning to show more detail as some have been revamped and they showed information regarding the support required by staff, to ensure the physical health of people living at the home, and there was information to inform staff of peoples personal history, which ensures their social and emotional well being is supported, though at times this was not followed up. For example, the plan said has a strong faith, but then no information as to whether a vicar had been asked to visit, or similar, to ensure this persons spiritual needs were met. On another plan it stated the persons favourite colour was lilac but no follow up to see how this could be put into her daily life to provide stimulation, e.g. painting her bedroom this colour, and another plan stated likes dogs, but nothing to suggest how this need would be met, by a pat Care Homes for Older People Page 13 of 29 Evidence: a dog scheme or similar. Continence information was recorded though no detailed assessment to work out the individual needs of a person so staff could prompt before someone needed to go to the toilet. The Manager said this would be followed up. Staff said they had not read all Care Plans. This is still needed so that they can fully understand and meet peoples needs. Risk assessments were in place in terms of falls, risk, nutrition etc but whilst they recorded the risk they did not always record what action was needed to ensure protection of peoples health. For example a person was assessed to have a high risk to ensure their moving and handling needs were met, and according to the form this meant that a hoist will be needed, but the care plan stated that she had other equipment, not a hoist, to help her. Records are good in general in terms of detail and legibility so it can be quickly seen what the persons needs are on a daily basis and whether any follow up action is needed to protect their welfare. Accident records were checked and medical services are now contacted when a person has had a potentially serious injury. We saw who had had accidents, but a full monthly audit is recommended to be in place to review why accidents happened so that preventative steps can be put in place, thus protecting peoples health. People said when they were not well then staff were quick to alert medical services, and this was also supported by relatives we spoke to. The District Nurse said that staff contacted her when needed. We checked the medication records, and found that there was generally good recording of the administration of the medicines in the home, and we saw evidence of staff training, though we also saw medication being recorded before it was given to people, who could have refused to take it, and therefore this would not have reflected what medication they took, potentially affecting their health if medical services were not aware of what they have taken. Although the medication trolley was locked when a staff member went to bedrooms to give it to people there, there were still creams and liquids on open display which people could have helped themselves to, to the possible detriment of their health. There was good information on most peoples medication sheets regarding allergies, as needed medication etc so that peoples health is protected. Controlled medicines storage was in a secured office cabinet, and the Manager has contacted the pharmacist to supply a new cabinet that meets current requirements. We checked this supply and all medications were in order. We spent time watching staff interaction with people living at Livesey Lodge. We saw staff being friendly and caring to people throughout the day doing their best to meet the needs of people living at the home. A District Nurse and relatives we spoke with confirmed that staff supplied good care to Care Homes for Older People Page 14 of 29 Evidence: people. There was one comment from a person that some younger staff tend to rush the personal care they are giving to people and that not all staff knock before entering rooms. The Manager said this would be monitored. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not enough opportunities for people at Livesay Lodge to take part in activities. Evidence: People said that they had been asked about activities but there was not enough of them and there was no outings or staff able to take people out - they had to rely on their relatives. A person said, I would like to do more. We have been told there will be an Activities Organiser but nothing so far. We saw that Staff Meeting notes confirmed that the Owners have advertised for this position. We saw evidence of a current list of activities but staff asked were unaware of it. The Manager said it was due to be organised in the near future. People said they had activities sometimes like bingo and games but no music and movement now or trips out or walks out to the local shops/gardening centres/tea shops etc. Someone said that the new TV in the main lounge was really good. There was also evidence of staff helping a person to arrange her birthday, which she was pleased about. There was evidence of staff talking to people and one staff giving foot massage to a person and showing her the garden from the lounge window, and reading a newspaper to people. The Manager said that the Owners were to erect a ramp from the lounge so people Care Homes for Older People Page 16 of 29 Evidence: can go out to the garden in good weather. There was no specific activities for people with dementia and no evidence that memory boxes had been set up to help people with reminiscence or training for staff on providing specialist activities. There were again comments that there needs to be more one to one time with people, especially people with dementia, and there needs to be more outings. There were again comments as to other activities that could be offered - crafts, nostalgia talks etc. The relations between staff and people were observed to be relaxed and friendly. People again said there were no rules and they could choose to go to the lounge or stay in their bedrooms, they had choice of food, choice of getting up and going to bed times etc though there was uncertainty if people could keep their own alcohol if they were risk assessed to be safe to do so, which the Manager is to follow up. Visitors are welcomed at Livesey Lodge and we were again informed by visiting relatives that they could come at any reasonable time and they were always greeted in a friendly way by staff. People largely said they enjoyed the food: You cant fault the food. The cook is really good though when she is off its not so good, one person said. Lunch was a choice of two hot dinners, though a person said she did not like the pasta dish so this was not a proper alternative for her, and that there should be more variety on the menu. Another person said that portions were not big enough and seconds not offered, though we did not find this to be the case as we witnessed the cook offering second helpings to people. Food for the main choice looked and tasted appetising, though the pasta dish was bland. Dessert was rice pudding, which was tasty. Mixed vegetables were served and we found them served very regularly - five times in a week, which did not show variety. We saw there was a lot of fruit available this for people - this showed a commitment to healthy eating. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from abuse. Evidence: People again said if they had a complaint they would be take it to the Management where they thought it would be sorted out - I think Sue would deal with it properly, one person said. We saw no recorded complaints since the new Provider has taken over. The Aqaa stated that staff have been trained in Safeguarding people and we spoke with staff and asked what they would do if it was reported that a member of staff had been seen hitting a person who lives in the home. They were clear that this was unacceptable and needed to be reported to the Manager and then to other outside agencies if it was not properly dealt with. The Complaint Procedure has been changed but not in the Terms and Conditions document, as it did not give the option to go to the Lead Agency, the Adult Care Department, at the initial point of the complaint. Instead it gave the Lead Agency as CQC, which is not correct. Care Homes for Older People Page 18 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. People living at Livesey Lodge live in a generally homely and well maintained environment. Evidence: All the people spoken with again said they liked their bedrooms: I have all my own things here and it is kept clean, one person said. We saw people at Livesey Lodge living in a home that was in the process of being refurbished (the lounge has been redecorated and communal and some bedroom carpets are to be replaced according to the Manager), and we saw that it was a generally well maintained environment. A ramp has been fitted to the front door to help people access the home. The furnishings in communal areas are homely, and people can bring their personal possessions into their bedrooms. The service has not yet improved the environment to further help people with dementia, e.g. photos on bedroom doors to orientate them to their bedrooms, colour coding toilet doors, pictures of favourite scenes on bedroom doors etc to make facilities clearer, e.g. orientate people to go to their own bedrooms etc. There were no other odours. The Manager said that a ramp from the lounge to the garden will be installed by Care Homes for Older People Page 19 of 29 Evidence: summer this year so people can use the garden - the maintenance person also confirmed this was on his list to do. We saw that the runners on toilet doors in bedrooms and rails had been fitted and the Manager said that there will be more areas decorated including toilets. There was one comment that it would be nice if toilet seats could be wooden, not plastic, as they were cold, and that there should be better extractors in the toilets. Management need to follow these issues up. Care Homes for Older People Page 20 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. Peoples needs are now largely met as staffing levels have been increased but these need to be maintained to ensure peoples needs are always met, and that more staff training is needed to ensure full individual care is provided. Evidence: There are more staff around now, one person said. The AQAA stated that there are good staffing levels, and we saw that staffing levels have increased since our last inspection, but this is not always the case as the rota indicated three care staff on duty through out the day of the inspection but this dropped down to two staff in the afternoon as a staff member was sick, though the management had time to contact an Agency to get another staff replacement. A relative said in a survey that three care staff are always needed as, there are a number of residents who need two staff to take them to the toilet, so what happens to the other people who need help? There are now separate domestic and kitchen staff so care staff are not busy with these duties in the morning. GP surveys said that there needs to be better communication between staff, as staff are sometimes unaware for which resident a doctor has been requested. This needs to be progressed by management. Care Homes for Older People Page 21 of 29 Evidence: A staff member said that she had been encouraged by management to do recent training courses. We found on records and the Training Matrix that some staff have been on a number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control, Dementia, Health and Safety (though, for example, only six staff have attended this training), though not on other peoples conditions such as Challenging Behavior, Sight and Hearing Impairment, Stroke, Parkinsons Disease, Mental Health conditions, Diabetes etc. The Manager said that these would be added to the training programme. The Provider has indicated that they would want all staff to be trained to the National Vocation Standard - only a third of staff have currently attained this by the day of the inspection. Staff records showed that proper checks had been carried out to protect people from unsuitable staff. Care Homes for Older People Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to protect the health and safety of people but these need to be strengthened. Evidence: Sue Dawes is the Manager of the home at present. The Provider has previously confirmed he will be appointing a Registered Manager but this has not yet happened and needs to in the short term. Sue has received training in how referrals need to be made regarding a deprivation of liberty in their best care interests, and has referred a person to the Deprivation of Liberty team to ensure that this persons needs can be met in a lawful way. Staff reported that they are supported by Sue in doing their work, though one staff member was critical of the Registered Providers, stating that staff morale is low because the Owners consistently speak to staff in a derogatory manner... and they need to learn some basic people skills. Satisfaction questionnaires have now been supplied to people who live in the home but not other relevant parties and there was no analysis of comments to see where Care Homes for Older People Page 23 of 29 Evidence: improvements in the service were needed. Written records regarding finances for two people that management hold the monies on behalf of were properly in place, and monies checked were found to be correct. There was evidence of residents meetings discussing relevant issues - activities, food etc, which shows their involvement in the running of the home. Safe working practice Risk assessments were not fully in place though do not cover all risks in the home so these need to be expanded, e.g. the Manager was asked to review the Risk Assessment on window restrictors to ensure that windows can open to provide air in warmer weather as well as preventing intruders entering the building, whether radiators need covers to prevent burning risks to residents, and health and safety in all areas used by people to prevent tripping hazards etc. We saw that there was a potential tripping hazard in the reception area as there was a box and wrapped Christmas presents there. This was then moved. Hot water was measured as being within the National Standard level of close to 43c so that people are not scalded, but measured 48c in the staff toilet where the door leading to the toilet was left unlocked. Supervision of staff has been introduced to support them and check that their practice meets peoples needs, though this only consisted of one pre printed topic a session taken by a person who does not manage staff. Fire records were not fully in place - we saw in records that fire drills have not taken place since 11/3/09, which means that there is a risk that staff may not have reacted properly to a fire with consequent danger to peoples lives. Am Immediate Requirements Notice was issued to rectify this and the Manager later confirmed this had been carried out. Staff were asked re the fire drill and they knew what to do except one staff missed the first step of sounding the alarm. The Manager was asked to review the Risk Assessment and follow up the Fire Report of 2005 as there was no evidence that this had been done. Care Homes for Older People Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 38 13 The Provider needs to ensure 16/08/2009 health, safety and welfare of residents and staff in relation to fire and safe working practices. Care Homes for Older People Page 25 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 1 7 15 Care plans must include all 12/03/2010 relevant care details. For example individual toileting programmes and detailed action if a need is identified etc so as to have a care plan which supports their individual requirements, and staff need to read and follow the plans, so as to ensure peoples conditions are managed effectively. To meet peoples care needs. 2 9 12 Medication must be kept 12/02/2010 securely and signed for after it has been supplied to people. To protect peoples health. 3 31 8 A Registered Manager needs 14/04/2010 to be in post. To ensure that peoples welfare interests and quality of life is always met. 4 38 13 Health and safety systems 14/02/2010 need to be fully in place in respect of regular fire drills, staff knowledge of the fire procedure, people protected from hot water, and no tripping hazards in the home. To protect the health and safety of people living in the home. Care Homes for Older People Page 26 of 29 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 People should only have been admitted only on the basis of a full assessment, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. Staff performance in respect of always respecting people who live in the home and ensuring their privacy is always maintained, needs to be monitored. A full Activities programme needs to be introduced to meet the needs of people including ensuring that relevant activities are offered to people with dementia, so as to provide proper stimulation to all people living in the home. More variety of vegetables are needed and to review the skills of staff cooking when the main cook is not on duty. The Complaints Procedure needs give the complainant the opportunity to go to the Lead Agency to make their complaint. A ramp is needed to the garden so residents can enjoy this space. The home needs to review the signing of the home to assist people with dementia to provide prompts and stimulation to make everyday living clearer for them. 2 9 3 12 4 5 15 16 6 19 7 8 9 10 27 28 29 31 Staffing levels need to be maintained at all times to ensure peoples needs are always met. More vocational training is needed to ensure a properly skilled workforce. More staff training needs to take place so as to provide a fully safe and effective service. Staff need to be treated in a positive manner at all times to ensure good morale and a good atmosphere for people in Page 27 of 29 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 the home. 11 33 Quality assurance surveys need to be analysed to produce an Action Plan to improve services. 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). 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