Inspection on 23/11/09 for Restgarth Care Home

This is the latest available inspection report for this service, carried out on 23rd November 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: Restgarth Care Home Restgarth Langreek Lane Polperro Cornwall PL132PW     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: Helen Tworkowski     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 28 Information about the care home Name of care home: Address: Restgarth Care Home Restgarth Langreek Lane Polperro Cornwall PL132PW 01503272016 01503273966 restgarth@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Orchard Care (South West) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who may be accommodated is 36. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (Code OP) Dementia aged 65 years or over on admission (Code DE(E)) - maximum of 8 places Mental disorder aged 65 years or over on admission (Code MD(E)) - maximum of 8 places Date of last inspection 0 0 0 Over 65 8 8 36 Care Homes for Older People Page 4 of 28 Brief description of the care home Restgarth is a large detached modern house situated on the sides of a wooded valley, on the outskirts of Polperro. The home has some parking and the access to the home is up a slope. The home is registered to provider care for 36 older people, some of who may have a mental disorder or dementia. The accommodation is over three floors and the home has a shaft lift, and stair lifts. Many of the rooms have en-suite toilets and are of a good size. Information about the cost of the service is available from the home. Information about the services provided (Service User Guide) is also available from the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This inspection included a site visit to Restgarth which was carried out between 9.45 am and 4.45 pm on 23rd November 09 and 9.45 and 5pm on 24th November 09. Prior to this visit we had sent survey forms to 30 of the people who live at the home, 16 were returned. We also sent survey forms to 20 staff, 7 were returned. During the site visit we looked around the home, at the care records and medication relating to six people. We also observed medication being administered and sat in the dining room whilst people had lunch. We spoke with six of the people who live at Restgarth and interviewed four of the care staff. We also met with the cook and visiting District Nurses. Other records we looked at included those relating to the recruitment and management of staff, health and safety and general management of the home. The Manager and the Responsible Individual, Helen Fuller, were present in the home during this inspection visit. Care Homes for Older People Page 6 of 28 This is the first inspection of this home under the ownership of Orchard Care (Southwest) Ltd. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking about moving to Restgarth are given the information they need about the home, to help them make a decision. The system for finding out about peoples needs before they move is not as comprehensive as it needs to be however the Management of the home are aware of this. Evidence: We looked at the information that is provided to the people who are thinking about moving to Restgarth. This is in the form of a Service User Guide. We found that there was a copy of this document near the front door, however when we checked it, it lacked a copy of the Complaints Procedure. This was quickly added to the document during this inspection. We also looked at the Statement of Purpose, a document that is aimed at professionals, including people commissioning a service. This document had been supplied and agreed when the home was recently registered with the Commission. We found that this document lacked some of the elements that are required by regulation. Care Homes for Older People Page 10 of 28 Evidence: We looked at the files of individuals who had recently moved or come to stay at the home. It is important that a comprehensive assessment of need is done before some one moves. This will help ensure that the prospective resident can be confident that their needs will be met. We found that where there was a pre-admission assessment these were not particularly detailed. For one person who had recently stayed at Restgarth for respite there was no evidence that checks had been made to ensure that the information held from the previous stay was still up to date. We discussed the preadmission assessment process with the Manager and she confirmed comprehensive assessments would be done on people before they moved. Surveys were returned by 16 people who live at Restgarth, twelve of the individuals said that they had enough information, before they moved to help them decide if this was the right place to live. Fifteen of the sixteen people told us that they had received written contracts.It should be noted that many people answering these questions may be referring to when the home was under the previous owners. The Responsible Individual, Helen Fuller, showed us and told us that new contracts had been issued to the people who live at Restgarth. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel they receive a good standard of care, and are treated with respect by staff. However the documentation that will help ensure that all care needs are met in the agreed manner or that risks have been minimized, is incomplete. Medication is generally well managed, though there is a lack of information in relation to the administration of insulin to demonstrate that staff can carry out such tasks. Evidence: We spoke with six of the people who live at Restgarth about the care and support they receive. All six were happy with their care, comments included There are no faults with the staff, Its marvelous, I have no complaints,..., I wouldnt want to be anywhere else. Fourteen of the sixteen people who responded to the surveys said that they always received the care and support needed, the other two people said that they usually got it. We received six surveys back from care staff at Restgarth, five of the staff said that they are usually given up to date information about the needs of the people care for, Care Homes for Older People Page 12 of 28 Evidence: the sixth person said that is was always the case. We spent two days in the care home during this visit, and throughout this time we noted that people were treated with respect, we noted that people knocked on doors and care was given in private. We looked at the documents such as plans of care and risk assessments to see what had been agreed about how needs are to be met. The Manager told us that they had started to review all of the existing care documents, as they recognised that they were not satisfactory. We were told that new care plans were being developed. We looked at the care plans that were in use and confirmed that they lacked detail and did not provide sufficient guidance about the actions staff are to take. There was a lack of information and guidance particularly in relation to specific conditions such as diabetes and in relation to seizures. Staff told us about the actions they took in relation to diabetes, however that was no specific written plan. The District Nurse has trained and deemed competent a number of the staff to enable them to administer insulin. We spoke with two visiting District Nurses to the home. They confirmed that they were called out appropriately and that staff followed the advice given. There were no moving and handling assessments that would give clear guidance to staff on how to assist an individual who needs help. Risk assessments and moving and handling assessments are one of the ways that care homes reduce the risk to the people who live in the home and to care staff. We discussed these issues with the Manager and Responsible Individual, and they were aware of these shortfalls and had started to take action to remedy the situation. We observed a member of staff giving medication at lunch time and was shown the medication system by the Manager. The medication was appropriately administered and we were told that staff had been trained in giving medication and were observed and checked to be competent by the Manager. Staff are involved in administering insulin, and whilst we were told that staff had been trained to do this and that this responsibility had been delegated by the Diabetic Nurse, there was no record of this, or of the residents own agreement. The records we saw were generally of a good standard, though we noted that on a few occasions medication had been administered but not signed as such. We discussed with the Manager the need to have a system in place to ensure that any gaps in recording are followed up at the first opportunity. We also raised concerns that Care Homes for Older People Page 13 of 28 Evidence: medication held in the home for administration by the District Nurse was not signed out. There must be a clear audit trail to show what happens to all medication. We looked at the homes system for storing and recording controlled drugs, this was all in order. We discussed with the Manager the considerable stock of medication that was held in the home. The Manager explained that they were working with the pharmacist to reduce this stock. The Manager also said that they were requesting General Practitioners review medication where needed. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices about how they spend their time, they are offered the opportunity to take part in activities, and they are treated as individuals. Meals are well cooked and presented, and there is good choice of food. Evidence: We asked people in the home about whether there are any rules, such as getting up times. We were told that there were no such rules, it was up to each individual to decide what they wanted to do. We spoke with staff about rules and routines, and again staff confirmed that there was no pressure on them to ensure that anyone had to fit in with a schedule. One of the staff told us how on that morning she had spent an hour with an individual, helping her to get up. The staff said that it had meant that they were all a bit behind with the work, but it was recognised by the team and management that this was how things should work. One of the staff told us about how she had recently received training in relation to the Mental Capacity Act and Deprivation of Liberty. She explained how useful she had found this training in helping her to consider how she could allow people to have the maximum Independence, and where appropriate provide support and guidance to keep safe. Care Homes for Older People Page 15 of 28 Evidence: We were told that more activities were being offered, and that one of lounges that gets less use is going to be set up for arts and crafts. On one of the days we visited people were involved in making Christmas decorations, and were enjoying chatting with each other and staff in the process. One of the staff who responded to a survey commented that he/she felt that one of the things that the home does well is Indoor games for residents such as bingo, films, singsongs, pom-pom making etc, the same person commented that they would like to do more outdoor activities or trips, but also said We do take residents down to the village in wheelchairs in the summer sometimes, but not all residents get the chance to do this. One of the staff told us that one of the residents enjoys sitting with the Manager whilst she is doing her paper work in the office. One of the staff explained to us that the reason she loved working at the home is that people are treated as individuals. We sat with people having lunch on the first day of the inspection. People told us that they enjoyed the food, and it was well presented. Fourteen of the people who responded to the survey said that always or usually enjoyed the food whilst one person said that they sometimes did. We met with the cook on the second day of our inspection. He explained the systems that were in place to ensure that good food hygiene was maintained. He also explained, and we were shown, how he keeps a record of food eaten by each person, so that if there are any concerns then these can be easily followed up. The cook told us about how people were given a choice at meals, and that he talked with residents and found out about what they liked and did not like. We saw that the cook did go and talk with people during our visit. There is the option of a cooked breakfast every day and care staff are able to provide snacks or light meals in the evening or night when there is no one working in the kitchen. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Restgarth have their rights respected, their concerns dealt with, and are protected from abuse by competent management. Evidence: We were shown a copy of the homes complaints procedure, which was included in the Service User Guide, that tells people about the home. The Manager told us that they had not received any complaints. Fourteen of the fifteen people who responded to the survey said that they knew who to speak to if they were not happy, whilst every one who responded said they knew how to make a complaint. All seven of the staff who replied to our survey said that they knew what to do if someone has concerns. One referral has been made to Social Services by the current Manager about concerns regarding the protection of a person at the home. This situation was well managed and appropriate actions were taken so that people were made safe. We saw from looking at the staff training matrix and from talking to staff that staff were receiving training in relation to the Mental Capacity Act and the Deprivation of Liberty. Staff who had not received training in relation to Safeguarding were being identified and training sought. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Restgarth provides a very good standard of clean and comfortable accommodation. Improvements need to be made to ensure that all the relevant checks are made to keep people safe. Evidence: We were shown around Restgarth by one of the staff, and saw nearly every room in the home. The house was very clean and tidy, without being clinical. The bedrooms, most of which had en-suite toilets, were all of a good size, and were well furnished. The people we spoke with about their rooms were very satisfied with the accommodation. All of the doors have locks, so that rooms can be locked from the inside, however when we checked these a few were not working, including one on a bathroom. There is a large laundry in the basement with equipment that is suitable for the level of laundry produced. We saw that there was liquid soap and hand towels in nearly all toilets and bathrooms, and that disposable gloves and aprons are both available to and in use by staff. There are a number of bathrooms on different floors, we checked the temperature of hot water in some of these baths. No thermometer was available in the home to ascertain the exact temperature of the water. We found that one shower over a bath Care Homes for Older People Page 18 of 28 Evidence: was excessively hot. The Manager arranged for this shower to be disconnected during the inspection to prevent any possible injury to anyone. We asked to see records to show that water was stored and distributed at appropriate temperatures, both to prevent infections from Legionella and to avoid people being scalded. No such records were available. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by competent staff, who feel well supported by the management of the home. Evidence: Eleven of the people who responded to a survey told us that staff were always available when they were needed, a further five people told us that they were usually available when needed. Three staff, responding to our survey, told us that there were always or usually enough staff to meet peoples needs, and further three said that there sometimes enough staff, whilst one person thought that there was never enough staff. We asked some of the staff about this during the inspection, and was told that there generally enough staff, though there were shortages when people phoned in sick, however all efforts were made by management to cover these gaps. We discussed staffing with the Manager and she said that she believed that there were now sufficient staff for the people who live at Restgarth as some people who had very high care needs had moved.She said that she had worked providing care on shift and was therefore in a position to be able to assess the levels of staffing needed. We looked at the rota, and discussed with the Manager ensuring that there is a proper record of shift times, not just Early. As part of this inspection we looked at recruitment records. No new staff had been Care Homes for Older People Page 20 of 28 Evidence: employed at the home since the change of ownership, however two staff were in the process of being recruited. We discussed with the Responsible Individual, Helen Fuller, the Commissions expectations that the following will be obtained prior to an individual starting work: a full employment history, including clarification of any gaps in employment, two relevant references (including one from when the person last worked with vulnerable people), and a check of people not suited to work with vulnerable people. These checks must be carried out for volunteers as well as paid employees. As part of this visit we looked at records relating to people employed by the previous owners, but who have transferred across. We found that not all the relevant checks had been completed. We discussed with the Responsible Individual the need to carry out a review of the recruitment records of existing staff, and to make a judgment as to whether any gaps need to pursued. The Responsible Individual and Manager showed us a training matrix that they had completed to ascertain which staff had received training, and where there were gaps in the training. We spoke with staff about the training and support they received. All of the staff we spoke with were very positive about the current management arrangements. They told us that they felt they could go and talk with the Manager or Responsible Individual at any time, and that any issues that they raised would be dealt with and not ignored. One staff told us about how she was being trained to do take on extra responsibilities, and how much she valued the opportunity for this further training. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Restgarth benefit from competent management who are highly motivated and committed to providing a good standard of care. Evidence: There is no Registered Manager at this home, however there is a Manager who is in the process of applying to be Registered by the Commission. We met with this Manager, and with the Responsible Individual, Helen Fuller, over the two days of this inspection. On arrival we were shown an action plan that detailed all the perceived short falls in the service and a plan of how these would be tackled within a given time scale. We were impressed by the way this management were tackling issues, and how much of an effect that they had had in a relatively short period, on long standing issues. It was particularly good to hear that staff felt well supported and that they were listened to. Staff also told us about how they saw the Manager leading by example. There was a high level of enthusiasm and commitment to the service that only comes Care Homes for Older People Page 22 of 28 Evidence: about, we believe, through good management. We were told that systems had been set up for staff and residents meetings, and that a number of these had already happened. The Manager told us that one of things the people at the home wanted was a pet cat, and she was in the process of finding a suitable candidate. The home does not hold any money on behalf of the people who live at the home, however the Manager informed us that they would be happy to do this if necessary. We were shown a large set of Risk Assessments relating to the environment. We discussed with the Manager the need to review these documents in the light of the change of ownership. We looked at some of the accident reports that were on file in individual files and discussed with the Manager the importance of not only having a record of each incident, but that there should be a system for monitoring accidents and taking action where necessary. We looked at the record of fire checks and noted that there was a letter from the Fire Brigade to the previous owners in relation to a number of issues. The Fire Brigade was contacted immediately and a visit arranged to clarify what works had to be undertaken. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 An up to date and comprehensive pre admission assessments must be obtained before a person moves to or stays at the home. People staying at the home need to confident that staff will know about their needs and that the home has the resources to meet them. 28/02/2010 2 7 15 There must be 28/02/2010 comprehensive, detailed and up to date care plans for everyone who lives at Restgarth. This must be agreed with teh individual concerned. Care Plans help ensure the consistency and quality of care. Care Homes for Older People Page 25 of 28 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 3 8 12 Risk assessments and moving and handling assessments must be completed for each person, where appropriate. The management of risk helps to keep people safe to enjoy their lives. 28/02/2010 4 8 15 Care Plans must detail and agree (with consent) how specific conditions such as diabetes and seizures are to be managed. Where appropriate staff must be trained and this must be recorded. There must be clarity of how needs are to be met, to help ensure they are met. 28/02/2010 5 9 13 There must be a system in place to ensure that any omission in recording medication are quickly and appropriately dealt with. People need to be confident that they will get their medication as prescribed. 31/01/2010 6 25 13 Appropriate checks, based 31/12/2009 on a risk assessment, must be made of the water system to ensure minimal risk from Legionella infection or from accidental scalding. Care Homes for Older People Page 26 of 28 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 Risks must be managed to protect people from unnecessary harm. 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 1 The Statement of Purpose and Service User Guide should be reviewed to ensure that they contain all of the information that is required by regulation. The recruitment checks of existing staff should be checked for any gaps, and a decision taken and recorded as to whether further checks are needed. 2 29 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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