Inspection on 06/07/09 for Acorn Nursing Home

This inspection was carried out on 6th July 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Acorn Nursing Home 29/12/09

Acorn Nursing Home 25/09/09

Acorn Nursing Home 30/04/09

Acorn Nursing Home 10/02/09

Acorn Nursing Home 27/03/08

Acorn Nursing Home 02/10/07

Acorn Nursing Home 11/01/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ     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: Christopher Bond     Date: 0 6 0 7 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 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: Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ 01253392440 01253305705 matron@acornnursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Axelbond Ltd Name of registered manager (if applicable) Mrs Diane Maureen Buckley Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N. To people 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, Physical disability - Code PD. The maximum number of service users who can be accommodated is: 40. Date of last inspection Brief description of the care home Acorn Nursing Home is a large home situated in a residential part of Blackpool. The home is close to Stanley Park and Victoria Hospital. The town centre is approximately two miles away and can be reached by a bus service, which stops near by. There are some small shops in the local vicinity. There are several parking spaces to the side of the house. The building has three floors and a lift is available for the residents to use. Care Homes for Older People Page 4 of 29 Over 65 37 0 0 3 1 0 0 2 2 0 0 9 Brief description of the care home Most of the rooms are on the ground floor and the first floor. There are two dining areas and three lounge areas. The main lounge is at the rear of the house overlooking an extensive garden. There is plenty of space for the residents to sit out when the weather is warm. Information about the home is available in a welcome pack that is given to prospective residents and their families. A copy of this information is also placed in the bedrooms at the home, so that everyone has good, current information about the services that are provided. At the time of this visit the information given to the Commission showed that the fees for care at the home are from GBP 361.06 to GBP 495.97 per week, with added expenses for hairdressing and chiropody. 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: As part of this key inspection process we undertook a visit to the home on the 6th July 2009. This lasted for six hours and we looked at the information that the service held regarding the care of the people who lived there. We also looked at the other records that the home had, such as information about the care staff, what training they had received and how this enabled them to do provide a better standard of care. We also looked at what arrangements were in place to help the people who use the service to voice their concerns and views, and how well they were safeguarded from harm. Safety certificates and insurance documents were also seen. A Care Quality Commission pharmacy inspector was part of the team that visited the home to assess the progress that was made after a random inspection that took place in June 2009. A full key inspection also took place on the 10th February 2009. Care Homes for Older People Page 6 of 29 We spoke to four residents about their experiences and care at the Acorn Nursing home. We also spoke to the manager of the service, three of the care staff and the administrative assistant. There were several visitors to the home whilst we were there. We spoke to three visitors as part of this inspection. Every year we ask the manager of the service to send us an Annual Quality Assurance Assessment that tells us about her views on how well the service is progressing. This also tells us about what changes have been made and what future changes will be needed. This document is used by us to focus out inspection activity and provides us with essential information. As a result of our last inspection of this service we required the owner to submit an improvement plan to the commission showing how our requirements were being adressed in order to improve outcomes for the people who use this service. 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: Although there were many positive changes within this service since our last visit, there were issues around medication that were still of concern. There issues were around poorly completed records and insufficient checking of medication. This could put the people who use this service at risk. Care Homes for Older People Page 8 of 29 Quite a few of the double glazed units within the bedrooms were now obscured by condensation, making it more difficult for the residents to look out. We noticed this on our last visit and this problem seems to have become worse. The manager told us that the owner of the service had been looking into replacing the windows throughout the home. The small ground floor lounge did not smell very fresh. The owner of the home should look into the causes of this, and ensure that this area of the building smells freshly at all times. It affects peoples dignity when they are asked to spend time in a room where there is a bad odour. The manager told us that an individual supervision programme for the care staff had not yet been started. This kind of support is important because individual support regarding such areas as training needs and performance issues can be discussed and recorded. This programme should commence and take place at least six times yearly for all staff. Records should be kept confidentially, on appropriate files. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is gathered regarding nursing and care needs before people are admitted to this home: this helps the carers to provide proper care and support. People had enough information about this home to make a decision as to whether the service was right for them. Evidence: We found that this home had information available that was given to prospective residents and their families about what services the home provides. There were two documents available; the Service User Guide and the Statement of Purpose. These contained information about the accommodation, the manager, the staff, and other important information such as the vision and values of the home, and the complaints procedure. There was also a small leaflet available that gave general information about the service. We spoke to three residents during this inspection. We were told that sufficient Care Homes for Older People Page 11 of 29 Evidence: information was given to residents and their families prior to moving in. The manager also invited people to look round the home to view the facilities before they made a decision to move to this service. All of the care plans that we looked at contained pre- admission assessments that documented peoples needs before they moved in. These were used to assess whether the service could meet their needs, and also to gather information to help ensure that current health care requirements were being met consistently. 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. Care records in this home support the care that was being given to individual people. There were still some issues regarding the way medication was administered, although improvement had been made. Evidence: All of the people who lived at this home had a care plan that documented their daily health care and social needs. The care plans had been improved since we last saw them and each plan was now being reviewed reguarly to help ensure that the information was current and consistent. There was plenty of information in each plan regarding areas such as nutrition, skin condition, risk of falling, social and spiritual needs, and general health needs. This information was used by the care staff on a daily basis in order that peoples health could be monitored and to ensure that they received the right type of care. Some people needed special care because of pressure sores, or skin tears. This was recorded clearly within the care plan and any care the person received was documented properly. There were special mattresses on some of the beds to help Care Homes for Older People Page 13 of 29 Evidence: relieve pressure for residents who were more prone to tissue damage. There were also pressure pads and other equipment available to help prevent pressure sores. A recognised tool was used within the care plans to assess and review skin condition. There was evidence that residents were turned regularly whilst in bed to aid pressure relief. We also found that peoples weight was being recorded properly and regularly within the care plan. A change in someones weight could be an indicator of underlying health issues. Weight was being closely monitored. The management of continence issues were good at this home. People were assessed properly and changes were made to protect their dignity and comfort. Appropriate continence aids were used and we saw that the residents were helped to use the toilet regularly. As part of this visit the pharmacist inspector looked at medicines handling to see how concerns identified at the previous visit were being addressed. We saw that the manager had continued to audit (check) the handling of medicines in the home and to help bring about improvement, ensured that staff were made aware of any shortfalls. It was of concern that up to the end of June we continued to see records that showed medicines were not given correctly, one example impossibly showed that more antibiotics had been given than actually supplied. But, a comparison of current records and stock showed that with the exception of a rare discrepancy we could account for the handling of medicines at the home. We saw that handwritten entries on the medicine administration record were not always checked and countersigned. This is recommended to reduce the risk of errors; we saw one poorly completed hand-written record that did not include the dosage instructions. Records were not always completed to show the application of prescribed creams, and we saw one example where no record was made to show the administration of someones eye drops. It is important that complete and accurate records are maintained for all medicines, including external preparations (creams). We saw that medicines stock control had improved and that all unwanted medicines had been sent for safe disposal. But, we were concerned that there are weaknesses in the procedure for checking-in the monthly medicines order that need to be addressed. We saw that one person had missed some doses of medicine for two days because although there was enough left to allow medicines to be given until their new supply arrived, they had not been carried forward to the current month. Similarly, staff had noted that a medicine was missing for one person, this was followed-up on the next working day, but there were still none in stock on the visit day, six days later. This could have been addressed more quickly. Care Homes for Older People Page 14 of 29 Evidence: We looked at medicines administration. People are able to take their own medication should they wish to and are able; this promotes their independence. But, as previously seen, we found that written assessments were not always completed to help identify any support people may need to manage their medicines safely. As at the previous visit we found that everyone was given their morning medicines by night staff before 8, o clock in the morning, although breakfast is taken until much later in the morning. Consideration should be given to the times that medicines are administered to help ensure they are offered at both the best and right times. It was of concern that arrangements had not been made for someones medicines when they were away from the home at teatime. Nurses explained that they had not known the person was going out. It is important that staff give consideration to peoples medicines needs when people are away from the home. We saw there was sometimes a lack of clear information about the use of medicines prescribed when required and that a care plan for administering a medicine both orally (by mouth) and through a feeding tube could have been clearer. Records of doctors visits were mostly clearly recorded so changes to peoples medicine could be tracked. But, there was confusion about whether a medicine had been discontinued for one person, or whether checks were being made to see if it should still be given. Care needs to be taken to ensure records are always clearly written to help ensure any changes or queries are promptly and accurately followed-up. Further improvement is needed to ensure medicines are safely handled and current good practice guidance is consistently followed. It is important that medicines audits continue to help ensure that any weaknesses are identified and promptly addressed. This was a nursing home, and action had been taken by the manager to improve the quality of care available when people were nearing the end of their lives. End of life care training was continuing at the home. There were plans to re-introduce a preferred place of care document within the care plan. We found that peoples wishes were not recorded properly last rime we looked at these. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities were frequently available for the residents and planned as part of the routines of the service. Catering arrangements were very good and people commented about the quality of the food that was served. Visitors were encouraged and made welcome, ensuring that valued relationships were continued. Evidence: We sampled the lunchtime meal during our visit to this service. The meal was nicely cooked and presented, and there was a choice of food for the residents. We spoke to three residents about the food that was served at the home and all said that the quality of the catering was very good and that they looked forward to meal times. The dining area was pleasant and the tables were set nicely. One of the people who used this service commented; The meals are usually very nice. There are occasional things that I dont like but they always sort out an alternative. We looked at the menus for the home and it was clear that a balanced, nutritional meal was always planned. This service had an activities co-ordinator to oversee how daily activities were Care Homes for Older People Page 16 of 29 Evidence: provided. There was a planned programme of activity that the residents could view and make a decision as to whether they would like to join in. We were told by the manager and the coordinator that activities were regular and that games, live entertainers, sing-a-longs, organists, reminiscence therapy, music, and board games were regular feature of life within the home. Three residents confirmed that activities took place and that there was usually something to do. The manager confirmed that activities were indeed regular and that a mini-bus was being used so that people could enjoy activities within the community. There were also times when residents went out for the afternoon to the pub or to other venues. There were records available to show that the residents had the opportunity to attend arranged meetings where they could voice their opinions about the service and suggest changes. We spoke to two visitors during the inspection. It was clear that visitors were made welcome and offered privacy. One relative told us that he was always made very welcome and offered refreshments. When he visited at weekends he was always offered lunch and the chance to join in with daily life at the home. 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. Complaints about the service are handled properly and taken seriously. The processes when voicing concerns about this home are clear and easy to follow, meaning that people feel listened to. People are safer because safeguarding issues are promoted and taken seriously. Evidence: We sent out surveys to the care staff who work within this service and all of the care staff who completed a survey said that they knew what to do if someone had concerns about the home. The complaints procedure was displayed in the home and was part of the Service User Guide. Timescales were given for the handling of complaints and the manager confirmed that all complaints and concerns were handled properly and seriously. The manager and the owner of the home had both ensured that people were able to access a current and full complaints procedure that held current information, should they wish to voice a concern. There were regular residents meetings held, and concerns could be dealt with at this level before they escalated to an official complaint level. We looked at the information that was available in the home that helped to safeguard people from harm. There were policies and procedures to guide the manager and staff in safeguarding policies. The manager was aware of what action to take should a safeguarding issue arise within the service. The care staff had also been trained in protecting vulnerable adults and the staff that we spoke to were aware of Care Homes for Older People Page 18 of 29 Evidence: safeguarding issues and how to report things that they were unsure or uncomfortable about. Most of the care staff had also received this training via a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents of this service live in a clean and pleasant home with nice things around them. Double glazed window units were old and the views were obscured in some of the bedrooms. Investment in the facilities was continuing to help ensure that the environment was pleasant. Evidence: The manager accompanied us on a tour of this home. The bedrooms were of a good size and there were plenty of personal possessions around that people had brought with them to make their rooms more homely and pleasant. Four of the residents that we spoke to during our visit told us that they were pleased with their bedrooms and felt comfortable there. One resident commented, My rooms nice, it meets my needs. The home was generally decorated well. The manager told us that there were plans to replace parts of the flooring in the main lounge with hard flooring. The carpet had been cleaned since we last visited this service. We noticed that there were several rooms where the double glazed units were old, and condensation was obscuring the view. The manager told us that this was being looked into by the owner and that estimates had been requested to replace the units throughout the home. A new boiler was being fitted whilst we were at the home. This would mean that the Care Homes for Older People Page 20 of 29 Evidence: hot water supply would improve to the bedrooms throughout the building and that the home would be warmer in the winter. It was good to see that the owner of the home was investing in the building to improve the facilities. There were adequate bathroom facilities throughout the building. bathrooms were decorated well and bathing facilities were good. There was a choice of showers or baths. The home was clean and fresh smelling in most areas. Domestics were cleaning the rooms whilst we were there and some of the residents told us that the service was generally clean and pleasant. We did, however, find that one of the small lounge areas did not smell very nice. The manager was aware of this. Action should be taken to help ensure that this room is fresh smelling at all times for the well-being and comfort of the residents. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care staff are well trained and are employed in enough numbers to ensure that the residents needs are properly met. Good recruitment practices help to make sure that only suitable staff are working at the home. Evidence: There were enough care staff on duty to help ensure that the assessed needs of the people who used this service were properly met. The staffing rotas were looked at and staffing levels were consistent. We spoke to three residents who told us that their needs were being met and that the carers always had time to listen and act upon issues. There was an appropriate mix of care staff to help ensure that all of the residents care needs were addressed. Recruitment was good within this service. Each of the care staff had a file where their information was kept, along with a current photograph. This is important because good information helps to ensure that the people who use the service remain safe, and protected from unsuitable care staff. The service had a training programme and care staff confirmed that they had recent instruction in care related matters and safety issues, such as ensuring that people with poor mobility are moved around the home safely and professionally. All of the care staff had a nationally recognised qualification in care (National Vocational Care Homes for Older People Page 22 of 29 Evidence: Qualification level 2 or 3), or were working towards this. There had been training in wound care and continence awareness. A good training programme helps to ensure that the care staff have their skills and abilities updated and refreshed at regular intervals. There was a good induction process to help ensure that new care staff were competent before commencing their role. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improving management regimes mean that people live in a home that is run with their interests in mind. Evidence: We found that there had been improvement in the way that this home was being managed. The current manager had, at the time of this inspection, applied to become registered with the Care Quality Commission. It was good to see that improvements had been made and that the manager was more aware of quality control throughout the home. There were, however, still some concerns regarding the administration of medication, although recent progress had been made. Some of the residents had small amounts of money that were being held by the service. There were records to show that this was being managed properly and checked regularly. The service had an administration assistant who completed most of the paperwork for the service. This allowed the manager to concentrate on running the home, ensuring that the people who used the service were cared for properly. It Care Homes for Older People Page 24 of 29 Evidence: was pleasing to see that the residents care was being planned properly and that recordings were clear and accurate. There was clear evidence of review in the plans that we looked. The manager was ensuring that people were being cared for professionally and properly. The manager had begun to complete yearly appraisals of the care staff who worked at this home. Individual supervision is still an issue and were not taking place. This type of support is essential, allowing the care staff to voice their opinions individually, and ensuring that training needs are being met properly. This type of individual support should take placw at least six times a year and the results recorded confidentially. There were certificates to tell us that safety checks on major appliances were being carried our appropriately. Safety training was being carried out for the care staff in mandatory areas, and the home was adequately insured. This helped to show that people lived in a safer home and that their well- being was being protected. There were risk assessments available on peoples care plans to help ensure that areas of potential hazard were being addressed and acted upon. The manager was ensuring that moving and handling was a key issue, and that people who had mobility issues were being helped to move around the home safely and professionally by the care staff. There was evidence to show that a representitive of the company visited the service on a regular basis and took an interest in how the home was progressing. He was investing in the service to improve the facilities and environmwent for the peole who lived there. Care Homes for Older People Page 25 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 9 13 Where people choose to self- 01/06/2009 administer medication assessments need to be completed and any support needed recorded to help ensure people always receive any help they may need to safely selfadminister. 2 9 13 Complete, clear and accurate 01/06/2009 lists of currently prescribed medication must be maintained for people living at the service. And, Sufficient stocks of medicine must be maintained without overstocking to help ensure medicines are safely administered as prescribed. Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Complete, clear and 21/08/2009 accurate records of currently prescribed medication and the time and date of administration must be maintained. To help support and evidence the safe administration of medication. 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 Procedures for checking medication deliveries to the home should be reviewed to help ensure that discrepancies or unexpected changes are promptly followed up. Where medicined are described as as and when required there should be clear and concise guildelines to help ensure that this is administered properly. The double glazed units are old, and are in need of replacement. This will help ensure the comfort and wellbeing of the residents. 2 9 3 19 Care Homes for Older People Page 27 of 29 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 4 26 The unpleasant smell in the small, ground floor lounge should be investigated and erradicated. The people who use the service should be able to live in clean and fresh smelling surroundings. Individual supervision of the care staff should take place at least six times per anum. This is to help ensure that the care staff are properly supported and that their performance is monitored. 5 38 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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